A nephrostomy is a form of a catheter that is used to prevent the buildup of urine in kidneys thereby protecting against kidney damage. It is usually inserted through the skin on the back to the kidney. Urine from the kidney drains into a bag that can be emptied by the patient. Patients can still pass urine normally with a nephrostomy catheter in place (Pabon-Ramos et al., 2016). This paper describes the measurable objectives when caring for nephrostomy catheters on renal compromised patients in an Interventional Radiology county hospital. The importance of immersion in the project site on education on the care of post nephrostomy catheter placement is also discussed.
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Three Measurable Objectives
The first measurable objective in nephrostomy catheters is preventing infection of the catheter insertion site. The skin around the insertion site should be kept clean and dry to prevent infection. Symptoms of infection include swelling, redness, and high temperatures (Szvalb et al., 2019). Internal infections can also arise and can manifest as bloody or cloudy urine. Urine may also produce an abnormally strong smell to indicate infection.
The second measurable objective is preventing blockage of the nephrostomy catheter. Mechanical obstruction can prevent the normal flow of urine within the catheter. Biological fluids can also interfere with the normal flow of urine from the kidney to the catheter bag. The hallmark of catheter blockage is no urine drainage from the tube without an increase in the volume of urine passed normally.
The third measurable objective is preventing complications associated with catheter use. Patients with nephrostomy catheters can bleed from the kidney following catheter insertion or prolonged use. This problem can be observed as blood-stained urine. It is also possible to have urine leaking from the kidney and accumulating in the abdomen (Ritz, Speroni, & Walbridge, 2016). Therefore, nephrostomy nurses should monitor the incidence of such complications.
Importance of Immersion in the Project Site
The adoption of innovation is influenced by individual, organizational, and environmental features (Aloweni, Teh, Tan, & Ang, 2017). The impact of these factors on specific healthcare projects can be identified and addressed through immersion in the project site. For example, identifying specific needs requires an understanding of the dynamics of a hospital as well as any challenges that need to be addressed. Immersion makes it possible to observe the day-to-day operations in a hospital and relate them to issues that may pose challenges when caring for nephrostomy catheters in renal compromised patients.
For instance, the prevention of infection at the catheter site requires stringent aseptic measures during insertion. Therefore, hand washing protocols should be observed. The site should also be cleaned and dressed appropriately. Immersion at the project site can help to identify any insufficiencies related to these procedures thus improving the likelihood of project success.
Immersion in the project site provides creative and interactive strategies to ensure that interventions designed to address a clinical problem are relevant to the clinical setting. For example, the post-nephrostomy catheter placement care entails maintaining catheter patency, preventing infection, avoiding catheter-associated complications, and improving patient comfort during catheter use (Pabon-Ramos et al., 2016). Consequently, physical presence at the site provides one-on-one interactions with patients to advise them appropriately.
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Immersion in the project site provides a detailed and hands-on learning experience. It facilitates the learning of new knowledge and skills through complete engagement in project activities. Immersion also develops research and problem-solving skills by improving the ability to execute evidence-based interventions to enhance patient outcomes. In this project, immersion would aid the implementation of evidence-based strategies of providing nephrostomy care.
Nephrostomy catheters are crucial devices in the care of renal compromised patients. However, their success depends on proper insertion, prevention of complications during use, and caring for the patient after catheter insertion. Immersion in the project site provides experiential learning and room to implement project interventions effectively.
Aloweni, F., Teh, A. H. M., Tan, S. B., & Ang, S. Y. (2017). Promoting research competence: Introduction of the nursing research immersion program in Singapore General Hospital. Proceedings of Singapore Healthcare, 26(4), 267-269.
Pabon-Ramos, W. M., Dariushnia, S. R., Walker, T. G., d’Othee, B. J., Ganguli, S., Midia, M., & Siddiqi, N. (2016). Quality improvement guidelines for percutaneous nephrostomy. Journal of Vascular and Interventional Radiology, 27(3), 410-414.
Ritz, V. G., Speroni, K. G., & Walbridge, D. (2016). Reducing complications and hospitalizations through an innovative catheter care clinic for percutaneous nephrostomy catheter patients. Journal of Radiology Nursing, 35(4), 275-280.
Szvalb, A. D., El Haddad, H., Rolston, K. V., Sabir, S. H., Jiang, Y., Raad, I. I., & Viola, G. M. (2019). Risk factors for recurrent percutaneous nephrostomy catheter-related infections. Infection, 47(2), 239-245.