Abstract: Implementing a Bladder Ultrasound Program

Nancy Ann Lewis, MSN, RN, CRRN. "Implementing a Bladder Ultrasound Program." Rehabilitation Nursing 20 (Jul/Aug 1995) 4: 215-17.

Objectives:
* Lewis describes the implementation and results of a bladder ultrasound program at a rehabilitation facility, where the BladderScan^® BVI 2500 was used to measure post-void residual volume as part of a standard assessment of patients' bladder function.

Methods:
* At Lewis' facility, nurses and physician worked together to implement a bladder ultrasound program. Prior to purchasing a BladderScan^®, they surveyed all patients in the facility on a given day to determine their bladder management needs. According to Lewis, "The results of the survey supported the theory that many of our patients require evaluation of the bladder emptying ability. Urethral catheterization was required to measure post-void residual bladder volume." Yet the volume found in 48 out of 72 post-void residual catheterizations was too low to justify catheterization.
* Lewis and her colleagues decided to purchase three bladder ultrasound instruments, and planned to purchase two more in the new budget year. The BladderScan^® was subsequently used in place of catheterization to measure post-void residual bladder volumes.

Results:
* Lewis' facility found the BladderScan^® BVI 2500 to be "user-friendly" and "easy to learn," requiring "no technical training" to operate. "Within a month of the implementation of the bladder ultrasound program, the nursing and medical feedback was extremely positive."
* The percentage of patients with orders for catheterization decreased from 80% to 60% following the implementation of the ultrasound program. Sixty-eight 79% of post-void residuals done by bladder ultrasound found volumes of 100cc or less, and catheterization was avoided for these patients.

Conclusions:
* "Patients with incomplete bladder emptying are at risk for over-distention, bladder dysfunction, and urinary tract infection."
* "Catheterization has been the standard method to measure residual urine; however, urethral catheterization is also associated with increased risk of infection, urethral trauma, and discomfort for the patient."
* "Bladder ultrasound scanning allows nursing staff to perform noninvasive assessment for post-void residual urine volume, assess patients who are unable to void, implement a bladder management program, or request urological evaluation as needed. The bladder ultrasound has proven to be a valuable tool in the bladder management program of this facility."

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