Urology difficult catheterisation 'Grab-bag' Quality Improvement Project
BAUS ePoster online library. De Castro F. Jun 25, 2019; 265259; CU-6
Dr. Francis De Castro
Dr. Francis De Castro
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Acute urinary retention is a common urological presentation, which requires urgent management for prompt patient relief. Rapid catheterisation is indicated for the majority of these patients; however, some complicated cases may require specific urological equipment, such as a suprapubic catheter (Reynard & Brewster, 2013). The management of these complex patients can often be hindered by the difficulties of obtaining the correct equipment. Urology registrars can be delayed, particularly during a busy evening on-call shift, by poor accessibility to these tools and by inefficiencies in stock and availability.

This project addressed this issue by introducing a urology grab-bag, which would act as a readily available emergency tool kit that contained the standard urological equipment used for difficult catheterisations. Following its introduction, the grab-bag appears to reduce delays in obtaining the necessary catheterisation equipment, thus improving the efficiency of the urology registrar's management of complex urinary retention cases.
The urology registrar on call can encounter patients in retention who are difficult to catheterise, which require the use of specific equipment. For on call doctors, especially new house officers, it can be an arduous task to obtain these specific urology tools within the hospital. Consequently, this can delay the management of the patient, and prolong the duration the patient is suffering from urinary retention.
Acute urinary retention is one of the most common emergency presentations managed by the on call urology team. Whilst most urethral catheterisation is performed successfully by allied specialties prior to urology assessment, some patients have underlying pathology, which renders this a challenge, such as urethral strictures or locally advanced prostate cancer. In this instance specialist equipment and expertise is required in order to successfully catheterise the patient and relieve sympto
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