Participatient

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Participatient is a smartphone app to involve patients in decision making during their hospital stay. The app was created as an academic project in the Netherland to use eHealth as a tool to stimulate patient engagement. This project started at the Dutch Hacking Health (DHH) and won the 2016 DHH award for best eHealth innovation, under the name 'Bedpartner'. [1] [2]

The Participatient app has modules with information on the ward and the admission, pain medication, and urinary catheter use, with the goal to stimulate patient participation and make the hospital stay safer and more pleasant. The app is designed to encourage communication and awareness in patients and medical staff. This was be evaluated in the PECCA project (Patient Engagement Counter CAUTI with an App), [3] supported by the Netherlands organisation for health research and development (ZonMw). [4]

In the PECCA study, urinary tract infections significantly decreased after the implementation of patient-centred app, together with clinical lessons, feedback via e-mails and support rounds for staff members. Although, the project did not significantly reduce the prevalence of inappropriate urinary catheter use. However, the inappropriate catheter reduction of 5.8% and an odds ratio of 0.27 suggest a positive trend. Patient participation appears to reduce CAUTI and could reduce other healthcare-associated infections. [3]

Participatient is one of the founding projects of the Dutch National eHealth Living Lab (NeLL). [5]

Related Research Articles

<span class="mw-page-title-main">Urinary tract infection</span> Infection that affects part of the urinary tract

A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyelonephritis). Symptoms from a lower urinary tract infection include suprapubic pain, painful urination (dysuria), frequency and urgency of urination despite having an empty bladder. Symptoms of a kidney infection, on the other hand, are more systemic and include fever or flank pain usually in addition to the symptoms of a lower UTI. Rarely, the urine may appear bloody. Symptoms may be vague or non-specific at the extremities of age.

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The medical uses of silver include its use in wound dressings, creams, and as an antibiotic coating on medical devices. Wound dressings containing silver sulfadiazine or silver nanomaterials may be used to treat external infections. The limited evidence available shows that silver coatings on endotracheal breathing tubes may reduce the incidence of ventilator-associated pneumonia. There is tentative evidence that using silver-alloy indwelling catheters for short-term catheterizing will reduce the risk of catheter-acquired urinary tract infections.

<span class="mw-page-title-main">Urinary catheterization</span> Insertion of a catheter through the urethra to drain urine

In urinary catheterization, a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into the bladder through the urethra to allow urine to drain from the bladder for collection. It may also be used to inject liquids used for treatment or diagnosis of bladder conditions. A clinician, often a nurse, usually performs the procedure, but self-catheterization is also possible. A catheter may be in place for long periods of time or removed after each use.

Bloodstream infections (BSIs) are infections of blood caused by blood-borne pathogens. The detection of microbes in the blood is always abnormal. A bloodstream infection is different from sepsis, which is characterized by severe inflammatory or immune responses of the host organism to pathogens.

<i>Klebsiella pneumoniae</i> Species of bacterium

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<i>Proteus vulgaris</i> Species of bacterium

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<span class="mw-page-title-main">Hospital-acquired infection</span> Infection that is acquired in a hospital or other health care facility

A hospital-acquired infection, also known as a nosocomial infection, is an infection that is acquired in a hospital or other healthcare facility. To emphasize both hospital and nonhospital settings, it is sometimes instead called a healthcare-associated infection. Such an infection can be acquired in a hospital, nursing home, rehabilitation facility, outpatient clinic, diagnostic laboratory or other clinical settings. A number of dynamic processes can bring contamination into operating rooms and other areas within nosocomial settings. Infection is spread to the susceptible patient in the clinical setting by various means. Healthcare staff also spread infection, in addition to contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or in some cases, the source of the infection cannot be determined. In some cases the microorganism originates from the patient's own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier. Though the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it develops in the health care setting. The term nosocomial infection is used when there is a lack of evidence that the infection was present when the patient entered the healthcare setting, thus meaning it was acquired or became problematic post-admission.

<span class="mw-page-title-main">Urinary retention</span> Inability to completely empty the bladder

Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of urinary tract infections.

<span class="mw-page-title-main">Foley catheter</span> Medical device

In urology, a Foley catheter is one of many types of urinary catheters (UC). The Foley UC was named after Frederic Foley, who produced the original design in 1929. Foleys are indwelling UC, often referred to as an IDCs. This differs from in/out catheters. The UC is a flexible tube if it is indwelling and stays put, or rigid if it is in/out, that a clinician, or the client themselves, often in the case of in/out UC, passes it through the urethra and into the bladder to drain urine.

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An Indiana pouch is a surgically-created urinary diversion used to create a way for the body to store and eliminate urine for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrophy or who are not continent due to a congenital, neurogenic bladder. This particular urinary diversion results in a continent reservoir that the patient must catheterize to empty urine. This concept and technique was developed by Drs. Mike Mitchell, Randall Rowland, and Richard Bihrle at Indiana University.

<span class="mw-page-title-main">Neurogenic bladder dysfunction</span> Bladder disorder due to disease or injury of the nervous system

Neurogenic bladder dysfunction, often called by the shortened term neurogenic bladder, refers to urinary bladder problems due to disease or injury of the central nervous system or peripheral nerves involved in the control of urination. There are multiple types of neurogenic bladder depending on the underlying cause and the symptoms. Symptoms include overactive bladder, urinary urgency, frequency, incontinence or difficulty passing urine. A range of diseases or conditions can cause neurogenic bladder including spinal cord injury, multiple sclerosis, stroke, brain injury, spina bifida, peripheral nerve damage, Parkinson's disease, multiple system atrophy or other neurodegenerative diseases. Neurogenic bladder can be diagnosed through a history and physical as well as imaging and more specialized testing. In addition to symptomatic treatment, treatment depends on the nature of the underlying disease and can be managed with behavioral changes, medications, surgeries, or other procedures. The symptoms of neurogenic bladder, especially incontinence, can severely degrade a person's quality of life.

<span class="mw-page-title-main">Overactive bladder</span> Condition where a person has a frequent need to urinate

Overactive bladder (OAB) is a common condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. The frequent need to urinate may occur during the day, at night, or both. Loss of bladder control may occur with this condition. This condition is also sometimes characterized by a sudden and involuntary contraction of the bladder muscles, in response to excitement or anticipation. This in turn leads to a frequent and urgent need to urinate.

Enterococcus faecium is a Gram-positive, gamma-hemolytic or non-hemolytic bacterium in the genus Enterococcus. It can be commensal in the gastrointestinal tract of humans and animals, but it may also be pathogenic, causing diseases such as neonatal meningitis or endocarditis.

<span class="mw-page-title-main">Cystometry</span> Medical evaluation of bladder function

Cystometry, also known as flow cystometry, is a clinical diagnostic procedure used to evaluate bladder function. Specifically, it measures contractile force of the bladder when voiding. The resulting chart generated from cystometric analysis is known as a cystometrogram (CMG), which plots intravesical pressure against the volume of fluid in the bladder.

<span class="mw-page-title-main">Purple urine bag syndrome</span> Medical condition

Purple urine bag syndrome (PUBS) is a medical syndrome where purple discoloration of urine collection bag occurs in people with urinary catheters and co-existent urinary tract infections. PUBS is most prevalent in elderly females with constipation. Constipation alters the gut bacteria, reducing gastrointestinal motility and leading to increased growth of bacteria in the colon. High bacterial counts in urine are the most important factor causing purple urine bag syndrome. Bacteria in urine produce the enzyme indoxyl sulfatase. This converts indoxyl sulfate in the urine into the red and blue colored compounds indirubin and indigo. People with urinary tract infections using catheters will increase the conversion of indoxyl sulfatase to indirubin and indigo. Indirubin dissolves in plastic and therefore causes urine discoloration. The purple discoloration is the result of reaction between indirubin and plastic urine bags, as well as the presence of indigo. Bacteria in the urine can be found through bacteria culture test. People with purple urine bag syndrome may present with elevated bacterial loads on their culture tests when compared to those who are not affected by this syndrome. The most commonly implicated bacteria are Providencia stuartii, Providencia rettgeri, Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli, Morganella morganii, and Pseudomonas aeruginosa. Purple urine bag syndrome treatment should aim for underlying issues rather than the condition itself. The purple discoloration is harmless and can be resolved with treatments targeted to specific bacteria or any underlying medical conditions. Treatment also consists of providing comfort to both patients and their family, administering antibiotics and performing regular catheter changes. The prognosis is good, however, the morbidity and mortality rates associated with PUBS are elevated depending on patient's underlying health status.

Suprapubic aspiration is a procedure to take a urine sample. It involves putting a needle through the skin just above the pubic bone into the bladder. It is typically used as a method to collect urine in child less than 2 years of age who is not yet toilet trained in an effort to diagnose a urinary tract infection.

Catheter-associated urinary tract Infection, or CAUTI, is a urinary tract infection associated with urinary catheter use.

An infection rate or incident rate is the probability or risk of an infection in a population. It is used to measure the frequency of occurrence of new instances of infection within a population during a specific time period.

Healthy.io is a health care company offering remote clinical testing and services enabled by smartphone technology. Launched in 2013 by founder and CEO Yonatan Adiri, the company uses smartphones to enable at-home diagnostics testing for the detection of signs of kidney disease, urinary tract infections, and pregnancy complications. Its digital wound management solution is used by medical personnel to measure and track wounds using a smartphone.

References

  1. "Terugblik: Dutch Hacking Health 2016 - TrendITion". smarthealth.nl. Retrieved 2018-04-20.
  2. "www.lumc.nl/cen/att/1015200/lumc-magazine". lumc.nl. Retrieved 2018-04-20.
  3. 1 2 Bentvelsen, R.G.; Laan, B.J.; Bonten, T.; van der Vaart, R.; Hetem, D.J.; Soetekouw, R.; Geerlings, S.E.; Chavannes, N.H.; Veldkamp, K.E. (May 2024). "Patient engagement to counter catheter-associated urinary tract infections with an app (PECCA): a multicentre, prospective, interrupted time-series and before-and-after study". Journal of Hospital Infection. 147: 98–106. doi: 10.1016/j.jhin.2023.11.005 . hdl: 1887/3754891 . ISSN   0195-6701 . Retrieved 19 October 2024. Creative Commons by small.svg  This article incorporates textfrom this source, which is available under the CC BY 4.0 license.
  4. "Reducing the risk of catheter-associated urinary tract infections via a smartphone application for patients – Participatient". ZonMw. Retrieved 2018-04-20.
  5. "Participatient - NeLL". nationalehealthlivinglab.nl. Retrieved 2018-04-20.