Analysis of surveys conducted with users and healthcare personnel on a new urine collection bag.
Introduction with topic, purpose or objective
- At the dawn of history, the human species lacked sphincter control. This control led to radical improvements in aesthetics and social aspects, but above all, in hygiene and sanitation. This brought with it the problem of having to hold it until reaching the right place to relieve one’s physiological needs.
- The challenges of collecting urine in a controlled manner in people with limited autonomy have led to the emergence of a multitude of devices dedicated to this purpose.
- These devices have evolved from Ambrosio Paré’s collector to the ones used today.
- Currently, the most commonly used devices are rigid containers, which are either disposable or require cleaning after use.
- Our proposal is to use a recyclable plastic bag with a non-return system, single-use, disposable, to collect urine in men.
- The objective of this study is to compare the analysis of preferences and opinions of healthcare professionals (nurses, nursing assistants, and healthcare assistants) regarding the use of bottles or gourds and the new bag with that conducted with patients and/or users.
- From this study, we will obtain information that will allow us to measure:
- The different views of the same product.
- The product’s quality, with a comprehensive review.
- Other applications.
- Possible improvements.
- We note that there is no bibliographical background.
Keywords:
Bag, Diuresis bag, Excretory bag, diuresis, urine bag.
Material and methods
It is a descriptive-analytical cross-sectional study.
Study Population:
- Male patients admitted to the General and University Hospital of Valencia with limited autonomy and undergoing oncological treatments, both inpatient and outpatient.
- Healthcare professionals providing direct patient care.
Study Period:
- From June 1 to July 31, 2002, for users.
- From July 15 to July 31, for healthcare professionals.
Sample:
- Non-probabilistic, criterion-based sampling:
- 150 healthcare professionals (nurses and nursing assistants) out of a total of 600, representing 25%.
- 120 users out of a total of 570, representing 21.05%.
- Although initially, doctors and other healthcare assistants were included in the study as part of the healthcare personnel group, a later review decided to exclude them since they do not typically handle this type of device.
Source of Information:
- A self-developed questionnaire consisting of 8 questions:
- 6 dichotomous questions.
- 2 open-ended questions.
Completion Method:
- Self-completion: The questionnaire was distributed to both patients and healthcare professionals along with three bags, which they used before filling out the survey.
- Since the same questionnaire was given to both groups, this allowed for direct comparison and analysis.
Collection Method:
- Surveys were collected in person by visiting hospital units to minimize data loss.
Analysis:
- To analyze differences, nurses and nursing assistants were grouped into a single category: “professionals”.
- Likewise, hospitalized patients and outpatient clinic patients were combined into a single group: “patients”.
- A bilateral hypothesis test was applied using Fisher’s exact test for statistical contrast
Results:
A total of 325 questionnaires have been completed. Some questions were not answered by all respondents, so the total number of responses ranges between 325 and 310.
A total of 109 professionals (35.16%) and 201 patients (64.84%) were surveyed. All patients were male, as the study did not include family members.
1st Question
Do you consider the new bag comfortable?
Responses:
- Professionals: Yes, 82% – No, 18%
- Users: Yes, 94% – No, 6%
The majority of respondents stated that the new bag is more comfortable, with a statistically significant difference. The highest percentage (98.4%) corresponds to outpatient clinic patients (oncology treatments), while the lowest percentage is among nurses (75%).
2nd Question
Do you think it is more hygienic than the previous container?
Responses:
- Professionals: Yes, 99% – No, 1%
- Users: Yes, 95% – No, 5%
It is widely considered to be more hygienic, with no statistically significant difference. Although the percentage of responses in favor of the new bag is very high, the almost unanimous agreement among nurses is particularly noteworthy.
3rd Question
Do you think it is easier to use?
Responses:
- Professionals: Yes, 66% – No, 34%
- Users: Yes, 88% – No, 12%
Among professionals, 66% believe it is easier to use, while a notable 34% disagree. Within the professional group, 54% of nurses believe it is easier to use, compared to 79% of nursing assistants.
This analysis is related to the following:
- Nursing assistants are primarily responsible for providing or placing bottles, bedpans, or the new bag for patients. They also benefit the most from the new system, as it reduces cleaning work, prevents spills with its anti-return system, and keeps urine in a closed system.
- Nurses place bedpans, bottles, or the new bag for patients who are in worse clinical condition. They have to hold the penis with their hand to insert it into the bag and do not initially associate the advantages of the change (greater asepsis and spill prevention).
4th Question
Do you think it is easier to dispose of?
Responses:
- Professionals: Yes, 93% – No, 7%
- Users: Yes, 96% – No, 4%
Both patients and professionals consider the new bag easier to dispose of and more discreet than the bottle, with no statistically significant difference.
5th Question
Do you consider it more discreet than the previous container?
Responses:
- Professionals: Yes, 95% – No, 5%
- Users: Yes, 95% – No, 5%
An overwhelming majority consider the new bag more discreet than the previous container. It is difficult to find a logical explanation for the 5% who believe it is less discreet.
6th Question
Which do you prefer to use, the new bag or the previous container?
Responses:
- Professionals: The new bag, 80% – The previous container, 20%
- Users: The new bag, 91% – The previous container, 9%
The majority of respondents prefer using the new bag. Patients show a 91% preference compared to 80% among professionals, a statistically significant difference.
Additional Proposed Uses
Seven additional uses have been suggested, with the most notable being:
- “Collection of vomit during travel”
- “Spitting or expectorating”
The suggestions have been grouped into thirteen categories, with the most frequent being “increased capacity”.
It has also been verified that:
Advantages of the New Bag
1- The bag has an anti-spill system (a non-return valve that prevents urine from leaking once inside). The bottle or bedpan can tip over or spill when removed, causing discomfort for the patient, extra work for healthcare staff, and added costs (changing bed sheets, washing the patient, etc.).
2- The new bag eliminates bad odors. Since the urine does not oxidize when sealed, it does not come into contact with the air and, therefore, does not produce any odor.
3- The new bag is hygienically superior:
- For patients, it prevents possible cross-contamination between patients due to confusion with shared bottles or bedpans.
- For healthcare professionals, it eliminates the need to handle and clean reusable containers.
4- The new bag is an important tool in the fight against nosocomial infections.
5- The new bag leads to cost savings in human and material resources:
- Reduces work and time for nursing assistants.
- Saves on cleaning products, disinfection, water, packaging, and reduces the risk of cross-infection.
- Takes up significantly less space for transportation and storage.
6- The new bag improves the overall image of healthcare facilities.
7- The new bag eliminates the unsightly presence of a bottle or bedpan on bedside tables, in hospital rooms, etc.
8- In conclusion, we can affirm that the introduction of this bag opens new possibilities, similar to those brought by the introduction of diuresis bags for catheters, disposable syringes, etc.
Today, it would be unthinkable to wash and disinfect these products for reuse with other patients.
Conclusion and Discussion
In our hospitals, the number of male patients with mobility limitations is increasing, forcing them to use containers to collect urine. This also applies to home hospitalization, chronic care hospitals, and nursing homes (as they prefer to be called).
The results obtained in this study support the introduction of this new system, with comfort and hygiene being the most highly valued aspects.
It is also noteworthy that, although both groups predominantly prefer the new bag, patients are more in favor of the change than professionals.
The healthcare system is constantly evolving, with each new system improving on the previous one. Considering our results, the new bag can provide greater comfort and safety for men with limited mobility. Since it is single-use, it eliminates the risk of infection for both patients and healthcare staff.
