Shared care ved Skift af permanent blærekateter - Sundhedsstyrelsen

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En efterfølgende konkret udvikling, afprøvning, tilpasning og implementering af modellen ligger nationalt hos relevante organisationer som Dansk Urologisk Selskab, Dansk Selskab for Almen Medicin og Sammenslutningen af urologisk interesserede sygeplejersker, hos regionale, kommunale og lokale samarbejdsfora og i de enkelte kommuner, sygehusafdelinger og lægepraksis. 13 Shared care ved skift af permanent blærekateter
Summary introduction A number of diseases lead to urinary retention and/or incontinence, which in some cases leads to catheterization using a longterm indwelling urinary catheter (hereafter called urinary catheter). Common for users of these catheters is a need for regular catheter insertion. The patients are catheterized at home, at their general practitioner (GP) and quite a few are catheterized at hospitals in highly specialized urological wards, even though many of the patients already are in contact with both the local home care and their GP. The health care system experiences that patients with urinary catheter has a number of common problems regardless of the reason for the catheterization, and, at present, there exist no evidence based guidelines for an optimized crosssector treatment for these patients. The consequence of this is lack of crosssector collaboration can be experienced as e.g.: ■ ■ ■ 14 Shared care ved skift af permanent blærekateter Difference in quality of treatment. The necessary expertise and routine is not always present Lack of use of the LEON principle (using the lowest effective cost level), that is to say the patients receives a treatment at the hospital which could have been provided to them in primary care at a lower cost Dissatisfaction in the care system regarding collaboration. Therefore it is desirable to establish a collaboration model (shared care model) across the secondary sector (hospitals) and the primary sector (local home care and GPs) for patients with urinary catheter. purpose This HTA forms the basis for establishing joint evidence based guidelines for treatment of persons with urinary catheter including guidelines for collaboration across the different sectors in a shared care model for the involved parties. method The analyses are based on a literature review, interviews with patients and staff in the organisations in question, a questionnaire study and an examination of medical records and estimation of costs of catheterization in home care, at GPs and in the highly specialized urological wards, respectively. technology In Denmark, there is no approved and published ‘national’ guideline for urethral catheterisation. If a locally developed guideline is used for the procedure it is based on the recommendations of ‘Danish Standards’. In this HTA, Danish Standards recommendations for use of urinary catheter have been assessed by comparing this to three national guidelines and one European guideline. It can be concluded that there are agreement between the guidelines in several areas but with the following exceptions: ■ Wash with water and soap versus sterile wash before the catheterization
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Page 5 and 6: projektgruppens forord Projektgrupp
Page 7 and 8: 5. Organisation 52 5.1 Indledning 5
Page 9 and 10: ■ 10 Shared care ved skift af per
Page 11: tentiale, hvor besparelserne kun vi
Page 15 and 16: Catheter change is performed in gen
Page 17 and 18: The specific development, testing,
Page 19 and 20: Ordliste Abdomen bughulen Afasi tab
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Page 23 and 24: 2. kateterisation 2.1 introduktion
Page 25 and 26: ■ ■ ■ ■ ■ ■ 26 Shared c
Page 27 and 28: En standard specificerer en række
Page 29 and 30: Det fremhæves dog, at et af målen
Page 31 and 32: Sæbe/vaskecreme skal fordeles på
Page 33 and 34: derover. I retningslinjen fra EAUN
Page 35 and 36: anbefaler, at alle typer bør overv
Page 37 and 38: konkrete handlinger. Det foreslås,
Page 39 and 40: Formålet med en retningslinje er a
Page 41 and 42: tidligere fået kateteret skiftet p
Page 43 and 44: ”Hygiejne har vi faktisk ikke få
Page 45 and 46: ”Hvis jeg må sige det, så vil j
Page 47 and 48: Andre havde en meget forstørret pr
Page 49 and 50: var en mand. Plejesektoren er i Dan
Page 51 and 52: 5. Organisation 5.1 Indledning Anl
Page 53 and 54: Fokusgruppeinterviewet og den efter
Page 55 and 56: 22 af de 190 patienter fik også sk
Page 57 and 58: I Protapundersøgelsen deltog 203
Page 59 and 60: Manglende kompetence og rutine i pr
Page 61 and 62: Shared care er ifølge litteraturen
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Tilgængelighed (katetermateriale)
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6. Økonomi 6.1 indledning Det frem
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Det har ikke været muligt at få o
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var i et udredningsforløb, hvorfor
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Tabel 10. Totale årlige omkostning
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Opmærksomheden skal endvidere rett
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På denne baggrund og med inspirati
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patienten kan kalde og hvem persona
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som kateterbæreren og evt. dennes
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7.5 afsluttende bemærkninger Katet
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17. Stickler DJ, Steven MJ, Gabriel
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52. Det fælleskommunale Løndatako
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ilag 2: interviewguides (organisati
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■ ■ ■ ■ 90 Shared care ved
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■ ■ Andet (fx standarder/anbef
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ilag 3: forslag til retningslinje f
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ilag 4: patientinformation Du har f
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www.sst.dk Sundhedsstyrelsen Monito
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Shared care ved Skift af permanent blærekateter - Sundhedsstyrelsen

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