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Kathryn Getliffe

Publications and source records attributed to Kathryn Getliffe.

7 recordsLinked to original sources
PubMed2006

Catheter-associated urinary tract infection in primary and community health care.

INTRODUCTION: Although often a last resort, urinary catheterisation is a relatively common management option for bladder dysfunction in older people and others cared for in community settings. Catheter-associated urinary tract infection (CAUTI) is a well-recognised source of increased morbidity and economic burden in acute care services, but much less is known about the prevalence and impact of CAUTI in primary and community care. OBJECTIVES: The aim of this study was to examine the criteria and outcome measures used in reporting CAUTI, to identify sources and quality of data recorded on CAUTI and to determine a base-line prevalence rate for CAUTI in community settings. METHODS: (i) A mapping exercise to identify local, national and international sources of data on CAUTI and (ii) a retrospective prevalence survey of CAUTIs, recorded within three Primary Care Trusts in England during 1 month (October 2004). RESULTS: Published or other recorded data on CAUTI in community settings were very limited. Criteria and outcome measures were variable and commonly failed to distinguish between symptomatic and asymptomatic CAUTI. A prevalence rate of 8.5% was determined by retrospective survey of patient records. CONCLUSIONS: Limitations in the quality and consistency of catheter-related information collected by healthcare services present a major obstacle to robust epidemiological analysis of risk and impact of CAUTI in primary and community care. Standardised routine data collection is essential to determine the magnitude of risk associated with CAUTI, to enable the development of a longitudinal database of long-term catheterised patients and to provide base-line data against which infection-control initiatives in primary and community care can be evaluated.

Female↗
PubMed2004

Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour.

OBJECTIVES: To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia. DESIGN: Randomised controlled trial. SETTING: University teaching hospital in southern England. PARTICIPANTS: 99 nulliparous women with dystocia (cervical dilation rate < 1 cm/hour in active labour) at low risk of complications. Interventions Immersion in water in birth pool or standard augmentation for dystocia (amniotomy and intravenous oxytocin). MAIN OUTCOME MEASURES: Primary: epidural analgesia and operative delivery rates. Secondary: augmentation rates with amniotomy and oxytocin, length of labour, maternal and neonatal morbidity including infections, maternal pain score, and maternal satisfaction with care. RESULTS: Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5). They showed no difference in rates of operative delivery (49% v 50%, 0.98 (0.65 to 1.47), NNT 98), but significantly fewer received augmentation (71% v 96%, 0.74 (0.59 to 0.88), NNT 4) or any form of obstetric intervention (amniotomy, oxytocin, epidural, or operative delivery) (80% v 98%, 0.81 (0.67 to 0.92), NNT 5). More neonates of women in the water group were admitted to the neonatal unit (6 v 0, P = 0.013), but there was no difference in Apgar score, infection rates, or umbilical cord pH. CONCLUSIONS: Labouring in water under midwifery care may be an option for slow progress in labour, reducing the need for obstetric intervention, and offering an alternative pain management strategy.

Analgesia, Epidural↗
PubMed2004

Improving continence services--a case study in policy influence.

This article presents a case history of the process followed by a group of nurses who used their power and influence to improve the provision of continence services within the National Health Service in England. The process and outcomes demonstrate how nurses can achieve change using their political influence combined with a planned or evolving strategy.

England↗
PubMed2003

Managing recurrent urinary catheter blockage: problems, promises, and practicalities.

Long-term urinary catheterization is rarely completely free of complications, and encrustation by mineral salts leading to catheter blockage is common in around 40% to 50% of long-term catheterized patients. Recurrent blockage is a problem, which is both distressing to patients and caregivers and costly to health services in terms of time and resources. This article addresses the causes of recurrent urinary catheter blockage, proactive approaches to care, and the evidence for use of catheter maintenance solutions to reduce buildup of mineral deposits.

Biofilms↗
PubMed2002

Managing recurrent urinary catheter encrustation.

Recurrent blockage of the urinary catheter is a common problem in around 40-50% of long-term catheterized patients, leading to problems which are distressing to patients and costly to health services in both time and resources. Blockage is frequently caused by the build-up of mineral deposits on the catheter surface following precipitation from the urine under alkaline conditions. The presence of urea-splitting bacteria in the urine promotes a strongly alkaline urine and their adhesion to the catheter as a biofilm makes them extremely difficult to remove. This article addresses strategies for early identification of potential 'blockers'; proactive approaches to care; and the evidence for use of catheter maintenance solutions.

Biofilms↗
PubMedDate not supplied

The effect of acidic maintenance solutions on catheter longevity.

Long-term urinary catheterisation is rarely completely free of complications. Catheter blockage from mineral salt encrustation occurs in 40-50 per cent of patients. Recurrent blockage is distressing to patients and carers and costly to health services in both time and resources. Laboratory-based evidence shows acidic maintenance solutions can be effective in dissolving encrustations. This is supported by clinical experience but there are few clinical studies and no well-controlled clinical trials to date. This article examines the range of evidence for the effect of maintenance solutions on catheter longevity.

Anti-Infective Agents, Urinary↗