Temiz Aralıklı Kateterizasyon Uygulamasında Hemşire ve Bakım Vericilerin Eğitimine Yönelik Güncel Bakış

Year 2023, Volume: 8 Issue: 1, 150 - 161, 01.04.2023

Canan Sarı Birsel Canan Demirbağ

https://doi.org/10.25279/sak.1035100

Abstract

Temiz aralıklı kateterizasyon hem nörojenik hem de nonnörojenik mesane bozuluğu olan hastalarda, mesaneden idrarın boşaltılması amacıyla, yaklaşık 50 yıldır kullanılan en etkin ve güvenli yöntemdir. Yapılan çalışmalar sonucunda TAK kullanımının; hastaların yaşam kalitesi, beden imajı, öz güven gelişimini artırdığı, üriner sistemi oluşturan organları koruduğu, morbidite ve mortalite oranını ise azalttığı belirlenmiştir. Çocuklarına TAK uygulaması yapan bakım vericilerin, hemşireler tarafından oluşturulmuş standart klavuz ve protokoller doğrultusunda sağlık eğitimi alması ve yaşadıkları bu yeni sürece adapte edilmesi gerekmektedir. Bakım vericilerin TAK uygulamasına yönelik yeterli eğitim almadığı ve yeterince adapte edilmediği durumda hata yapma oranının arttığı belirlenmiştir. Böylece hastalarda idrar yolu enfeksiyonu olmak üzere sonucu organ yetmezliğine varabilecek komplikasyonların görülme sıklığı da artmaktadır. Ülkemizde hem bakım vericilere yönelik TAK uygulama eğitimi veren sağlık personeli hem de bu eğitimi alacak bakım vericiler için oluşturulmuş standart klavuz ve protokoller bulunmamaktadır. Bu sebeple TAK kullanımının oluşturabileceği komplikasyonların önlenmesi amacıyla ülke genelinde kullanılacak standart protokol ve klavuzlar oluşturulmalıdır.

Keywords

Bakım verici, Çocuk, Hemşire, İdrar yolu enfeksiyonu, Temiz aralıklı kateterizasyon

Supporting Institution

Bu çalışma Karadeniz Teknik Üniversitesi Bilimsel Araştırma Proje Birimi tarafından desteklenmiştir

Project Number

Bu çalışmanın proje numarası THD-2021-9673'dür.

Thanks

Çalışmamıza katkılarından dolayı Karadeniz Teknik Üniversitesi Bilimsel Araştırma Proje Birimi'ne teşekkür ederiz.

A Current View on Nurses and Caregivers Education in the Application of Clean Intermittent Catheterization

Abstract

Clean intermittent catheterization is the most effective and safe method that has been used for nearly 50 years to drain urine from the bladder in patients with both neurogenic and non-neurogenic bladder disorders. As a result of the studies, the use of CIC; It has been determined that it increases the quality of life, body image, and self-confidence development of the patients, protects the organs that make up the urinary system, and reduces the morbidity and mortality rate. Caregivers who apply to CIC their children need to receive health education in line with standard guidelines and protocols created by nurses and adapt to this new process they live in. It has been determined that the rate of making mistakes increases in cases where caregivers do not receive adequate training and are not adequately adapted to the application of CIC. Thus, the incidence of complications that may result in organ failure, such as urinary tract infection, increases. In our country, there are no standard guides and protocols created for both the health personnel who give training on CIC practice for caregivers and the caregivers who will receive this training. For this reason, standard protocols and guidelines to be used throughout the country should be established in order to prevent complications that may arise from the use of CIC.

Keywords

Caregivers, Child, Nurses, Urinary tract infections, İntermittent urethral catheterization

Project Number

Bu çalışmanın proje numarası THD-2021-9673'dür.

References

• Afşar, S. I., Yemişçi, O. U., Coşar, S. N. S., ve Çetin, N. (2013). Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study. Spinal Cord , 51(8), 645-649.
• Akan, S., Ürkmez, A., Yıldırım, Ç., ve Haki Yüksel, Ö. (2017). Temiz aralıklı kateterizasyona bağlı gelişen intraperitoneal mesane perforasyonu olgusu ve literatürün incelenmesi. Haydarpasa Numune Med J, 57(3), 179–182.
• Akpınar Balcı, R. (2014). Üriner boşaltım. Atabek Aştı T, Karadağ A (Ed.), Hemşirelik Esasları (ss 973- 1015) Akademi Basın ve Yayıncılık, İstanbul.
• Alencar, V. P., Gomes, C. M., Miranda, E. P., Dos Santos Lelis, M. A., Fera, P., de Bessa, J., Srougi, M., Bruschini, H. (2018). Impact of the route of clean intermittent catheterization on quality of life in children with lower urinary tract dysfunction. Neurourol Urodyn, 37(8), 2833-2840.
• Atchley, T. J., Dangle, P. P., Hopson, B. D., Graham, A., Arynchyna, A. A., Rocque, B. G., Joseph, D. B., Wilsond, T. S. (2018). Age and factors associated with self-clean intermittent catheterization in patients with spina bifida. J Pediatr Rehabil Med, 11(4), 283–291.
• Başoğlu, N., ve İşlek, İ. (2019). Çocuklarda idrar yolu enfeksiyonuna yaklaşımda yenilikler. Med J Bakirkoy, 15(4), 317-322.
• Beauchemin, L., Newman, D. K., Le Danseur, M., Jackes, A., ve Ritmiller, M. (2018). Best practices for clean intermittent catheterization. Nursing, 48(9), 49-54.
• Bektaş, H. (2015). Üriner Boşaltım. Bektaş H (Ed.), Taylor Klinik Hemşirelik Becerileri (ss 595-660) Nobel Akademik Yayıncılık, Ankara.
• Benicio, C. D. A. V., Rocha, D. M., Dourado, G. O. L., Bezerra, S. M. G., Andrade, E. M. L. R., Nogueira, L. T. (2018). Factors associated with the knowledge of patients and caregivers about clean intermittent urethral catheterization: an integrative review. Rev Esc Enferm USP, 52(13), 1-9.
• Biardeau, X., ve Corcos, J. (2016). Intermittent catheterization in neurologic patients: update on genitourinary tract infection and urethral trauma. Ann Phys Rehabil Med, 59(2), 125-129.
• Campbell, J. B., Moore, K. N., Voaklander, D. C., Mix, L. W. (2004). Complications associated with clean intermittent catheterization in children with spina bifida. J Urol, 171(6), 2420-2422.
• Cobussen Boekhorst, H., Hermeling, E., Heesakkers, J., ve Van Gaal, B. (2016). Patients’ experience with intermittent catheterisation in everyday life. J Clin Nurs, 25(9-10), 1253–1261.
• Collins, L. (2019). Intermittent self-catheterisation: good patient education and support are key. Br J Nurs, 28(15), 964-966.
• Cornejo Davila, V., Duran-Ortiz, S., ve Pacheco-Gahbler, C. (2017). Incidence of urethral stricture in patients with spinal cord injury treated with clean intermittent selfcatheterization. Urology, 198(4), 735-736.
• European Association of Urology Nurses (EAUN). (2013). Catheterisation: Urethral intermittent in adults: Evidence-based guidelines for best practice in urological health care. Erişim adresi:http://nurses.uroweb.org/wpcontent/uploads/2013_EAUN_Guideline_Milan_2013Lr_DEF.pdf.
• Faleiros, F., de Oliveira Kappler, C., Rosa, T., ve Gimenes, F. R. E. (2018). Intermittent catheterization and urinary tract infection a comparative study between Germany and Brazil. J Wound Ostomy Continence Nurs, 45(6), 521-526.
• Feneley, R. C., Hopley, I. B., ve Wells, P. N. (2015). Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol, 39(8), 459-470.
• Gould, C. V., Umscheid, C. A., Agarwal, R. K., Kuntz, G., ve Pegues, D. A. (2010). Guideline for prevention of catheter associated urinary tract infections 2009. Infect Control Hosp Epidemiol 31(4), 319- 326.
• Gray, M., Wasner, M., ve Nichols, T. (2019). Nursing practice related to intermittent catheterization: A cross-sectional survey. J Wound Ostomy Continence Nurs, 46(5), 418-423.
• Gündüz, B., ve Erhan, B. (2003). Omurilik yaralanması sonrası gelişen nöropatik mesanenin fizyopatolojisi. Türk Fiz Tıp Rehab Dergisi, 49(3), 3-5.
• Holland, J. E., de Maso, D. R., Rosoklija, I., Johnson, K. L., Manning, D., Bellows, A. L., Bauer, S. B. (2015). Self-cathing experience journal: Enhancing the patient and family experience in clean intermittent catheterization. J Pediatr Urol, 11(4), 1-6.
• Jenks, J. (2015). Clean intermittent self-catheterisation: to teach or not to teach? Br J Nurs, 24(10), 541.
• Kaye, I. Y., Payan, M., ve Vemulakonda, V. M. (2016). Association between clean intermittent catheterization and urinary tract infection in infants and toddlers with spina bifida. J Pediatr Urol, 12(5), 1-16.
• Kessler, T. M., Ryu, G., ve Burkhard, F. C. (2009). Clean intermittent self-catheterization: A burden for the patient? Neurourol Urodyn, 28(1), 18-21.
• Kibar, Y., Demir, E., Aydur, E., ve Dayanç, M. (2006). Ürolojide temiz aralıklı kateterizasyon uygulamaları. Neurourology and Female Urology, 32(4), 529-532.
• Lake, H. (2018). Intermittent self-catheterisation: Patient perceptions and experience. Br J Nurs, 27(18), 4-6.
• Lapides, J., Diokno, A. C., Gould, F. R., ve Lowe, B. S. (1976). Further observations in self catheterization. J Urol, 6(2), 169-171.
• Lapides, J., Diokno, A. C., Silber, S. J., ve Lowe, B. S. (1972). Clean, intermittent self catheterization in the treatment of urinary tract disease? J Urol, 107(3), 458-461.
• Leach, D. (2018). Teaching patients a clean intermittent self-catheterisation technique. Br J Nurs, 27(6), 296-298.
• Le Danseur, M., Stutzman, S. E., Wilson, J., Sislak, I., ve Olson, D. W. M. (2016). Is the CABIC clean intermittent catheterization patient education effective? Rehabil Nurs, 43(1), 40-45.
• National Institute for Health and Care Excellence (NICE). (2012a). Infection prevention and control of healthcare-associated infections in primary and community care Erişim adresi: http://tinyurl.com/kbjz3ob. National Institute for Heath and Care Excellence (NICE). (2012b). Urinary incontinence in neurological disease: management of lower urinary tract dysfunction in neurological disease. Erişim adresi: http://tinyurl.com/pfamjjs.
• National Institute for Health and Care Excellence (NICE). (2012). Healthcare–associated infections: prevention and control in primary and community care. CG139. 12. 10. 2021. Erişim adresi: https:// tinyurl.com/pguqymm.
• Neveus, T., von Gontard, A., Hoebeke, P., Hjalmas, K., Bauer, S., Bower, W., Jorgensen, T. M., Rittig, S., Walle, J. V., Yeung, C. K., Djurhuus, J. C. (2006). The standartization of terminology of lower urinary tract function in children and adolescents: report from the standardisation committee of the International Children’s Continence Society. J Urol, 176(1), 314-324.
• Oh, S. J., Ku, J. H., Jeon, H. G., Shin, H. I., Paik, N. J., Yoo, T. (2005). Health-related quality of life of patients using clean intermittent catheterization for neurojenic bladder secondary to spinal cord injury. Urology, 65(2), 306-310.
• Radojicic, Z., Milivojevic, S., Milic, N., Lazovic, J. M., Lukac, M., Sretenovic, A. (2019). Impact of bowel management in alleviating symptoms of urinary incontinence in patients with spina bifida associated with overactive bladder and detrusor sphincter dyssynergia. BJU Int, 123(1), 118–123.
• Royal College of Nursing Catheter Care (RCN). (2012). Guidance for nurses. 12.09.2021. Erişim adresi: www.rcn.org.uk.
• Seth, J. H., Haslam, C., ve Panicker, J. N. (2014). Ensuring patient adherence to clean intermittent self-catheterization. Patient Prefer Adherence, 12(8), 191-198.
• Singh, R., Rohilla, R. K., Sangwan, K., Siwach, R., Magu, N. K., ve Sangwan, S. S. (2011). Bladder management methods and urological complications in spinal cord injury patients. Indian J Orthop, 45(2), 141-147.
• Solanki, S., Babu, M. N., Jadhav, V., Shankar, G., ve Ramesh, S. (2015). Continent catheterizable conduit for urinary diversion in children: applicability and acceptability. Afr J Pediatr Surg, 12(1), 33-35.
• Svihra, J., Krhut, J., Zachoval, R., Svihrova, V., ve Luptak, J. (2018). Impact of clean intermittent catheterization on quality adjusted life years (QALYs) in spinal cord injury patients with neurogenic urinary incontinence. Neurourol Urodyn, 37(1), 250-256.
• Şenturan, L. (2015). Üriner sistem uygulamaları. Sabuncu N, Akça Ay F (Ed.), Klinik Beceriler Sağlığın Değerlendirilmesi, Hasta Bakım ve Takibi (ss 476-493). Nobel Tıp Kitabevi, İstanbul.
• Tunç, T. (2015). Temiz aralıklı kateterizasyon yapılan çocuk hastalarda idrar yolu enfeksiyon sıklığı ve enfeksiyon oluşumunu etkileyen faktörler. (Yüksek lisans tezi). İstanbul Bilim Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
• Wyndaele, J. J. (2002). Complications of intermittent catheterization: their prevention and treatment. Spinal Cord, 40(10), 536-541.
• Wyndaele, J. J., Brauner, A., Geerlings, S. E., Bela, K., Peter, T., ve Bjerklund Johanson, T. E. (2012). Clean intermittent catheterization and urinary tract infection: review and guide for future research. BJU Int, 110(11), 910-917.
• Zegers, B., Uiterwaal, C., Kimpen, J., van Gool, J., de Jong, T., Winkler-Seinstra, P., Houterman, S., Verpoorten, C., ve de Jong-de Vos van Steenwijk, C. (2011). Antibiotic prophylaxis for urinary tract infections in children with spina bifida on intermittent catheterization. J Urol, 186(6), 2365-2370.