An At-Home Monitoring Device and Remote Nursing Protocol to Prevent Nephrostomy Tube Dislodgement in Children: A...

Purpose: The study was to assess the effects of an at-home monitoring device and remote nursing protocol (early warning system) for children undergoing nephrostomy. Methods: This observational, descriptive, and retrospective study recruited 58 children who underwent nephrostomy between January 2018 and December 2019 at Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. The patients were divided into an early warning system group (n = 32) and a conventional nurse group (n = 26), according to the catheter monitoring method. The primary endpoint was catheter-associated complications, whereas the secondary endpoints included parental satisfaction and the Pediatric Renal Caregiver Burden Scale (PR-CBS). Results: Patients in the early warning system group were associated with a reduced risk of catheter-associated complications compared to those in the conventional system group [OR, 0.019; 95% confidence interval (CI): 0.004-0.092; P < 0.001]. For specific catheter-associated complications, the risk of catheter detachment (OR, 0.060; 95% CI: 0.004-0.991; P = 0.048), poor drainage (OR: 0.061; 95% CI: 0.007-0.523; P = 0.011), and retrograde infection (OR: 0.195; 95% CI: 0.046-0.822; P = 0.026) in the early warning system group was lower than that in the conventional nurse group. Furthermore, overall parental satisfaction was higher in the early warning system group than in the conventional nurse group (P = 0.016). The PR-CBS score for each domain in the early warning system group was lower than that in the conventional nurse group (P < 0.001). Conclusions: Using an early warning system could improve catheter-associated complications, parental satisfaction, and PR-CBS in children undergoing nephrostomy during continuous nursing.