The effectiveness of implementing a bladder ultrasound programme in neurosurgical units

This paper reports an evaluation of the differences among rates of unnecessary catheterization, urinary retention and urinary tract infection before and after implementing a bladder ultrasound programme to assess urine volume.

Bladder ultrasound is a non-invasive alternative to urethral catheterization for the determination of bladder urine volume. Much of the literature available on bladder ultrasound technology addresses the accuracy of the equipment, with little research on the clinical outcomes or benefits of the intervention.

A quasi-experimental design was adopted. Data were collected from March 2001 to May 2001 in a control group in two neurosurgical units in Taiwan. During July and August 2001, nurses were taught how to operate a portable ultrasound machine and how to implement the programme. Data were collected from September to November 2001 in the study group.

The rates of unnecessary catheterization in the control group and the study group were 35.3% and 7.0%, respectively. The urine volume (more than 500 mL) in the control group and the study group were 13.4% and 20.3%, respectively. The study group had a statistically significantly lower average catheterization volume than that of the control group (676.9 mL vs. 777.1 mL, t = 1.84, P < 0.05). During 3 months before and after the implementation of the programme, the urinary tract infection rates in the control group and the study group were 3.47% and 2.87%, respectively. After 6 months the urinary tract infection rates decreased to 1.39%.

The bladder ultrasound programme was successful and could be used to manage patients with urination disorders in neurosurgical units.