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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:

  1. 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
  2. the importance of working within your sphere of competence and when to seek advice if faced with situations outside of your sphere of competence
  3. 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
  4. the anatomy and physiology of the male and female lower urinary tract in relation to lower urinary tract function and continence status including :
    1. urine production and what influences this
    2. normal micturition
    3. the nervous system including autonomic dysreflexia
    4. the bowel and its links to bladder problems
    5. skin
    6. the endocrine system
    7. sexual function and links catheter usage
    8. the prostate gland, urethral sphincters and the urethra
    9. applied anatomy and physiology to voiding dysfunction and how a supra pubic catheter could be used to relieve this
    10. anatomy and physiology links of how common catheter related complications occur
  5. how to advise individuals in the use of catheters in relation to their anatomy, its function and sensation
  6. the reasons why suprapubic catheterisation is necessary including; maintaining urethral integrity, urethral surgery, long term catheterisation, sexual needs
  7. lifestyle advice and activity and how this impacts on the function of the suprapubic catheter
  8. the short and long term risks and health implications associated with suprapubic catheterisation and intermittent or continual bladder drainage
  9. how to manage over granulation of the cystostomy tract
  10. the adverse effects and potential complications that may occur during suprapubic catheterisation and appropriate actions
  11. how to minimise any unnecessary discomfort during and after the procedure
  12. how to terminate the usage of a suprapubic catheter in an effective and safe manner
  13. how to assess the function of a supra pubic catheter and the methods available to undertake this
  14. the types of catheters, urinary drainage bags, link systems and catheter valves that can be used and why you should select the appropriate catheter
  15. how to obtain, store and dispose of catheter care equipment
  16. the types of support methods, including garments, straps and stands, used in conjunction with urinary drainage systems
  17. the types of sterile dressings, indications for use, aseptic care and when to change them in relation to a cystostomy site
  18. 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
  19. 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
  20. the importance of respecting individuals’ privacy, dignity, wishes and beliefs and how to do so
  21. the effects of catheterisation on the individual’s comfort and dignity
  22. the ethical issues surrounding catheterisation as applied to individuals
  23. those who may accompany the individual (e.g. carers, chaperones) and be present during the process and how to work with them
  24. the causes of urinary tract invasion from bacteria and how to minimise this in all care settings
  25. the importance of applying standard precautions for infection control and the potential serious life threatening consequences of poor practice
  26. how to meet standards of environmental cleanliness in the area where catheterisation is to take place to minimise the infection risk
  27. 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:

  1. apply standard precautions for infection prevention and control and take other appropriate health and safety measures
  2. comply with the correct protocols and procedures relating to managing a supra pubic catheter
  3. ensure that the environment is suitable, and that comfort and dignity are maintained throughout the procedure
  4. observe the cystostomy site for any abnormalities and take the appropriate action
  5. remove the previous indwelling supra pubic catheter in accordance with protocols
  6. observe the catheter on removal and contain any leakage from the cystostomy
  7. aseptically clean the site for insertion of the new catheter and administer appropriate lubrication or anaesthetic gel
  8. insert the catheter safely, aseptically and correctly, according to manufacturer’s instructions and with minimal discomfort and trauma to the individual
  9. ensure the catheter is in the correct position using the appropriate indicators before balloon inflation
  10. inflate the balloon according to manufacturers instructions
  11. attach the catheter correctly to the appropriate drainage system or catheter valve and confirm it is functioning correctly
  12. dispose of the used catheter and associated equipment and materials safely and correctly
  13. monitor the individual’s condition as part of catheter care
  14. recognise any adverse effects and potential complications and take the appropriate action
  15. maintain supra pubic catheters and associated equipment in accordance with protocols and as part of scheduled catheter care
  16. record clearly, accurately and correctly any relevant information in the necessary ongoing catheter care records
  17. 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
CC04 Manage supra pubic catheters
Final version approved June 2010 © copyright Skills For Health
For competence management tools visit tools.skillsforhealth.org.uk
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