Abstract: Evaluation of Portable Bladder Ultrasound: Accuracy and Effect on Nursing Practice in an Acute Care Neuroscience Unit

Breeda O'Farrell, Margaret K. Vandervoort, Deborah Bisnaire, Patricia Doyle-Pettypiece, Wilma J. Koopman, and Lynn McEwan. "Evaluation of Portable Bladder Ultrasound: Accuracy and Effect on Nursing Practice in an Acute Care Neuroscience Unit." Journal of Neuroscience Nursing 33 (December 2001) 6: 310-309.

Objectives:
* To assess the accuracy of the BladderScan^® in assessing bladder volume in an acute neuroscience population, and to determine how BladderScan use affects nursing practice.

Methods:
* In a six week study, 105 paired ultrasound measurements were performed (using the BladderScan BVI 5000) by 45 nurses on 30 patients suspected to be retaining urine. Sixty-seven catheterizations were performed, and volumes were compared with corresponding ultrasound measurements.
* Nurses measured bladder volume twice using the ultrasound instrument and recorded these volumes. If catheterization was performed, they also recorded the catheterized volume. Nurses then answered the following yes/no questions: 1) "Is this a postvoid residual assessment?" 2) "Did you catheterize the patient?" and 3) "Did the bladder ultrasound results change your usual practice?"

Results:
* The volumes from ultrasound and the catheterized volumes were highly correlated. Patient age and gender did not change the relationship between ultrasound and catheterized volumes.
* Ultrasound assessment changed nursing practice in 51% or the instances
* The most common change in nursing practice (32%) was that nurses did not catheterize the patient.
* In cases where the ultrasound assessment did not change nursing practice, the most common reason (41%) was that the ultrasound confirmed the need to catheterize the patient.

Conclusions:
* "The instrument was judged to be an accurate and reliable tool that changed nursing practice in an acute care neuroscience unit."
* Avoiding catheterization was the most common change in practice that resulted from BladderScan use.
* The authors of the study recommend that "Ultrasound should be incorporated into clinical guidelines that address the broader issue of assessment and management of urinary dysfunction in an acute care neuroscience area."

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