Better bladder management for intrapartum and postpartum women

Pelvic floor dysfunction poses a significant global health challenge. Insufficient bladder care during labour and the postnatal period is associated with an increased risk of developing pelvic floor disorders, notably voiding dysfunction. This condition can have enduring adverse effects on a woman's quality of life, and wellbeing. When postpartum urinary retention goes untreated, it may result in repetitive overdistension injuries and permanent damage to the detrusor muscle.

Consequently, there is a pressing need to raise awareness about the importance of bladder care during labour and the postpartum period. Furthermore, strategies should be developed to enhance the recognition of symptoms related to voiding dysfunction to promote timely intervention.

A best practice implementation project achieved substantial improvements in bladder management. The project was undertaken at a maternity hospital in Taiwan, and followed the 7-phase JBI framework for evidence implementation. Relational leadership theory, which integrates inclusion, empowerment, purposefulness, ethical behaviour, and process orientation, underpinned the project. 

The project considered challenges in perinatal bladder care from a nursing perspective, and helped intrapartum and postpartum women to reduce their incidence of urinary disorders and hospitals to improve their compliance with the evidence-based criteria for bladder management. The project may have helped nurses to reduce their workload relating to urinary problems in perinatal women and give birth centre staff a sense of achievement. All the team members decided to conduct follow-up audits every 6 months and continue to improve the quality of care they provided, based on the audit results.

Terry Olson provides a video commentary on the best practice implementation project.

A published paper on the project is available in the September issue of the JBI Evidence Implementation.

Enhancing bladder management for intrapartum and postpartum women at a maternity hospital in Taiwan

Pan, Wan-Lin; Chen, Li-Li; Wang, Chia-Hui; Mu, Pei-Fan; Tsay, Shwu-Feng; Gau, Meei-Ling

JBI Evidence Implementation 21(3):p 197-207, September 2023. | DOI: 10.1097/XEB.0000000000000357