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. 2025 Aug 7.
doi: 10.1097/PEC.0000000000003461. Online ahead of print.

Nurse-Performed Bladder Ultrasound Effect on Pediatric Bladder Catheterization Success

Carrie Ng  1   2 , Grace Promer  1   2 , Brent Troy  3 , Abby Lewis  1   2 , Ashley Hoyos  2 , Laura Covelo  2 , Olivia Carlson  2 , Naina R Reddy  2 , Calvin Abdallah  2 , Avnee Sarnaik  2 , Jeffrey Ling  2 , Andrew Jergel  4 , Claudia R Morris  1   2 , Tal E Berkowitz  1   2
Affiliations

Nurse-Performed Bladder Ultrasound Effect on Pediatric Bladder Catheterization Success

Carrie Ng et al. Pediatr Emerg Care. .

Abstract

Background and objectives: Bladder catheterization (BC) is a routine procedure, but unsuccessful attempts due to inadequate bladder volume are common and stressful for children and caregivers. Physician-performed bladder point-of-care ultrasound (POCUS) improves BC success rates, but the effect of nurse-performed POCUS remains understudied.

Methods: We randomized children under 24 months of age to receive either nurse-performed POCUS before BC or standard blind BC in the pediatric emergency department to compare dry catheterization rates. A simplified POCUS technique using a single bladder measurement was employed to enhance efficiency and feasibility for nursing staff. We also compared caregiver satisfaction and procedural time between groups. Statistical comparisons used the Pearson χ 2 test for categorical variables and the Wilcoxon rank sum test for continuous variables. A P value of <0.05 was considered statistically significant. Univariate logistic regression estimated the odds of outcomes with POCUS versus standard care.

Results: In the POCUS group, the dry catheterization rate was 5% compared with 17% in the standard group (odds ratio=0.24, 95% CI=[0.09, 0.72]), indicating fewer dry BCs in the POCUS group. Caregivers of children in the POCUS group reported higher satisfaction ( P =0.02). There was no significant difference in the time from BC orders to initial BC attempt between groups.

Conclusions: Nurse-performed POCUS before BC reduces dry BCs and improves caregiver satisfaction without causing procedural delays. Incorporating nurse-performed POCUS into standard BC workflows may enhance patient care.

Keywords: bladder catheterization; point-of-care ultrasound; ultrasound.

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Conflict of interest statement

Disclosure: C.R.M. is the inventor or co-inventor of several UCSF-Benioff Children’s Hospital Oakland patents that include nutritional supplements and is an inventor/co-inventor of several Emory University School of Medicine patents/patent-pending applications for nutritional supplements for autism, coronaviruses, and pain, is a consultant for CSL Behring, F. Hoffmann-La Roche Ltd, is on the Scientific Advisory Board of TRILITY, is an editor for the Sickle Cell Disease-Fever and Sickle Cell Disease-Pain reference for UpToDate, is the Founder and Executive Director for Food as Medicine Therapeutics, LLC, and has received research support from the US Food and Drug Administration, Health Resources & Services Administration (HRSA, agency of the US Department of Health and Human Services), and the National Institutes of Health. The remaining authors declare no conflict of interest.

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