Aims (1) To see how well are we performing in this area, (2) To suggest changes to improve the standard of patient care.
Background Intrapartum and postpartum bladder care are of great clinical importance. Overdistension of the bladder can cause permanent damage of the bladder. If voiding difficulties are recognised and treated early, both short and long-term morbidity may be prevented. Currently, there are no clear national guidelines available and further research is needed to develop evidence-based guidelines.
Methods Data were collected using proformas retrospectively. 36 case notes within the year of 2009 were chosen randomly.
Results Over 90% patients laboured within 16 h. Among 17 women who laboured within 4 h, 3 women (18%) had spontaneous void. Among women who laboured within 8 h, 9 out of 13 women (69%) did not void at all nor had bladder emptied. Similar findings were noted in women with longer labours. Postnatally, there was adherence to duration and timing of removal of catheter in two out of four women (50%). Following the catheter removal, one out of four patients (25%) manage to void within 6 h. There is no documentation regarding bladder care in the other three patients. 59% of women who had normal delivery had no postdelivery voiding documentation recorded. None of the patients has acute postpartum urinary retention.
Conclusions This audit demonstrates a lack of consistency in the management of intrapartum and postpartum bladder care. It is important to increase awareness of bladder care to prevent bladder damage.
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