B
CC04 Manage supra pubic catheters
Overview
This standard covers the managing of supra pubic catheters following agreed local protocols, procedures and guidelines. The management of supra pubic catheters includes changing, securing and monitoring such catheters. The initial insertion of a suprapubic catheter is a surgical procedure and is not addressed within this standard.
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:
- the current European and National legislation, national guidelines, organisational policies and protocols in accordance with clinical/corporate governance which affect your work practice in relation to the management of supra pubic catheters
- the importance of working within your sphere of competence and when to seek advice if faced with situations outside of your sphere of competence
- the importance of documentation, the data protection act, care of records and disclosure of information with consent from the individual and your employer and the legal and professional consequences of poor practice
- the anatomy and physiology of the male and female lower urinary tract in relation to lower urinary tract function and continence status including :
- urine production and what influences this
- normal micturition
- the nervous system including autonomic dysreflexia
- the bowel and its links to bladder problems
- skin
- the endocrine system
- sexual function and links catheter usage
- the prostate gland, urethral sphincters and the urethra
- applied anatomy and physiology to voiding dysfunction and how a supra pubic catheter could be used to relieve this
- anatomy and physiology links of how common catheter related complications occur
- how to advise individuals in the use of catheters in relation to their anatomy, its function and sensation
- the reasons why suprapubic catheterisation is necessary including; maintaining urethral integrity, urethral surgery, long term catheterisation, sexual needs
- lifestyle advice and activity and how this impacts on the function of the suprapubic catheter
- the short and long term risks and health implications associated with suprapubic catheterisation and intermittent or continual bladder drainage
- how to manage over granulation of the cystostomy tract
- the adverse effects and potential complications that may occur during suprapubic catheterisation and appropriate actions
- how to minimise any unnecessary discomfort during and after the procedure
- how to terminate the usage of a suprapubic catheter in an effective and safe manner
- how to assess the function of a supra pubic catheter and the methods available to undertake this
- the types of catheters, urinary drainage bags, link systems and catheter valves that can be used and why you should select the appropriate catheter
- how to obtain, store and dispose of catheter care equipment
- the types of support methods, including garments, straps and stands, used in conjunction with urinary drainage systems
- the types of sterile dressings, indications for use, aseptic care and when to change them in relation to a cystostomy site
- the indications, mode of action, side-effects, cautions, contra indications and potential interactions of medication, antibiotics, anaesthetic agents and associated solutions used for individuals with suprapubic catheters
- how to obtain valid consent, that the individual has the ability to consent and cooperate and how to confirm that sufficient information has been provided on which to base this judgement
- the importance of respecting individuals’ privacy, dignity, wishes and beliefs and how to do so
- the effects of catheterisation on the individual’s comfort and dignity
- the ethical issues surrounding catheterisation as applied to individuals
- those who may accompany the individual (e.g. carers, chaperones) and be present during the process and how to work with them
- the causes of urinary tract invasion from bacteria and how to minimise this in all care settings
- the importance of applying standard precautions for infection control and the potential serious life threatening consequences of poor practice
- how to meet standards of environmental cleanliness in the area where catheterisation is to take place to minimise the infection risk
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when to undertake urinalysis, obtain a catheter specimen of urine (CSU) or screen for multi resistant bacteria
Performance Criteria
You must be able to do the following:
- apply standard precautions for infection prevention and control and take other appropriate health and safety measures
- comply with the correct protocols and procedures relating to managing a supra pubic catheter
- ensure that the environment is suitable, and that comfort and dignity are maintained throughout the procedure
- observe the cystostomy site for any abnormalities and take the appropriate action
- remove the previous indwelling supra pubic catheter in accordance with protocols
- observe the catheter on removal and contain any leakage from the cystostomy
- aseptically clean the site for insertion of the new catheter and administer appropriate lubrication or anaesthetic gel
- insert the catheter safely, aseptically and correctly, according to manufacturer’s instructions and with minimal discomfort and trauma to the individual
- ensure the catheter is in the correct position using the appropriate indicators before balloon inflation
- inflate the balloon according to manufacturers instructions
- attach the catheter correctly to the appropriate drainage system or catheter valve and confirm it is functioning correctly
- dispose of the used catheter and associated equipment and materials safely and correctly
- monitor the individual’s condition as part of catheter care
- recognise any adverse effects and potential complications and take the appropriate action
- maintain supra pubic catheters and associated equipment in accordance with protocols and as part of scheduled catheter care
- record clearly, accurately and correctly any relevant information in the necessary ongoing catheter care records
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advise the individual and relevant others in the care and use of their catheter, common complications and actions to take
Additional Information
This National Occupational Standard was developed by Skills for Health in partnership with the Royal College of Nursing in December 2007.
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