Turkiye Klinikleri Journal of Nursing Sciences

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Yoğun Bakım Hastalarında Kalıcı Üriner Kateter Klempleme Yönteminin Kateterle İlişkili Komplikasyonlar Üzerine Etkisi: Randomize Kontrollü Bir Çalışma
The Effect of Indwelling Urinary Catheter Clamping Method on Catheter-Associated Complications in Intensive Care Patients: A Randomized Controlled Study
Hülya KOÇYİĞİT KAVAKa , Şerife KARAGÖZOĞLUa
aSivas Cumhuriyet Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü Hemşirelik Esasları AD, Sivas, Türkiye
Turkiye Klinikleri J Nurs Sci. 2024;16(4):1102-12
doi: 10.5336/nurses.2024-103332
Article Language: TR
Full Text
ÖZET
 Amaç: Kateter klempleme yoluyla yapılan mesane eğitimi, geleneksel hemşirelik uygulamalarında önemli bir uygulama olarak kabul edilmektedir. Bu konuda henüz klinisyenler arasında fikir birliği sağlanamamış olup, güçlü kanıtlar elde edilene kadar daha fazla araştırma yapılması gerektiği vurgulanmaktadır. Bu araştırma, üriner kateter klemplenmesi yoluyla mesane eğitiminin, enfeksiyöz ve enfeksiyöz olmayan komplikasyonlar, ilk idrara çıkma, ilk idrar hacmi, üriner retansiyon, yeniden kateterizasyon ihtiyacı ve hastanede kalış süresi dâhil olmak üzere çeşitli sonuçlar üzerindeki etkisini araştırmayı amaçlamaktadır. Gereç ve Yöntemler: Bu randomize kontrollü araştırma, gastroenteroloji ameliyatı geçiren yoğun bakım hastaları ile yürütülmüştür. Araştırma örneklemi, 55 hasta klempli drenaj grubu ve 55 hasta serbest drenaj grubundan oluşmaktadır. Bulgular: Kalıcı üriner kateter klempleme yoluyla gerçekleştirilen mesane eğitimi ile serbest drenaj uygulamasının kateter çıkarıldıktan sonra yoğun bakım hastalarının; enfeksiyöz olmayan komplikasyon, ilk idrara çıkış süresi, ilk çıkarılan idrar hacmi, üriner retansiyon gelişme durumu, rekateterizasyon gereksinimi ve kateterizasyon nedeniyle hastanede kalış süresi üzerinde istatistiksel olarak anlamlı bir fark olmadığı, ancak enfeksiyöz komplikasyonlar üzerine istatistiksel olarak anlamlı bir fark olduğu sonucuna ulaşılmıştır. Sonuç: Klempli drenaj grubunda enfeksiyöz komplikasyonlar daha yüksek oranlarda görüldüğü saptanmıştır. Bu önemli bulgunun dışında kateter klempleme yönteminin herhangi bir avantaj veya dezavantajı saptanmamıştır. Bu konu ile ilgili güçlü kanıtlar oluşturacak randomize kontrollü çalışmaların, farklı tanılara sahip hastalar üzerinde çok merkezli denemeleri önerilebilir.

Anahtar Kelimeler: Üriner kateterizasyon; komplikasyonlar; yoğun bakım; randomize kontrollü çalışma
ABSTRACT
 Objective: Bladder training via catheter clamping has been accepted as an important application in traditional nursing practices. There is no consensus among clinicians yet in this subject, and it is emphasized that more research should be conducted until strong evidence is obtained. This study aimed to explore the impact of bladder training via urinary catheter clamping on various outcomes including infectious and non-infectious complications, first urination, first urine volume, urinary retention, recatheterization need, and hospital stay duration. Material and Methods: This randomized controlled study as conducted with intensive care patients undergoing gastroenterology surgery. The research sample consists of 55 patients in the clamped drainage group and 55 patients in the free drainage group. Results: Bladder training performed through permanent urinary catheter clamping and free drainage had no statistical effect on non-infectious complications, time to first urination, first urine volume, development of urinary retention, need for recatheterization, and length of hospital stay due to catheterization in intensive care patients after catheter removal. It was concluded that there was no significant difference, but there was a statistically significant difference on infectious complications. Conclusion: It was determined that infectious complications were observed at higher rates in the clamped drainage group. Apart from this important finding, no advantage or disadvantage of the catheter clamping method was detected. Multicenter randomized controlled trials on patients with different diagnoses may be recommended to produce strong evidence on this subject.

Keywords: Urinary catheterization; complications; critical care; randomized controlled study
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