Effectiveness of the Maguerez Arch in nursing teaching on vesical catheterism: an almost experimental study

Sousa, Jonatan Deyson do Nascimento de; Fernandes, Cristina da Silva; Ximenes, Maria Aline Moreira; Caetano, Joselany Áfio; Galindo Neto, Nelson Miguel; Barros, Lívia Moreira

doi:10.1590/1983-1447.2021.20200105

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Revista Gaúcha de Enfermagem

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Original Article • Rev. Gaúcha Enferm. 42 • 2021 • https://doi.org/10.1590/1983-1447.2021.20200105 copy

Effectiveness of the Maguerez Arch in nursing teaching on vesical catheterism: an almost experimental study

Eficacia del Arco de Maguerez en la enseñanza de enfermería en cateterismo vesical: un estudio casi-experimental

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To evaluate the effectiveness of the Arco de Maguerez in teaching nursing students about the Bladder Catheter.

Method

Quasi-experimental study conducted at a public university in northeastern Brazil, with 29 students, in a single group, in the period of october 2018. Data were collected before and after using the Arco de Maguerez in educational intervention, using validated instruments, referring to knowledge and practice. IBM SPSS Statistics software version 24 was used for statistical analysis. The level of significance was set at 5% and the 95% confidence interval. Data analysis was performed using the McNemar and Mann-Whitney test.

Results

The median of correct answers for knowledge was 7, in the pre-test, and 9 in the post-test (p> 0.001). Regarding practice, in the pre-test the median of correct answers was 28 and, in the post-test, it went to 36, p> 0.001. The academics explained that the AM technology based on the problematization of a fictitious clinical case made learning about Bladder Catheterization Delay clear and feasible.

Conclusion

The Arco de Maguerez was effective in improving the knowledge and skill of nursing students regarding the Bladder Catheter.

Keywords
Nursing; Urinary catheterization; Students nursing; Teaching materials; Educational technology

Stage	Objectives	Activities performed
Observation of reality and definition of a problem	Approaching the theme and identifying problems.	- Contact of students with reality similar to clinical practice, from clinical case. - Clinical, critical, and holistic observation of the case in question. - Identifying the problem about diuresis.
Key points	Reflecting on the identified problems and defining the key points for research.	- Group discussion on the case. - Identifying the main problems related to urinary changes. - Recognizing care needs.
Theorization	Investigating each key point, finding reliable information, and analyzing it to solve the problems.	- Contact of students with the scientific literature, from available scientific articles. - Discussion on the topic among students.
Solution hypotheses	Suggesting interventions to solve or reduce the damage of the problems for patients.	- Suggesting nursing interventions. - Reflecting on health promotion actions and active participation of the patient in care.
Application to reality	Expected return based on practice applied to reality.	- Practice and record of indwelling urinary catheterization. - Presentation of the expected results in practice based on the proposed nursing interventions. - Socialization of constructed knowledge, in talk session.

Questions	Pre-test n(%)	Post-test n(%)	p-value*
1. Selection of materials required for IUC	24 (82.8%)	26 (89.7%)	0.500
2. Preparation of the environment and materials before starting IUC	18 (62.1%)	19 (65%)	1.000
3. Correct sequence of the IUC technique	6 (20.7%)	17 (58.6%)	0.001
4. First step to avoiding UTI	25 (86.2%)	24 (82.8%)	1.000
5. Patient preparation for IUC	22 (75.9%)	23(79.3%)	1.000
6. Criteria for switching probes	1 (3.4%)	6 (20.7%)	0.125
7. Care of materials for catheterization	18 (62%)	27 (93.1%)	0.120
8. Correct sequence of penis cleansing	13 (44.8%)	18 (62.1%)	0.180
9. Material handling during IUC	8 (27.6%)	27(93.1%)	<0.001
10. Positioning of the penis during catheter insertion	7 (24.1%)	27(93.1%)	<0.001
11. Care in completion/fixation of the IUC	7 (24.1%)	21(72.4%)	0.004
12. Care after passage of IUC	28 (96.6%)	27(93.1%)	1.000

Questions	Pre-test n(%)	Post-test n(%)	p-value*
1. Checked prescription with IUC	11 (37.9%)	21 (72.4%)	0.031
2. Sanitized hands	16 (55.2%)	29 (100%)	<0.001
3. Identified and evaluated the user	26 (89.7%)	29 (100%)	0.250
4. Identified himself or herself to patient	27 (93.1%)	28 (96.6%)	1.000
5. Provides guidelines to patient about the procedure	27 (93.1%)	28 (96.6%)	1.000
6. Obtained patient consent	28 (96.6%)	28 (96.6%)	1.000
7. Prepared the necessary material	19 (65.5%)	29 (100%)	0.002
8. Ensured privacy	28 (96.6%)	28 (96.6%)	1.000

Questions	Pre-test n(%)	Post-test n(%)	p-value*
1. Positioned the patient	6 (20.7%)	12 (41.4%)	0.146
2. Put on procedure gloves	2 (6.9%)	27 (93.1%)	<0.001
3. Performed intimate hygiene	22 (75.9%)	24 (82.8%)	0.754
4. Took off the gloves	22 (75.9%)	22 (75.9%)	1
5. Sanitized hands	23 (79.3%)	23 (79.3%)	1
6. Placed the tray next to the patient	13 (44.8%)	24 (82.8%)	0.019
7. Correctly opened catheterization material and other materials	16 (55.2%)	29 (100%)	<0.001
8. Placed the catheter inside the tray	10 (34.5%)	27 (93.1%)	<0.001
9. Placed antiseptic in round tub or gauze	17 (58.6%)	27 (93.1%)	0.013
10. Put on sterile gloves	19 (65.5%)	29 (100%)	0.002
11. Tested the catheter balloon	21 (72.4%)	29 (100%)	0.008
12. Connected the catheter to the collecting bag	17 (58.6%)	29 (100%)	<0.001
13. Prepared anesthetic/lubricant gel.	14 (48.3%)	27 (93.1%)	0.001
14. Prepared ampoule of distilled water	20 (69%)	26 (89.7%)	0.109
15. Performed antisepsis	21 (72.4%)	26 (89.7%)	0.180
16. Correctly disposed of used gauze	11 (37.9%)	28 (96.6%)	<0.001
17. Placed fenestrated drape	22 (75.9%)	27 (93.1%)	0.180
18. Replaced possibly contaminated material	11 (37.9%)	20 (69%)	0.049
19. Injected anesthetic gel/lubricant into the patient's urethral meatus	18 (62.1%)	26 (89.7%)	0.039
20. Inserted catheter into urinary meatus after positioning the penis correctly	15 (51.7%)	22 (75.9%)	0.118
21. Inflated balloon with distilled water	15 (51.7%)	29 (100%)	<0.001
22. Positioned non-dominant hand correctly during the procedure	20 (69%)	29 (100%)	0.004
23. Gently pulled the probe until it reached the bladder neck	20 (69%)	29 (100%)	0.004
24. Did not contaminate material during the procedure	19 (65.5%)	26 (89.7%)	0.065
25. Removed the fenestrated drape	12 (41.4%)	15 (51.7%)	0.664
26. Fastened the catheter to the supra-pubic region	18 (62.1%)	26 (89.7%)	0.039
27. Positioned the collecting bag correctly	21 (72.4%)	28 (96.6%)	0.039

Questions	Pre-test n(%)	Post-test n(%)	p-value*
1. Provided catheter care guidelines	23 (79.3%)	29 (100%)	0.031
2. Ensured the patient was comfortable, disposed of material	19 (65.5%)	23 (79.3%)	0.424
3. Sanitized hands	8 (27.6%)	23 (79.3%)	<0.001
4. Recorded the procedure	12 (41.4%)	20 (69%)	0.096

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author
Cristina da Silva Fernandes cristina.sednanref@gmail.com