Measuring Bladder Volumes Scanning in the ICU
Measuring Bladder Volumes Scanning in the ICU
ICU patients are at risk for catheter associated urinary tract infection. Frequently patients
 can't tell clinicians if they need to void if the catheter is removed. If clinicians know
 that an accurate volume measurement s of urine volume in the bladder can be obtained when the
 catheter is removed, catheters could be removed earlier and more frequently and thus possibly
 avoid an infection. For this study, measures with ultrasound (directly visualizing the
 bladder to measure), bladder scanner (partially blind measure with placement of scanner over
 the expected bladder location on the skin) and urine catheterized volume will be obtained.
 The investigators also want to know if the technology is user dependent. The study will
 include 2 levels of nurses RN and advanced practice RN (APRN) perform the bladder scanner. An
 APRN and MD will conduct the ultrasound. Ultrasound is technology primarily used by
 physicians but APRNs are using the technology technology more frequently. After these 4
 measurements, the patient's nurse will perform an intermittent straight catheterization
 (catheter inserted, urine drained, and catheter removed) as the gold standard comparison.
The purpose of this correlational descriptive study is to compare measured bladder volumes
 with a bladder scanner (Verathon Prime), 3D ultrasound (Sono-Site II) and straight
 catheterization in ICU patients with low urine output receiving dialysis and in ICU patients
 unable to void.

 Upon consent of patient or LAR, patient's age, gender and BMI with the assigned study code
 number will be recorded on enrollment log. Study code number, patient initials and unit will
 be written on bedside data collection sheet.

 Sequence of 4 non-invasive (1-4) measurement will vary from day to day (see below)

 1. MD performs bladder ultrasound and records volume on data collection sheet and places in
 envelope

 2. APRN performs bladder scanner and records volume on data collection sheet and places in
 envelope.

 3. APRN performs bladder ultrasound and records volume on data collection sheet and places
 in envelope

 4. Bedside RN performs bladder scanner and records volume on data collection sheet and
 places in envelope

 5. The study team will record the data from the straight catheterization that is performed
 as part of clinical care.

 6. APRN or research nurse will retrieve catheterization urine volume measurement from RN or
 from chart and record on data collection sheet

 Each enrolled patient will have these 4 measurements performed only on one day. Each
 clinician research team member will record their result on a data collection form with the
 study number, patient initials, day of week, clinician initials, observation of abdominal
 fluid, and comment section for any other observations. The clinician research team member
 will place the completed form for their measurement in an envelope with the study number on
 the outside while the next clinician is in the room obtaining the next measure.

 Data collection is complete after catheter volume is recorded.
Inclusion Criteria:

 -  ICU dialysis patients who have their catheter removed per ICU medical team

 -  ICU patients without an indwelling urinary catheter and inability to void 6 hours post
 urinary catheter removal or 6 hours after admission

 Exclusion Criteria:

 -  Pregnant women Prisoners