Effect of Nursing Interventions on Prevention and Management of Postoperative Urinary Retention for Patients with Orthopedic Surgery under Spinal Anaesthesia

Urinary retention is a frequently observed as a postoperative complication that may lead to bladder damage, chronic nephropathy, urinary system infection and sepsis. Such complications can increase patient length-of-stay in a hospital and decrease quality of life. This study aimed at evaluating the effect of nursing interventions on prevention and management of Postoperative Urinary Retention (PUR) for patients that undergo orthopaedic surgery under spinal anaesthesia. This study is a randomised controlled clinical experimental study. This study was implemented at the orthopedics and traumatology clinic of a public hospital in Kocaeli between September 2013 and June 2014 with 132 patients fulfilling the research criteria and 66 patients each in the control and the intervention groups. Data were collected by using "Postoperative Urinary Retention Risk Factors Evaluation Form - I and II", "Postoperative Retention Management Protocol for Control and Intervention Groups" and a "Portable Bladder Ultrasound Device". Nursing interventions were performed in accordance with the "postoperative urinary retention management protocol" in intervention group, on the contrary patients in the control group were observed by the researcher without performing any nursing interventions. This work found that PUR is developed in almost all of the patients in the control group. Catheterization was not applied to almost all patients from the intervention group. Meanwhile, a catheter was placed for approximately 1/3 of the patients in the control group. Nursing interventions were effective in decreasing PUR incidence and consequently also reduced urinary catheterization incidence. Nursing interventions can be effective in the prevention and management of PUR. The results of this study will contribute to the improvement of patient care provided by nurses.