Perioperative Chemotherapy for Upper Tract Urothelial Cancer
Robert Dreicer, MD, MS, MACP, FASCO, highlights the complexities of managing high-grade urothelial carcinoma of the upper tract.
Read More
Charlottesville
Guidance on Troubleshooting Urostomy Management
Terran W. Sims, MSN, ACNP-C, CNN, COCN-C, provides comprehensive guidance on troubleshooting urostomy management, addressing the challenges faced by healthcare providers and patients. Her analysis focuses on practical strategies and evidence-based practices to optimize patient outcomes and improve the quality of life for those with urostomies.
Sims highlights the common complications associated with urostomies, such as skin irritation, stoma retraction, prolapse, and infections. She also discusses the selection of appropriate urostomy appliances.
Patient education is a cornerstone of Sims’s approach, underscoring the significance of empowering patients with the knowledge and skills necessary to manage their urostomies independently. Furthermore, Sims examines innovative solutions and emerging technologies that can enhance urostomy management, such as advanced wound care products and telehealth services.
Read More
Streamlining Management of the Neurogenic Patient Population with or without Incontinence
Mikel L. Gray, PhD, FNP, PNP, CUNP, CCN-AP, FAANP, delves into the management of neurogenic bladder dysfunction, with or without incontinence. He emphasizes the necessity for a comprehensive, multidisciplinary approach that integrates the latest advancements in diagnostics, therapeutics, and patient education to optimize clinical outcomes and enhance quality of life.
A focal point of Dr. Gray’s discourse is the importance of individualized care plans. Dr. Gray highlights the integration of pharmacological treatments, such as anticholinergics and beta-3 agonists, which are pivotal in managing symptoms of neurogenic bladder dysfunction. Additionally, he advocates for non-pharmacological interventions, including pelvic floor muscle training and neuromodulation therapies.
Looking ahead, Dr. Gray addresses emerging technologies and potential advancements in regenerative medicine. He highlights ongoing research and development efforts aimed at creating more effective and less invasive treatments, which could revolutionize care practices in the near future.
Read More
Chronic Catheter Patients Made Simple
Mikel L. Gray, PhD, FNP, PNP, CUNP, CCN-AP, FAANP, addresses the complexities of managing chronic catheter patients, offering insights and strategies to simplify their care. He discusses the types of catheters commonly used in chronic care, including indwelling urethral catheters, suprapubic catheters, and intermittent catheters, highlighting the indications for each type and providing guidance on selecting the most appropriate catheter based on individual patient needs and conditions.
Dr. Gray underscores the critical importance of infection prevention and best practices for catheter insertion and maintenance. He discusses the role of antimicrobial catheters and the appropriate use of prophylactic antibiotics in reducing infection rates and addresses the causes of catheter blockages.
Read More
In-Office Procedures and the ‘Scope’ of Practice for APPs
Terran W. Sims, NP, MSN, ACNP-C, CNN, COCN-C, discusses how to prepare and incorporate advanced practice providers (APPs) like nurse practitioners and physician assistants in urologic procedures. Ms. Sims begins by listing office procedures APPs might encounter, focusing on cystoscopy, stent removal, and difficult catheter insertion. She continues by posing a guiding question for her discussion: what is the best fit for APPs in practice?
Ms. Sims then briefly reviews differences in the scope of practice for APPs across the U.S., noting important state licensure requirements and highlighting the increasing presence of APP participation in urologic procedures. She emphasizes the American Urological Association’s (AUA) and Society of Urologic Nurses and Associates’ (SUNA) support for APP involvement, and utilizes cystoscopy as an example by detailing data that show increased levels of patient satisfaction as APPs have performed greater numbers of cystoscopy procedures.
Ms. Sims concludes by addressing the primary obstacles to additional APP role expansion: the lack of training and lack of standard curriculum. She encourages urologists to overcome these obstacles and invest in APPs by providing training, instilling confidence, and maintaining mentorship. She reiterates the benefits of APP involvement, including increased cost-effectiveness, profit margins, and team productivity.
Read More