The presented paper is devoted to the peculiarities of the provision of care to patients who have experienced nephrostomy. The given procedure can be considered a complex one and demands additional knowledge from the personnel to work effectively and contribute to the improvement of outcomes and achievement of better results. Additionally, there are also financial, strategic, and planning concerns associated with the issue that should be observed for patients with nephrostomy. The work is a literature review of relevant sources that are used to create the complete image of the described problem and reveal all peculiarities associated with the provision of care under such conditions. The paper shows the need for the consideration of all aspects mentioned above to ensure the continuity of care.
Aspects of Nephrostomy Care
Nephrostomy is a procedure that presupposes the creation of an artificial opening between the kidney and the skin to allow urinary diversity from the renal pelvis (Vargas-Cruz et al., 2017). In the majority of cases, it is used when a blockage prevents the urine from passing through the ureter. The procedure demands specific management and approaches.
According to Vargas-Cruz et al. (2017), nephrostomy remains a primary method for draining ureters with obstructions. It means that there will be many patients with such experiences and similar problems that should be solved. New, Deverill, and Somani (2018) support this opinion stating that the appearance of new patients with specific types of cancer will make the situation even more complex, preconditioning the need for effective management and planning to solve emerging problems. Investigating the same issue, Karim, Abed, and Bachuwa (2015) outline the fact that the demand for nephrostomy tubes increases every year, which indicates the existence of a particular along with the financial aspect of the effective solution to the problem. Hsu et al. (2016) are also sure that management of ureteral and other types of obstruction demands specific care that should follow nephrostomy and include all components needed for patients to recover and enjoy a high quality of life. For this reason, the organization of the appropriate care for patients with similar health issues and experiences of surgical interventions acquires the top priority in the modern healthcare sector (Garg, Bansal, Singh, & Sankhwar, 2019).
Analyzing the problem from various perspectives, Turo et al. (2018) assume that correct and effective planning might demand increased levels of competence among health workers regarding the focus on positive results. The main reason for this statement is the existence of multiple important factors. Garg, Menon, Rao, Arora, & Batra (2015) outline that in patients with bladder carcinoma, effective management of nephrostomy improves outcomes and significantly reduces the risk of complications. That is why it becomes critical to consider all existing problems such as poor organization, financial and management issues. Bayne, Taylor, Hampson, Chi, and Stoller (2015) analyze the current statistics among patients with nephrostomy and come to the conclusion that many of them experience dislodgement or similar problems because of poorly organized care or some other issues. That is why Noureldin, Diab, Valenti, and Andonian (2016) outline the necessity of the improvement of the existing post-nephrostomy care with the primary aim to attain better results and minimize risks faced by patients. Hosmer and Funaki (2013) adhere to a similar perspective on the issue, insisting on the fact that there is the need for the critical review of all aspects of the management associated with nephrostomy patients and care.
One of the central problems regarding the financial aspect of the proposed treatment measure is the emergence of complications in patients. The appearance of fungal infections can deteriorate treatment results and introduced the need for additional spending (Abdelhaleem et al., 2018). Ahmad et al. (2017) also emphasize the fact that the financial sphere of healthcare facilities experiences significant losses because of poor post-operational management or inappropriate approaches utilized by health workers while delivering care to this group of patients. They are revolving around the same issue, Chiancone et al. (2017) state that the decrease in the number of complications and utilization of more effective practices can help to reconsider the financial aspect of management and achieve better results. Fu, Yang, Xie, and Yan (2017) are also sure that the use of innovative solutions in the provision of care can help to minimize the threat. That is why they recommend devoting more attention to innovative solutions reducing spending. Guo et al. (2017) support the idea of the high financial burden of complications caused by ineffective management of patients or care provision. It means that the reconsideration of existing approaches is needed.
He et al. (2015) come to the conclusion that a nephrostomy tube can reduce percutaneous nephrolithotomy postoperative bleeding, which is critical regarding the need for improved management and complications’ avoidance. Analyzing the recent advancements in the sphere, Kim (2015) outlines the idea that innovative solutions and monitoring tools can be widely implemented to organize care for post-nephrostomy patients inappropriate ways and adhere to cost-saving patterns. Lee, Kim, Kim, Chung, and Cho (2014) show another possible approach that presupposes better cooperation with patients to educate them about the needs of individuals after similar operations and possible outcomes to avoid misunderstandings and complications. Ristolainen, Ross, Gavšin, Semjonov, and Kruusmaa (2014) are also sure that the current technological advance can serve as the guarantee of improved results. The comparatively high price for technology’s implementation can be compensated by better results. Speaking about the same issue, Berent (2014) emphasizes the role of interventional radiology as one of the possible ways to diagnose patients better and plan all actions needed for the achievement of better results.
Finally, Abbott, Cicic, Jump, and Davalos (2015) admit innovational and novel techniques as a possible alternative to other approaches that presuppose significant spending and a high risk of complications. The new methods can help to achieve success in the sphere. Sharma, Yadav, and Tomar (2015) state that the avoidance of complications becomes critical in nephrostomy care as they are the main reason for the deterioration of results. That is why innovations can be a potent solution to the problem. Kelley et al. (2019) have similar ideas; however, they are sure that the risk of rare complications can be minimized by additional training to nurses who provide care to patients who experienced the surgery. This suggestion is supported by Hwang et al. (2018), who underlines the fact that infants and children might also demand this intervention, which preconditions the high need for more effective management. The importance of the problem is evidenced by Trinchieri (2014), who admit the fact that urinary infections constitute a significant problem for the modern healthcare sector, and there is a need for effective measures to improve their management.
Altogether, nephrostomy care becomes a significant problem as it presupposes the existence of financial and managerial aspects that should be given more attention. The use of innovative technologies, reduction of complications and adverse effects, along education can be taken as effective methods to provide patients with the needed services and contribute to the improvement of their states.
Abbott, J., Cicic, A., Jump, R., & Davalos, J. (2015). Hemostatic plug: Novel technique for closure of percutaneous nephrostomy tract. Journal of Endourology, 29(3), 263-269. Web.
Abdelhaleem, O., Alandhari, I., Mahmoud, S., Khachatryan, G., Salah, M., Ali, O., & Shamsodini, A. (2018). Treatment of renal fungal ball with fluconazole instillation through a nephrostomy tube: Case report and literature review. American Journal of Case Reports, 19, 1179-1183. Web.
Ahmad, A. A., Alhunaidi, O., Aziz, M., Omar, M., Al-Kandari, A. M., El-Nahas, A., & El-Shazly, M. (2017). Current trends in percutaneous nephrolithotomy: An internet-based survey. Therapeutic Advances in Urology, 9(9-10), 219–226. Web.
Bayne, D., Taylor, E., Hampson, L., Chi, T., & Stoller, M. (2015). Determinants of nephrostomy tube dislodgment after percutaneous nephrolithotomy. Journal of Endourology, 29(3), 289-292. Web.
Berent, A. (2014). New techniques on the horizon: Interventional radiology and interventional endoscopy of the urinary tract (‘endourology’). Journal of Feline Medicine and Surgery, 16(1), 51–65. Web.
Chiancone, F., Fedelini, M., Meccariello, C., Pucci, L., Fabiano, M., & Fedelini, P. (2017). Spondylodiscitis: A rare complication following percutaneous nephrostomy. Urologia Journal, 84(4), 270–271. Web.
Fu, W., Yang, Z., Xie, Z., & Yan, H. (2017). Intravenous misplacement of the nephrostomy catheter following percutaneous nephrostolithotomy: Two case reports and literature review. BMC Urology, 17, 43. Web.
Garg, G., Bansal, N., Singh, M., & Sankhwar, S. (2019). Role of percutaneous nephrostomy in bladder carcinoma with obstructive uropathy: A story revisited. Indian Journal of Palliative Care, 25(1), 53-56. Web.
Garg, R., Menon, P., Rao, K., Arora, S., & Batra, Y. (2015). Pyeloplasty for hydronephrosis: Issues of double J stent versus nephrostomy tube as drainage technique. Journal of Indian Association of Pediatric Surgeons, 20(10), 32-36. Web.
Guo, J., Yang, W., Zhang, Y., An, F., Wei, R., Li, Y., & Zhang, H. (2015). Ultramini nephrostomy tract combined with flexible ureterorenoscopy for the treatment of multiple renal calculi in paediatric patients. Korean Journal of Urology, 56(7), 519-524. Web.
He, X., Xie, D., Du, C., Zhu, W., Li, W., Wang, K., … Guo, F. (2015). International Journal of Clinical and Experimental Medicine, 8(3). Web.
Hosmer, J., & Funaki, B. (2013). Management of transcecal renal transplant nephrostomy. Seminars in Interventional Radiology, 30(1), 87-90. Web.
Hsu, L., Li, H., Pucheril, D., Hansen, M., Littleton, R., Peabody, J., & Sammon, J. (2016). Use of percutaneous nephrostomy and ureteral stenting in management of ureteral obstruction. World Journal of Nephrology, 5(2), 172-181. Web.
Hwang, J., Shin, J., Lee, Y., Yoon, H., Cho, Y., & Kim, K. (2018). Percutaneous nephrostomy placement in infants and young children. Diagnostic and Interventional Imaging, 99(3), 157-162. Web.
Karim, A., Abed, F., & Bachuwa, G. (2015). BMJ Case Reports. Web.
Kelley, M., Spieler, B., Rouse, C., Karl, B., Marshall, R., & Carbonella, G. (2019). Urinothorax: A rare complication of percutaneous nephrostomy. Radiology Case Reports, 14(6), 729-733. Web.
Kim, B. (2015). Recent advancement or less invasive treatment of percutaneous nephrolithotomy. Korean Journal of Urology, 56(9), 614-623. Web.
Lee, J., Kim, K., Kim, M., Chung, D., & Cho, K. (2014). Intraoperative patient selection for tubeless percutaneous nephrolithotomy. International Surgery, 99(5), 662-668. Web.
New, F., Deverill, S., & Somani, B. (2018). Role of percutaneous nephrostomy in end of life prostate cancer patients: A systematic review of the literature. Central European Journal of Urology, 71(4), 404-409. Web.
Noureldin, Y., Diab, C., Valenti, D., & ANdonian, S. (2016). Circle nephrostomy tube revisited. Canadian Urological Association Journal, 10(7-8), 223-228. Web.
Ristolainen, A., Ross, P., Gavšin, J., Semjonov, E., & Kruusmaa, M. (2014). Acta Radiologica Short Reports, 3(5). Web.
Sharma, U., Yadav, S., & Tomar, V. (2015). Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy. Urology Anals, 7(4), 499-503. Web.
Trinchieri, A. (2014). Urinary calculi and infection. Urologia Journal, 81(2), 93–98. Web.
Turo, R., Horsu, S., Broome, J., Das, S., Gulir, D., Petterson, B.,… RukAwsare, N. (2018). Complications of percutaneous nephrostomy in a district general hospital. Turkish Journal of Urology, 44(6), 478-483. Web.
Vargas-Cruz, N., Reitzel, R., Rosenblatt, J., Jamal, M., Szvalb, A., Chaftari, A., … Raad, I. (2017). Antimicrobial Agents and Chemotherapy, 61(6). Web.