Medical Student Research Fellowship for Summer 2005

Mentor: Vivyenne Roche
Department: Geriatrics Section, Internal Medicine
Room number: Charles Sprague building 8.202
Mail Code: 8889
Phone number:214 648 9012
E-mail: Vivyenne.Roche@utsouthwestern.edu

Two projects

Project I title: Urinary symptoms and effect on quality of life

Human subjects IRB approved project number (where applicable):

Animal subjects IRB approved project number (where applicable): n/a

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient-based

Brief Description of Project: Urinary symptoms are very common but elderly patients frequently accept urinary symptoms as normal aging and fail to seek help. In 2004 we collected data on more than 100 patients about frequency and bother of urinary problems in a community based elderly cohort who did not present with urinary problems using the AUA symptom index and UDI-6 questionnaires and an assessment of their quality of life. Urogenital Distress Inventory- 6, UD1-6 is a validated questionnaire that assesses lower urinary tract symptoms, including incontinence, in women, and has also been studied in men. American Urolologic Association (AUA) symptom index score is a 7-item questionnaire validated in men to assess lower urinary tract symptoms including urinary incontinence and has also been used in women. AUA has been performed in women and evaluates the aging bladder. Quality of life is a visual scale from 0-10 to reflect their feelings about their urinary problem. This study is designed to assess the stability of this questionnaire in the same cohort a year later. Although these questionnaires are frequently used by urologists their stability over time is unknown.

Work closely with Dr Roche. Prepare Abstract for submission to the American Geriatric Society annual meeting.
Previous Research Activities or Publications with Medical Students: Worked with 2 medical students last year, 2 posters are accepted for national meeting presentation.May 2005, one for a presidential poster award

Project II title:Foley catheter intervention

Human subjects IRB approved project number expedited review

Animal subjects IRB approved project number (not applicable):

Project Type patient-based research

Brief Description of Project: Foley catheters may be placed for invalid reasons like urinary incontinence and incur discomfort, inadvertent removal, hematuria, urology consult, infection, false passage and unnecessary cost. This study is based on student research from last summer on Foley catheter use at PMH. We found that Foley catheters were inappropriately placed in some patients, some patients had adverse outcomes such as inappropriate duration and some were unaccompanied by MD orders for placement and removal. This study is designed to institute a Foley catheter template for use in acutely ill medical patients to optimize their use. The 4 indications for Foley catheter placement will be on the form 1)Neurogenic bladder/obstructive uropathy 2) Fluid status monitoring in acutely ill patients that directly impacts medical treatment (result in a change of treatment within 48 hours) 3) Stage 3 or Stage 4 pressure ulcers located on the buttocks 4) Dying patients. Forms will include placement and removal orders and an automatic removal after 3 days if not renewed by the medical team. We will then assess if we have improved the appropriateness of Foley catheter placement by chart review.

Duration: 6 weeks or until 100 patients enrolled.

Prepare Abstract for submission to the American Geriatric Society annual meeting.

Patients do not have to sign a consent form so we anticipate an expedited IRB approval.

Previous Research Activities or Publications with Medical Students:

Work closely with Dr Roche. Prepare Abstract for submission to the American Geriatric Society annual meeting.
Worked with 2 medical students last year, 2 posters are accepted for national meeting presentation.May 2005, one for a presidential poster award

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