Use Of Foley Catheter Research Articles

Timing of Urinary Catheter Removal Following Kidney Transplantation: A Retrospective Study

Kidney transplant outcomes have improved over recent decades because of medical and surgical advances.1 Bladder catheterization has remained constant.2-6 Foley catheter use facilitates bladder identification by retrograde saline infusion into the bladder before anastomosis. After transplantation, the Foley catheter prevents tension on the new anastomosis by continuous drainage of urine and is typically maintained in place for 4-10 days to prevent urinary complications.2,5 However, the optimal Foley duration to minimize urinary complications is unknown.

Can we improve delirium prevention and treatment in the emergency department? A systematic review.

BackgroundThis systematic review was conducted to evaluate any interventions to prevent incident delirium, or shorten the duration of prevalent delirium, in older adults presenting to the emergency department (ED).MethodsHealth sciences librarian designed electronic searches were conducted from database inception through September 2021. Two authors reviewed studies, and included studies that evaluated interventions for the prevention and/or treatment of delirium and excluded non‐ED studies. The risk of bias (ROB) was evaluated by the Cochrane ROB tool or the Newcastle‐Ottawa (NOS) scale. Meta‐analysis was conducted to estimate a pooled effect of multifactorial programs on delirium prevention.ResultsOur search strategy yielded 11,900 studies of which 10 met study inclusion criteria. Two RCTs evaluated pharmacologic interventions for delirium prevention; three non‐RCTs employed a multi‐factorial delirium prevention program; three non‐RCTs evaluated regional anesthesia for hip fractures; and one study evaluated the use of Foley catheter, medication exposure, and risk of delirium. Only four studies demonstrated a significant impact on delirium incidence or duration of delirium—one RCT of melatonin reduced the incidence of delirium (OR 0.19, 95% CI 0.06 to 0.62), one non‐RCT study on a multi‐factorial program decreased inpatient delirium prevalence (41% to 19%) and the other reduced incident delirium (RR 0.37, 95% CI 0.22 to 0.61). One case–control study on the use of ED Foley catheters in the ED increased the duration of delirium (proportional OR 3.1, 95% CI 1.3 to 7.4). A pooled odds ratio for three multifactorial programs on delirium prevention was 0.46 (95% CI 0.31–0.68, I2 = 0).ConclusionFew interventions initiated in the ED were found to consistently reduce the incidence or duration of delirium. Delirium prevention and treatment trials in the ED are still rare and should be prioritized for future research.

Analgesic Effect of Intravenous Nefopam for Postoperative Pain in Minimally Invasive Spine Surgery: A Randomized Prospective Study.

Randomized double-blind control study. To evaluate the effects of nefopam on reducing morphine consumption and postoperative pain in patients undergoing minimally invasive spine surgery (MISS) and to evaluate its effects on enhanced recovery after spine surgery. Enhanced recovery after surgery (ERAS) has become a major goal for spine surgery. Multimodal pain management combining non-opioid analgesics is a key element of this. However, there is little evidence regarding the use of nefopam in spine surgery as part of an ERAS protocol. One hundred patients undergoing MISS were randomized into two groups. Patients in the nefopam group received 20 mg of intravenous nefopam diluted in 100 mL of normal saline intraoperatively, followed by 80 mg of nefopam diluted in 500 mL of normal saline, given as a continuous infusion postoperatively for 24 hours. The control group received an identical volume of normal saline. Postoperative pain was managed by patient-controlled analgesia in the form of intravenous morphine. Morphine consumption in the first 24 hours was recorded as a primary outcome. Secondary outcomes regarding ERAS were also collected. There were no significant differences in either total morphine consumption or postoperative pain score in the first 24 hours postoperatively between patients receiving nefopam and the control group. Morphine consumption in patients receiving nefopam was 13.54±10.64 mg compared with 15.86±16.2 mg in the control group (p=0.41). Time to postanesthetic care unit discharge, times to first sitting and walking, length of hospital stay, as well as duration of Foley catheter use and time until drain removal were also similar. There were no serious adverse effects of nefopam compared with normal saline. Nefopam did not significantly reduce opioid consumption or postoperative pain score. Adding nefopam as part of multimodal analgesia did not show beneficial effects for enhancing recovery after spine surgery.

Foley catheter for cervical preparation prior to second trimester dilation and evacuation: A supply-based alternative for surgical abortion: A case series

ObjectiveTo document the use of Foley catheter as an alternative to osmotic dilators for cervical preparation before second trimester dilation and evacuation at a tertiary setting in Ethiopia MethodsThis is a retrospective case series conducted at St. Paul's Hospital Millennium Medical College (Ethiopia) from April 1, 2021 to August 30, 2021. Forty-three cases of dilation and evacuation (D&E) in which overnight intra-cervical Foley catheter placement was used to prepare the cervix were reviewed. Data were analysed using SPSS version 23 and simple descriptive statistics were applied to analyze the clinical characteristics of study subjects and procedure outcomes. Percentages and frequencies were used to present the findings. ResultsThe calculated median gestational age was 21.4(17–24.2) weeks. Around 40%(17/43) of cases had cervical dilation of 3 to 4 cm, with another 33% (14/43) achieving cervical dilation of 1.5 to 2.5 cm. Additional dilation during the procedure was required only in 12 cases (28%) prior to D&E procedure. In 36 cases (84%), the procedure was attended by family planning fellow. ConclusionCervical preparation using overnight Foley catheter before second-trimester D&E resulted in majority of the cases requiring no additional dilation immediately prior to D&E procedure. Where osmotic dilators are not available, Foley catheter can be an alternative method to prepare the cervix prior to D&E procedures. ImplicationsIn the absence of osmotic dilators, Foley catheter can be used as an alternate, and readily available means of cervical preparation for second trimester D&E procedures

Effects of delayed postoperative void and preoperative urologic symptoms on delay in time of discharge for elective lumbar decompression surgery

BACKGROUND CONTEXTAlmost half of all patients undergoing lumbar spine surgery have preoperative lower urinary tract symptoms (LUTS). These symptoms could affect postoperative voiding and subsequently length of stay. PURPOSETo investigate the association between preoperative LUTS and time to first void and between time to first void and time to discharge among patients undergoing elective lumbar decompression surgery. STUDY DESIGN/SETTINGRetrospective analysis of prospectively collected data among patients at a single academic medical center. PATIENT SAMPLEAll patients ≥18 years of age undergoing elective lumbar decompression surgery between July 2017 and March 2020. OUTCOME MEASURESThe physiologic measure of a delayed time to first void was defined as an initial postoperative void of > 4 hours after anesthesia stop time. The outcome of prolonged time to discharge was defined as a stay of >24 hours after anesthesia stop time. METHODSAt their preoperative visit, patients completed the validated International Prostate Symptom Score (IPSS) (range, 0–35 points), which is applicable for LUTS assessment in both sexes. Clinically relevant LUTS are defined as an IPSS score of ≥8. Patients were followed from their preoperative visit to surgery admission discharge. Association of LUTS with time to first void and time to first void with admission discharge were estimated using risk ratios (RR) and 95% confidence intervals (CI) from a multivariable Poisson regression with a robust variance estimate adjusted for potential confounding variables including age, sex, IPSS, and intraoperative Foley catheter use. RESULTSThe analytic cohort included 170 patients with an average age of 57 years and 103 (61%) were men. Preoperative LUTS prevalence was 45%, and 111 (65%) of patients voided within 4 hours after surgery. For patients with preoperative LUTS, the unadjusted RR for a first void of >4 hours was 1.04 (95% CI: 0.82–1.32) (p=.77). Adjustment for age, sex, intraoperative Foley catheter use, revision surgery, previous spine surgery, single versus multiple levels, and lumbar location did not materially alter the risk: the multivariable RR was 1.04 (95% CI: 0.82–1.31) (p=.74). The unadjusted RR for a discharge of > 24 hours for patients with a time to first void of > 4 hours was 2.17 (95% CI: 1.51–3.10) (p<.001). After adjusting for age, sex, intraoperative Foley catheter use, IPSS, revision surgery, previous spine surgery, single versus multiple levels, and lumbar location, the multivariable RR was 1.72 (95% CI: 1.22–2.41) (p=.002). CONCLUSIONSRegardless of preoperative LUTS status, an initial first void of >4 hours after surgery is associated with a longer time to discharge among patients undergoing elective lumbar decompression surgery. Future studies are needed to determine if encouraging early postoperative voiding results in timely discharge and shorter length of stay.

Inpatient versus outpatient transcervical Foley catheter use for cervical ripening: a randomized controlled trial

To evaluate the difference in time from hospital admission to delivery when undergoing inpatient versus outpatient cervical ripening with a transcervical Foley catheter. This was a randomized controlled trial of patients with singleton pregnancies, Bishop Score ≤ 6 and at least 37 weeks’ gestation, undergoing labor induction at Sinai Hospital of Baltimore and Thomas Jefferson University Hospital. Patients were randomized to outpatient or inpatient cervical ripening with a Foley catheter. Inpatients received concurrent oxytocin. Outpatients returned 12 hours after Foley placement, and on arrival oxytocin was initiated if the balloon was still in place. Foleys were removed if in place after 12-18 hours, and labor induction initiated with oxytocin as needed. The primary outcome was the difference in time from admission to delivery. A maternal satisfaction survey was also administered. Unpaired t-tests, chi-square tests, and Fisher’s exact test were performed to estimate differences in outcomes between the inpatient and outpatient arms of the study. Enrollment commenced January 2016 and continued until November 2020, after randomizing 30 patients (n=15 per group). The study was terminated prematurely due to low enrollment and temporary suspension during COVID-19. There was no significant difference in time from admission to delivery between outpatient and inpatient groups (14.5 ± 6.1 versus 18.9 ± 8.2 hours, P=.11). The total induction time was shorter for the inpatient group (24.9 ± 6.8 versus 17.3 ± 9.4 hours, P=.02). There were no differences in other maternal or neonatal outcomes (P>.05). Maternal satisfaction was similar between groups on a 1-10 scale (8.6 ± 1.7 versus 8.9 ± 1.0, P=.53), and all patients felt safe. No difference in the primary outcome of time from admission to delivery was noted between inpatient and outpatient cervical ripening with a Foley catheter; however, this may be a result of inadequate power related to early termination. Consistent with past studies, outpatient balloon cervical ripening appears to be safe, and overall satisfaction was high.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The impact of cervical effacement at time of amniotomy in patients undergoing induction of labor

There is evidence to suggest that early amniotomy during induction of labor (IOL) is advantageous. However, most amniotomy trials were performed prior to contemporary data in favor of foley catheter use. Often at foley removal, cervical effacement remains thick. We investigated whether cervical effacement at the time of amniotomy impacts outcomes among nulliparas undergoing IOL.

A Novel Technique for Securing a Bolster For Skin Grafting after Extensive Vulvar Resection.

Summary:Patients with stage III hidradenitis suppurativa of the vulva and adjacent areas, unresponsive to other therapies, may require extensive surgeries. These include excision of diseased areas on the buttocks, vulva, groins, and abdomen, followed by delayed skin grafting. Negative pressure wound therapy has been used over grafts, but it can be difficult to maintain a seal when extensive areas have been resected. We present a novel technique to bolster skin grafts for optimal success. A total vulvectomy and resection of the buttocks, groins, and abdomen are first performed for stage III HS, incorporating all diseased tissue. Negative pressure wound therapy is applied and changed on postoperative day 3–4. On postoperative day 7, split-thickness skin grafts are applied. The skin grafts are covered by Adaptic gauze (3M Company, Minn.), cotton, and a layer of Reston foam (3M Company, St. Paul, Minn.) which is cut to fit the size of the wound. Ostomy skin barriers (Hollister Incorporated, Libertyville, Ill.) are placed on the skin surrounding the excised areas. Pediatric Foley catheters are then placed through the ostomy skin barriers and tied together to prevent movement of the bolster. The use of ostomy skin barriers and pediatric Foley catheters to secure bolsters has not previously been described. We demonstrate a well-tolerated technique, using common surgical supplies, to provide consistent uniform pressure over the graft site. This technique also allows for easy bedside dressing change(s) when indicated.

Influencing factors of pressure injury healing in an acute care setting: A retrospective cohort study

AimThis study aimed to investigate the factors that influence healing during acute care hospitalization by examining the differences in pressure injury (PI) status between admission and discharge. Material and methodsA total of 371 patients who met the study's inclusion criteria were divided into two groups (aggravated or improved) based on the PI status observed at admission and discharge. We used bivariate analyses to compare demographics and clinical factors associated with wound severity and aggravation/improvement of wound condition. Using multiple logistic regression, we identified and examined independent predictors for significant association with aggravation/improvement of the wound status. ResultsThe prevalence rate of PI at acute hospital admission was 12.5%. By the time of discharge, only 5.4% of PI patients had improved PI, whereas 12.6% had aggravated PI. The significant aggravating factors of PI during acute care hospitalization were the patient's consciousness level, use of foley catheter, creatinine level, and Braden Scale scores (p < .05). Residential place prior to admission were found to be associated with the healing. ConclusionsNurses providing prophylactic management require close attention to patients who are admitted from long-term facilities to prevent aggravation of PI during acute care hospitalization.

A Rare Complication of Foreign Body Removal from the Oesophagus Using Foley Catheter: Esophageal Rupture

Delay in diagnosis and treatment of esophageal foreign bodies (FBs) increases morbidity and mortality. Anamnesis, radiological imaging and endoscopy are important in this diagnosis. A nine-month-old male patient was admitted to the hospital an hour after swallowing a coin. Pulmonary radiographic images detected the FB in the 2nd narrowing of the oesophagus and the FB was removed using a foley catheter. Six hours after removal of the FB, the patient was re-admitted by the emergency service upon development of puffiness in the neck and chest area. Physical examination revealed subcutaneous crepitation on the anterior wall of the thorax. Esophagography revealed that the contrast agent leaked from the right lateral of the oesophagus into the chest cavity. The nasogastric tube was inserted, the oral nutrition was stopped and antibiotherapy was started. Primary oesophagus repair was performed via thoracotomy on the 7th day of conservative follow-up upon the deterioration of the general condition and continuing leakage of contrast agent as observed in the fluoroscopy. In conclusion, The use of foley catheter in the removal of esophageal FBs can lead to serious complications.

Simultaneous use of high-volume Foley catheter (60ml) and misoprostol for labor induction in nulliparous women: Arandomized controlled trial.

To examine the simultaneous effect of high-volume Foley catheter (HVFC) (60ml) and vaginal misoprostol on labor induction in nulliparous women. A randomized, double-blind, controlled trial was conducted among nulliparous post-date (>40weeks) pregnant women between June and December 2019. At enrollment 100 women were randomized into each group (either HVFC and vaginal misoprostol or low-volume Foley catheter [LVFC] [30ml] and vaginal misoprostol), for labor induction. Demographic and clinical data were collected at enrollment and delivery. Women in the HVFC group had statistically significantly shorter induction to delivery interval (median 860min, interquartile range [IQR] 840-940min vs. 1160min, IQR 1080-1320min, P<0.001) and duration of labor (median 615min, IQR 600-680min vs. 750, IQR 692.5-800min, P<0.001). Mode of vaginal delivery (n=94 vs. n=78, P=0.002), number of doses of misoprostol required (median 2, IQR 1-2 vs. 2, IQR 1-3), and need of oxytocin augmentation (n=22 vs. n=39, P=0.014 and P<0.001), was significantly better in the HVFC group. However, there was no significant difference with respect to other maternal or neonatal outcomes. Simultaneous use of HVFC and vaginal misoprostol for labor induction significantly shortens the induction to delivery interval and duration of labor in nulliparous women. Clinical Trial Registry of India CTRI/2019/05/019394 (http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=31554&EncHid=&userName=Foley%20catheter).

Omitting Foley Catheter Use in Mastectomy Patients with or Without Immediate Reconstruction

Omitting Foley Catheter Use in Mastectomy Patients with or Without Immediate Reconstruction

345 Delirium Prevention and Treatment in the Emergency Department: A Systematic Review

Delirium is a dangerous syndrome of acute brain dysfunction and is common in the emergency department (ED), especially among the older adults. Most systematic reviews of interventions for delirium prevention and treatment, however, have focused on inpatient settings. The objective of this systematic review was to synthesize the existing evidence on pharmacologic and non-pharmacologic interventions to prevent incident delirium or decrease the severity or shorten the duration of prevalent delirium in older adults presenting to the ED. Inclusion criteria included any study of an intervention to prevent or treat delirium in older ED and inpatient settings. Searches using subject headings and keywords were conducted from database inception through June 2020 in Ovid MEDLINE, EMBASE, PsychINFO, CINAHL, ProQuest Dissertations and Theses Global, and Cochrane CENTRAL, as well as grey literature. Database searches were not limited by date or language. Two reviewers identified studies describing any interventions for delirium prevention and/or treatment in the ED. Disagreements were settled by a third reviewer. The risk of bias was evaluated by the Cochrane risk of bias tool or Newcastle-Ottawa (NOS) scale. We described the overall findings from selected articles for this systematic review instead of a planned meta-analysis. Our search strategy yielded 6, 838 studies of which 12 met study inclusion criteria. Our observed kappa was 0.79 (95% CI:0.56 - 1.0). Half of these studies were available in abstract only. Of included studies, two were randomized controlled trials (RCT): A total of seven studies used mixed study settings including ED. Two RCTs evaluated pharmacologic interventions for delirium prevention, three non-RCTs employed a multifactorial delirium prevention program, three non-RCTs evaluated regional anesthesia for hip fractures, two studies evaluated the implementation of delirium screening, and one study evaluated the use of Foley catheter, medication exposure, and risk of delirium (Table). Of the 12 studies included only four studies demonstrated a significant impact on a delirium incidence and duration – one RCT of melatonin, two non-RCT studies on multifactorial program, and one case control study on the use of Foley catheter. Our review demonstrated that research into delirium prevention and treatment in the ED setting is still in its infancy. Older adults with hip fracture appear to be a target population; however, interventions studied to date have not demonstrated a significant impact. Further research is needed into effective delirium prevention and treatment interventions in the ED.

P18. Preoperative lower urinary tract symptoms and subsequent risk of postoperative urinary retention after elective spinal fusion surgery

<h3>BACKGROUND CONTEXT</h3> The prevalence of lower urinary tract symptoms (LUTS) in patients undergoing elective spine surgery has been reported to be about 40%. However, there has been no study examining the relationship between preoperative LUTS and the risk of postoperative urinary retention (POUR) in this patient population. <h3>PURPOSE</h3> Among adult patients undergoing elective spinal fusion, we determined the extent to which the risk of POUR was elevated among patients with LUTS compared to patients without LUTS. <h3>STUDY DESIGN/SETTING</h3> Prospective cohort study. <h3>PATIENT SAMPLE</h3> All patients ≥ 18 years of age undergoing elective spinal fusion surgery at an academic medical center between July 2017 and March 2020 were evaluated. <h3>OUTCOME MEASURES</h3> POUR was identified by documentation of a Foley or straight catheter insertion between the time of anesthesia stop and admission discharge. <h3>METHODS</h3> Patients completed the validated 7-item International Prostate Symptom Score (IPSS) (score range 0-35 points) at their preoperative visit. The IPSS is appropriate for assessing LUTS severity in both men and women. Clinically relevant LUTS are defined as an IPSS score ≥ 8 points. Patient medical records were searched for the insertion of a Foley or straight catheter during the postoperative period and several potential confounding variables including age, sex and intraoperative Foley catheter use. The analytic sample was restricted to patients who completed a preoperative IPSS, underwent surgery, and were discharged ≥ 8 hours after surgery. The association of LUTS and risk of POUR was estimated with risk ratios (RR) and 95% confidence intervals (CI) from a multivariable Poisson regression with a robust variance estimate adjusted for potential confounding variables. <h3>RESULTS</h3> A total of 456 patients were included in the analytic cohort with 296 (61% women) undergoing lumbar fusion and 160 (62% women) undergoing cervical fusion. The means (standard deviation) of age were 63.2 (11.5) and 57.0 (11.9) among the lumbar fusion and the cervical fusion patients, respectively. Preoperative LUTS prevalence was comparable among the two groups of patients defined by location of fusion: 53% among those undergoing lumbar fusion and 58% among those undergoing cervical fusion. For lumbar fusion, 16 (12%) of 139 without LUTS and 25 (16%) of 157 with LUTS developed POUR. In cervical fusion patients, 3 (4%) of 68 without LUTS and 11 (12%) of 92 with LUTS developed POUR. Among all patients undergoing either type of fusion surgery, the unadjusted RR was 1.6 (95% CI: 0.9, 2.7) (P = 0.09). Adjustment for location of fusion (lumbar, cervical), age, sex and intraoperative Foley catheter use did not materially alter this association: the multivariable RR was 1.6 (95% CI: 0.9, 2.6) (P = 0.10). Although positive associations were observed, they were of borderline statistical significance. <h3>CONCLUSIONS</h3> Among adults undergoing lumbar or cervical fusion surgery, those with LUTS at the preoperative visit appear to be at higher risk of developing POUR. Improper or delayed management of POUR can lead to several complications including urinary tract infection and increased length of stay. These results suggest that routinely assessing preoperative LUTS in patients undergoing elective spinal fusion surgery could help identify those at higher risk of developing POUR. Early identification of these patients could allow prophylactic measures against POUR complications to be implemented. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Prolonged Indwelling Foley Catheter Use in Post-operative Gynecology Patient Associated with an Increased Incidence of Urinary Tract Infections

BACKGROUND: Urinary tract infection (UTI) is one of the common conditions and significantly contributes to expensive health treatment and associated with gynecological surgery which increases the cases up to 50% in women undergoing specific reconstructive procedures. Besides that, one indicator of surgical quality was post-operative UTI occurrence. AIM: This study aims to assess the relationship between Foley catheter usage and UTIs after gynecological surgery with a urinary catheter. METHODS: A total of 48 subjects examined at the Department of Obstetrics and Gynecology, Universitas Sumatera Utara Hospital, and Haji Adam Malik General Hospital, Medan, from June to September 2020. Subjects were performed urinalysis 8 days after surgery, or earlier if UTI symptoms occur. Personal data and illness data were taken from medical records. Statistical analysis was done using the Chi-square-based test. RESULTS: There was a significant difference of urine leukocytes in subjects with indwelled catheter for 24–36 h compared to subjects with 36–48 h of catheterization (p = 0.01). The 36–48 h group has a 2.15 odds of developing UTI compared to 24–36 h group (p = 0.01). CONCLUSION: This study found that prolonged indwelling Foley catheter usage may increase the risk of UTI after gynecology surgery.

COMPARATIVE STUDY BETWEEN COMBINED USE OF INTRACERVICAL FOLEY CATHETER WITH VAGINAL MISOPROSTOL VERSUS VAGINAL MISOPROSTOL FOR MID TRIMESTER ABORTIONS IN PATIENTS WITH PREVIOUS CAESAREAN SECTIONS

Background:There is a gradual increase in second-trimester abortion because of wide scale introduction of prenatal screening programs detecting women whose pregnancies are complicated by serious fetal abnormalities suchas aneuploidy, cardiovascular and skeletal malformation. It constitutes 10-15% of all induced abortions.With the global trend of raised cesarean section rate, obstetricians are faced with the challenge of termination of pregnancy in women with a scarred uterus.Termination of pregnancy in second trimester is associated with much more morbidity and mortality than when it is done in the first trimester. The various methods for second trimester termination of pregnancy are still controversial and the search for the ideal method which is the safest, easiest, cheapest and most effective is still going on. Search for alternative and effective method is the need of hour. In our study, we aimed at assessing the effectiveness and safety of intracervical foleys catheter with vaginal misoprost and comparing it with the vaginal misoprost for mid trimester abortions in patients with previous caesarean. Methods: This was a prospective randomized controlled trial conducted on 108 women undergoing mid trimester abortions at Patna medical college and hospital in 2019. Patients were randomly allocated in 2 groups Group I ( intracervical foleys and Misoprostol group): Intracervical Foley catheter inserted with a standard regimen of moistened misoprostol tablets (200 μg) 6 hourly intravaginally was used. Group II (misoprostol group): moistened misoprostol tablets (200 μg) 6 hourly inserted vaginally. Procedure efficacy (defined as complete abortion within 48 hours of first dose of misoprostol), safety and reduction in side effects ,acceptability, dose of misoprost required were assessed in both the groups. Results:The induction to abortion interval was 24.16 ± 1.52 hours in the combined group compared to 45.76 ± 1.63 hours in the misoprostol group (P value&lt;0.021) with success rate of 96% in the combined group and 80 % in misoprostol group. Total dose of misoprostol required in combined group was (682.33+_ 245) micrograms and (1100 +_ 212) micrograms in misoprost group with p value &lt; 0.001 No significant difference as regard occurrence of advere effects between the two groups. Conclusions:Combined use of intracervical foley catheter and vaginal misoprostol is a novel safe, effective and acceptable method for termination of second trimester in patients with previous caesarean sectionpregnancy.

Efficacy of an educational program for medical staff in preventing incidents related to Foley catheter insertion and maintenance: A single-institution retrospective study.

To analyze incidents related to Foley catheter insertion and maintenance, and to compare the rate of incidents before and after a medical staff education program. Data regarding Foley catheter insertion incidents and maintenance were collected at Toyama University Hospital, Toyama, Japan. The degree of harm for each incident was assessed. In the middle of the study period, a medical staff education program by urologists was implemented to help understand basic urological anatomy, urethral catheter insertion techniques and catheter safety. The incidents before and after the intervention were then compared. During the study period, Foley catheter insertion was carried out in 12476 patients. Related incidents were reported in 66 (0.53%), including 22 (0.18%) occurring during catheter insertion and 44 (0.35%) occurring during catheter maintenance. A total of 13 (0.10%) cases of urethral injury were reported. The degree of harm associated with catheter insertion incidents was moderate in 13. Nine of these incidents occurred before the education program (9/6799, 0.13%), and four were reported after the end of the program (4/5677, 0.07%, P=0.4303). Transient suprapubic cystostomy was required in two due to urethral injury reported before the program. Among 44 incidents occurring during catheter maintenance, 37 catheters were removed or cut by the patient. Such incidents occurred regardless of the education program. The rate of incidents related to Foley catheter use at our institution is low. A specific medical staff education program might prevent iatrogenic catheter-related urethral injury requiring cystostomy.

1081 Outpatient cervical ripening with foley catheter in low-risk women: a systematic review

Multiple studies have been conducted comparing inpatient versus outpatient pre-induction cervical ripening with the Foley catheter in low-risk women. We performed a systematic review of all existing data. This systematic review was completed via Pubmed search. Articles published prior to September 27, 2019 were included for review. We included two randomized control trials, one pilot randomized control trial, a clinical cohort study, and a retrospective cohort study in our review which met the following criteria: 1) compared outpatient versus inpatient use of Foley catheter for pre-induction cervical ripening in low-risk women at term (>37 weeks), Bishop score <5, cephalic presentation with an unfavorable cervix 2) detailed maternal and neonatal outcomes 3) full article text was available 4) article published in English. Five maternal and two neonatal primary outcomes were captured for analysis. Meta-analysis was completed via Stata v15.1 software. Five studies were included with 1,346 subjects. The final Bishop score, oxytocin infusion time, and induction-to-delivery time were greater in the outpatient group (Table 1, p<0.05). However, there was no difference in cesarean delivery, vaginal delivery, initial Bishop score, NICU admission, and Apgar score <7 at 5 minutes between the outpatient and inpatient groups. In this large cohort, outcomes between low-risk women who received the Foley catheter for pre-induction cervical ripening in the outpatient and inpatient setting were similar.

The use of foley catheter as a pharyngeal pack in maxillofacial surgery

Parapharyngeal packing during Maxillofacial surgery prevents passing blood and liquids into stomach. The use of cotton pack has some disadvantages like missing and retained pack at the end of surgery. Foley catheter is a good substitute for that.

A Nurse-Driven Protocol for Foley Catheter Utilization Decreases the Incidence of Traumatic Foley Catheterization.

Background: Traumatic urethral catheterization is a common reason for urologic consultation in hospitalized patients. The purpose of this study was to determine if a protocol designed to decrease Foley catheter use was effective and if implementation of the protocol decreased the incidence of Foley catheter–associated trauma.Methods: In an effort to decrease catheter use, our institution adopted a nurse-driven Foley catheter protocol in May 2015 that allowed nurses to remove Foley catheters that did not meet criteria. We conducted a retrospective medical records review of patients who had Foley catheter–associated trauma occurring between February 2013 and March 2018 and compiled data concerning Foley catheter use. Using t test statistical analysis, we compared rates of Foley catheter use and Foley catheter–associated trauma before and after protocol implementation.Results: During the 62-month study period, we documented 83 cases of Foley catheter–associated trauma. Prior to protocol implementation, our institution had mean of 2,903 patient-catheterization days per month. Following protocol implementation, the mean decreased to 2,604 patient-catheterization days per month (P<0.01). Prior to protocol implementation, the mean incidence of Foley catheter–associated trauma was 1.81 traumas per month. Following protocol implementation, the mean incidence decreased to 0.97 trauma per month (P<0.05).Conclusion: Implementation of the protocol was successful in decreasing Foley catheter use as well as Foley catheter–associated trauma.