Frekvensen av överfylld urinblåsa vid ortopedisk kirurgi en observationsstudie

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Sammanfattning: Background: The urinary bladder is an anatomical structure and its purpose is to store urine. This structure can be exposed to damage in a perioperative environment. Urinary retentionand postoperative urinary retention (POUR) are complications which can occur perioperative. These complications can result in overdistended bladder. Overdistended bladder can cause reversible or irreversible damage to the detrusor muscles and may result in unnecessary suffering for the patient. Safety is the basis for all aspects of quality care and patient safety has grown to become a central issue within the Swedish health care system. The definition of patient safety is” the prevention of harm to patients” and it seems that actions to prevent overdistended bladder often are overlooked. This problem can be a result of the Principle of Efficiency and Thoroughness (ETTO), which aims to explain how all people make Trade- Offs between efficiency, productivity, thoroughness and how this effects safety. The health care system in Sweden seems to be overrepresented by efficiency which results in a reduction of patient safety.Aim: To investigate the occurrence of overdistended bladder in patients undergoing orthopedic surgery.Method: In this quantitative observation study, a consecutive selection was used and included 38 adult patients undergoing orthopaedic surgery. The study was conducted in an orthopaedic surgical unit that showed interest in the study. BladdeScan BVI 3000 was used to measure the volume of the bladder in all participants both pre- and postoperative respectively.Result: Overdistended bladder has an incidence of 13.5% where all were women. Both elective and acute prosthetic surgery were represented.Conclusion: The prevalence of overdistended urinary bladder in orthopedic surgery was 5 patients of 37 (13.5%). This study reveals that overfilled bladder tends to occur more in women than in men. The problem may be due to the organization's structure and Trade-Offs between efficiency and productivity versus thoroughness and patient safety. We believe that bladder monitoring is a vital parameter that has been ignored for too long perioperatively and needs to be prioritized higher than it is today.

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