Abstract: The Scan that Saves

Elzbieta Trzepacz and Jan Fitzgerald. "The Scan that Saves." Advance for Nurses 2 (June 24, 2002) 13: 14-16.

Objectives:
Nurses at Baystate Medical Center, MA implemented the BladderScan^® in a pilot study, as part of the post-operative care for patients undergoing total joint replacement (TJR) surgery. The goal was to improve patient care by eliminating unnecessary catheterization.

Methods:
45 patients recovering from joint replacement surgery participated in the pilot study. Prior to the pilot study, the standard procedure of post-operative care for TJR was to place an indwelling catheter in the bladder until day 2. The catheter was then discontinued and the patient was expected to void spontaneously within 6 hours. If the patient did not void, he/she was catheterized. During the pilot study, Baystate nurses used the BladderScan to measure patients' bladder volumes six hours after indwelling catheter removal, to determine whether the patient's bladder volume justified catheterization.

Results:
In almost all cases, the patient's bladder volume was well below 300 cc, thus not generating the urge to void. In these cases, catheterization was avoided. The patient was subsequently scanned with the BladderScan every 1 to 2 hours. In most of these patients, spontaneous voiding occurred once bladder volume increased. Only 2 of the 45 patients in the study had bladder volumes that justified catheterization following indwelling catheter removal.

As a result of BladderScan use, the Baystate nursing team observed an increase in patient satisfaction, was were able to demonstrate a cost savings of approximately $15,000 when prorated over the course of the year, resulting from reduced staff time, reduced use of catheterization kits, and decreased use of antibiotic medication. "Best of all," commented one nurse, "the study prevented 171 unnecessary catheterizations and the potential for infection related to catheter use."

Conclusions:
BladderScan use successfully prevented unnecessary catheterization, reduced the risk of infection, and resulted in cost savings and increased satisfaction with care among patients and staff. According to the coordinator of the TJR program, "The pilot proved so successful that use of the BladderScan became immediately adopted as a standard procedure not only for TJR patients, but throughout Centennial 6A, a 44-bed unit for orthopedic and general surgery."

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