CHS9 Undertake care for individuals with urinary catheters

Overview

This standard covers undertaking care of individuals’ with urinary catheters.  It is applicable in any care setting where an individual has a urinary catheter in position.  This standard involves emptying catheter bags, providing catheter hygiene and removing urinary catheters, as and when directed by a competent practitioner. This standard does not cover insertion of urinary catheters. All of these activities must be undertaken using an aseptic technique and following local guidelines and procedures. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. the current European and national legislation, national guidelines and local policies and protocols which affect your work practice in relation to undertaking care for individuals with urinary catheters
2. your responsibilities and accountability in relation to the current European and national legislation and local policies and protocols
3. the importance of working within your own sphere of competence and seeking advice when faced with situations outside your sphere of competence
4. what informed consent means and why it must be obtained and confirmed prior to actions being taken
5. the importance of applying standard precautions and the potential consequences of poor practice
6. how your personal beliefs may cause you difficulties with certain procedures and how you manage this conflict in practice
7. why individuals should be supported and told about the nature of the urinary catheter activity
8. the concerns and worries which individuals or client groups may have in relation to some clinical procedures
9. the contra-indications which suggest that you need to stop and seek help and advice and how these may differ for different individuals, conditions and those from different ethnic groups
10. the adverse effects which may occur during and following procedures and how to identify and deal with these
11. the effects of having a urinary catheter in position on the individual’s comfort and dignity, and ways of minimising any adverse effects
12. the anatomy and physiology of the bladder and urethra related to urinary catheter activities
13. the normal appearance and content of urine
14. potential abnormal appearance and content of urine depending on the individual’s presenting medical condition
15. how aseptic technique contributes to the control of infection
16. the potential sources of contamination when undertaking urinary catheter activity and appropriate measures to reduce or deal with them
17. the types of pathogens specific to the urinary system
18. the potential consequences of contamination of urinary catheters and drainage systems
19. the equipment and materials required for urinary catheter activity
20. why resources should be prepared before you start the activity
21. the personal protective clothing and additional protective equipment which may be worn for the individual’s and your protection
22. the importance of maintaining the correct level of cleanliness for urinary catheter
23. the importance of following procedures for urinary catheter activity exactly as specified, and the potential effects of not doing so
24. the importance of packing up used equipment and materials  and covering receptacles containing urine prior to leaving the immediate care area
25. how and where to dispose of:
    1. used equipment and materials
    2. urine
26. the importance of ensuring catheter drainage systems are:
    1. safely positioned to prevent ascending infection and accidental damage
    2. carefully positioned to maintain the dignity of the individual
27. why questions which are beyond your role or knowledge need to be passed onto the appropriate member of the care team
28. the importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff
29. the importance of keeping accurate and up to date records the specific records required for reporting on urinary catheter activities

Performance Criteria

You must be able to do the following:

1. apply standard precautions for infection control and take other appropriate health and safety measures
2. give the individual relevant information, support and reassurance in a manner which is sensitive to their needs and concerns
3. gain informed consent to carry out the planned urethral catheter activity
4. confirm all equipment and materials for urethral catheter activity is:
   1. appropriate to the procedure
   2. fit for purpose
5. ensure the individual is positioned in a way that will:
   1. ensure their safety and comfort
   2. facilitate urinary catheter hygiene
   3. facilitate removal of the urinary catheter
6. carry out the urethral catheter activity:
   1. at an appropriate time according to the individual’s plan of care
   2. using appropriate techniques
   3. using equipment in line with manufacturer’s instructions
   4. in a manner which optimises the patient’s comfort and dignity and minimises pain and trauma
7. observe the individual throughout the activity, recognise and report any condition or behaviour which may signify adverse reactions to the activity and take the appropriate action
8. ensure the urinary catheter and drainage system are:
   1. functioning correctly
   2. securely attached
   3. securely positioned in a way that prevent discomfort and promotes dignity of the individual
9. ensure the individual is made comfortable following urethral catheter activity and dispose of waste according to agreed procedures
10. educate the individual as far as possible on the care of the catheter and attachments
11. empty drainage bags and measure and record urinary output whenever necessary at agreed intervals, or as directed by an appropriate member of staff
12. observe urinary output for any change in appearance and promptly inform the appropriate member of the care team
13. measure and record the volume of urine using the required documentation
report your findings and activity to the appropriate member of the care team

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB5: Provision of Care to Meet Health and Wellbeing Needs