Improving standards of care with a comprehensive long-term nephrostomy care bundle

For most percutaneous catheters, care bundles exist to provide a set of interventions that when used together, significantly improve patient outcomes. However, long-term nephrostomies seem to be an exemption and although recommendations are available, it is evident there is a lack of paperwork to complete from a nursing perspective when caring for patients with long-term nephrostomy catheters. This was discussed in Martin’s 2019 Nursing Times article Care & Management of Patients with a Nephrostomy, ‘Care and management of patients with a nephrostomy is a fundamental aspect of nursing, but information for nurses is poor and there is a lack of evidence and guidance.’

On a recent BSIR webinar, consultant Radiologists and Urologists discussed the number of patients referred back to hospital for avoidable complications that had arisen in community care; not surprising given the lack of resources available for community nursing teams. Complications which were discussed included catheter dislodgement during dressing changes, sepsis as a result of urostomy bags not being drained or changed often enough, and catheter occlusion that had not been managed by recommended flushing procedures soon enough. The UK nephrostomy audit, 2007 supports this discussion, with the most common complication post nephrostomy insertion being catheter dislodgement.

If a nephrostomy care bundle was applied to practise for long-term nephrostomies, the need for reintervention may be significantly reduced. In a bid to support with community resources, we have put together a district nursing care bundle for patients with long-term nephrostomies that can be downloaded at the link below (*please contact us for customisation).

Drainage accessories for nephrostomy care bundles:

We offer a range of drainage bags and dressings suitable for use with long-term nephrostomies. Find out more about our range of drainage accessories here.

References:

References:

  • Martin R, Baker H (2019) Nursing care and management of patients with a nephrostomy. Nursing Times [online]; 115: 11, 40-43.
  • The Christie NHS Trust, Guidelines for Management of Nephrostomy Tubes: advice for district nurses CHR/PRO/221/08.09.03 version 5 Review July 2018
  • Yoo, M (2019) Complications of Nephrostomy Tubes: ED Presentations, Evaluation, and Management
  • Chalmers, N (2007) The UK nephrosotomy audit. Can a voluntary registry produce robust performance data?