Due to the breadth of the female urinary incontinence (UI) device market, categorizing it can aid in better understanding it. The first distinction to be made is between products which are designed to prevent urinary incontinence episodes, and those which are designed to manage them. Within the former category, exist products such as pharmaceuticals, surgical options, bulking agents, nerve stimulation devices, bladder supports and inserts. Within the UI management device category, we find devices which are more commonly associated with incontinence: absorbents, such as diapers and briefs, and indwelling drainage devices, such as catheters. While not discussed in this section, the GR Dome UriCap-F would fall into this management category as well. A table depicting this categorization can be seen in Figure 1.
Pharmaceuticals
For UI, pharmaceuticals are typically used to alleviate urge incontinence and overactive bladder for all ages. These products are generally in pill or patch form and inhibit involuntary detrusor contractions[1]. The market is rather large, at $5 billion annually, and is expected to have strong growth[2]. The big players in the UI pharmaceutical market are Pfizer with their Detrol product, Johnson and Johnson with their Ditropan product, GlaxoSmithKline with Vesicare, Novartis with Enablex and Watson with Oxytrol. The name brand products typically cost around $94-212/month [3]. However, generics do exist and typically cost somewhere between $24-36 per month [4]. While these products are non-invasive and can device free, resulting in a great degree of freedom, so drawbacks do exist. The name brand products can be relatively expensive, and the side effects caused by the drugs can include dry mouth, rash, constip...
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...lderly but recent trends show them rolling out ad campaigns targeted at younger audiences.
Catheters, on the other hand, are the go-to device in hospitals. Actually, they may be overused in hospitals due to the lack of suitable alternatives and because of the tight hold the industry leader (Bard) has on the market. Catheters are the known device in the medical world, have a long history, are prevalent in the distribution channel, have reimbursement codes set up and are trusted. However, CAUTI is a real and costly problem with catheters which could potentially make a suitable alternative attractive, if brought to the market properly.
Finally, it should be mentioned that during the research conducted on competitive and substitute UI devices, nothing similar to the UriCap-F was found. An non-invasive, exdwelling female urine drainage device is truly novel to industry.
Transcatheter aortic valve replacement or TAVR is the latest technology used principally for the treatment of aortic stenosis, a condition in which one of the major valves of the heart, the aortic valve, becomes tight and stiff, usually as a result of aging (3). Since many patients who need aortic valve replacement for aortic stenosis are too sick to undergo major valve replacement surgery, they are unable to get the treatment they need. With the transcatheter aortic valve, this issue is bypassed because this valve can be implanted in the heart by accessing the patient’s heart through an artery in the groin. The valve can be inserted through a wire that can be pushed to the heart and the old valve is simply pushed to the side when the new valve is implanted. This technology has been in use in the US with Edwards’ Sapiens valve since 2011 and has saved the lives of many patients with aortic stenosis (4). Medtronic’s CoreValve uses similar technology and has won patent fights in Europe and has been in use internationally. However, within U.S., Medtronic has not been...
The unique design of the Rectal Rocket allows the suppository to remain in place and release medication directly to the inflamed tissues without lapsing into the rectum. The contoured front end is inserted into the rectum to treat internal hemorrhoids, while the larger flared base remains on the outer surface of the anus to treat external hemorrhoids. The specialized vent allows the Rectal Rocket to stay in place by allowing flatulence to escape without expelling the suppository. This ensures the suppository is in constant contact with the affected tissues. Superior Comfort =
Newspapers such as the New York Times published articles about “diseases” and their effects on everyday people. In the case of Detrol, reports of middle-aged people constantly having to empty their bladders lead many Americans to question their habits. Pharmacia used opinion polls and surveys as statistics, and several reporters used these surveys in their articles . Although the FDA warned Pharmacia that their claims did not have evidentiary support, the company continued to sell the disease and the drug to the American public. Companies such as Pharmacia were ruthless in their quest to sell their
As a result of Lily’s extensive hospitalisation period, a grade 3 pressure ulcers developed on her buttocks. A pressure ulcer is a localised injury to the skin which is usually located over a bony area as a result of pressure or pressure combined with friction (Willock et al., 2007). According to Sibbald et al., (2003) excreted bodily fluids are often common factors which contribute to the breakdown of skin, especially as a consequence of urinary or faecal incontinence. There were many factors which contributed to the breaking down of Lily’s skin, such as infrequent nappy changes and lack of mobilisation. Ensuring the maintenance of skin integrator within the critical care setting has its challenges. Often, patients are attached to multiple
Supports and enhances urinary flow. Say goodbye to the weak stream you have been having lately and experience relief as you urinate without the straining and the
Different studies had different result numbers or different percentage reduction rates which was primarily based on their indifferences in regards to study design utilized and sample size. As evidenced by research results (Magers, June 2013) and (Welden, 2013), these showed a reduction of urinary catheter days resulted in reduced CAUTI rates. Though different outcome results between the different research studies, they all strongly significantly supported the notion that a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter compared with a no protocol is essential to help in the reduction of CAUTIs. Interpreting these results, (Meddings et al., 2013) showed a drop greater than 52% in CAUTIs and a decrease in catheterization by 37%. The study results from the six scholarly research study articles showed nearly similar or corresponding outcomes. The results were significant enough to support the PICO question. In general, though the difference in sample size, the results still strongly supported excellent outcomes when a nurse-driven protocol is used to evaluate the necessity of continued urethral catheter use. (Chen et al., 2013, para.
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
Popp, W., Rasslan, O., Unahalekhaka, A., Brenner, P., Fischnaller, E., Fathy, M., . . . Gillespie, E. (2010). What is the use? An international look at reuse of single-use medical devices. International journal of hygiene and environmental health, 213(4), 302-307.
..., and as technology has improved, the machines have become smaller, portable and available for use at the patient's bedside.
There have been an incidents of prolonged hospital stay due to central line infections putting patients at risk for mortality, morbidity, and increase in medical cost. When central lines are placed at bedside or in interventional radiology, the inserter is required to document the steps and sterile procedure that took place in the electronic health record. Furthermore, with weekly and as needed dressing changes, nurses are required to use central line bundles and document what was used (ex: Chloraprep, biopatch, tegaderm, etc.) to track how the dressing was done. From these documented records, staff can gather data and measure the compliance of sterile procedure. Additionally, if a patient with a central line develops a fever without an unknown cause physician will order blood culture from the central line if catheter-related infection is suspected. If the test comes back positive, the team will initiate antibiotics immediately. By integrating electronic health records it can assist in CLABSI prevention strategies, raise the standard for best practices, and essentially reduce central line infections. With the quarterly results of CLABSI in our unit, CVC committee have re-educated the staff on appropriate dressing changes using sterile technique, transitioned to a different end
Loening-Baucke V. Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics 1997;100: 228-232
Interventions: Measure intake and output to make sure patient is voiding efficiently. Running warm water over perineal area to stimulate urination (Lowdermilk, Perry, Cashion & Alden,
The urinary tract is our body’s system for removing waste and excess fluids from our bodies, and the normal function of the urinary track depends on all of the various parts working together. The process begins in the kidneys where blood is filtered, producing one to two quarts of urine daily. From the kidneys, the urine the passes through thin tubes of muscle (ureters) to the bladder, a hollow, balloon-shaped organ that expands as it fills with urine. The bladder stores the urine until people find an appropriate time and place to urinate. However, problems in the normal function of the urinary track can be affected by urinary tract infections, or UTI’s
One day, this writer happened to see another nurse changing a Peripherally Inserted Central Catheter Line dressing. As a nurse leader, this writer asked the nurse why she is changing the dressing. The caregiver explained dressing changes can prevent infection to the site and there are lot of patients readmitted because of central line infections and subsequent complications. This nurse demonstrated good kn...