Urodynamics testing is performed in clinics and hospitals all across the globe, and the specifics of the testing can vary wildly. Often these specifics don't impact the final result, but often they do and often certain practices can have very detrimental results. Here at BHN we have a very long list of Best Practices that we use for the urodynamics testing we provide our clients. These best practices allow us to offer the best testing possible and help us be very efficient. Below we provide a short list of best practices that we think are very critical and can be helpful to others.
A subset of BHN's Best Practices:
- Urodynamics Procedure Objectives - Urodynamics should only be performed when documented medical indications (such as lower urinary tract dysfunction) are present and a set of well-defined “urodynamic questions” are available and need to be answered by the results of the urodynamic study. In other words, you should have specific questions you are trying to answer with the study.
- Urine Collection and Funnel Placement - For Uroflow and Voiding Cystometry, you should take special care in positioning the patient so that the funnel does not touch the urine collection beaker, causing data artifacts and leading to erroneous data being recorded.
- Catching Data Artifacts in Real-Time - Data artifacts can occur for many reasons (e.g. catheter problems, patient movement, equipment issues ). Any artifact that occurs should be recognized and corrected immediately, even if that means repeating that portion of the test. This prevents the famous GIGO (garbage in garbage out) problem.
- Proper Patient Input - A good urodynamic study should be performed interactively with the patient and the patient’s symptoms should be reproduced during the procedure. The nurse must be skilled at eliciting full and complete responses from the patient. Many patients are intimidated by medical procedures, so encouragement is often needed.
- Proper Protocol - A urodynamic filling study should include all of the following:
- minimum of three pressures(Pabd, Pves, Pdet)
- volume infused
- maneuvers (with proper maneuver documentation) to reproduce incontinence symptoms
- volume voided in the presence of incontinence
- recording of all standard information about sensations and recording of additional comments about symptoms