Abstract: The Implementation of Bedside Bladder Ultrasound Technology: Effects on Patient and Cost Postoperative Outcomes in Tertiary Care

Martha Frederickson, Jennifer J. Neitzel, Elaine Hogan Miller, Sharon Reuter, Terry Graner, and John Heller. "The Implementation of Bedside Bladder Ultrasound Technology: Effects on Patient and Cost Postoperative Outcomes in Tertiary Care." Orthopaedic Nursing 19 (May/June 2000) 3: 79-87.

Objectives:
* To determine how ultrasound assessment of bladder volume affects patient health, and cost of care for patients needing postoperative catheterization.

Methods:
* Two groups of patients were studied at a large tertiary care hospital. The first consisted of patients having general surgery (urologic, colon, or gynecological surgery), and the second consisted of patients having orthopaedic surgery (joint-replacement or spinal surgery).
* All subjects in the general surgery group had ultrasound technology used to measure bladder volume when catheterization was normally scheduled to occur. The following variables were assessed: number of catheterizations avoided due to ultrasound use, rates of urinary tract infection (UTI), cost of catheterization equipment used, and patient/provider satisfaction.
* Of the subjects having orthopaedic surgery, some served as a control group and were catheterized periodically according to standard practice; the others received ultrasound assessment of bladder volume to determine whether catheterization was necessary. The number of catheterizations, rates of UTI, cost of catheterization equipment used, and patient/provider satisfaction were assessed for both groups.

Results:
* In the general surgery group, catheterizations were avoided in 38% (in the "due to void" category) and 81% fewer catheterizations (in the "void with residual" category). Of the orthopaedic surgery group, there were 20% fewer catheterizations required in the group which received ultrasound assessment.
* UTI rates from hospital admission to 30 days after discharge were 17% for the general surgery group, 4% for the orthopaedic group who received ultrasound before catheterization, and 13% for the orthopaedic group who were catheterized without receiving ultrasound.
* Based upon acquisition catheter cost, approximately 3 years of ultrasound machine use would be needed to recover the acquisition cost for each machine. "Cost of UTI in the literature has been estimated to be $680. If 12 UTI were avoided on each unit using the bladder ultrasound technology, the cost of the equipment would be recovered ($8,300/$680 = 12.21)."
* "The patient and provider satisfaction with this technology is exceptionally high . . . . The dignity of the patient will be enhanced if less invasive catheterization needs to be done."

Conclusion:
* "In postoperative patients, bedside bladder ultrasound technology is accurate, is effective in decreasing numbers of catheterizations, reduces cost over time, and provides high patient and provider satisfaction."

If you would like to read this study, please contact us and we will send a copy to you.