CC03 Care for individuals with urethral catheters

Overview

This standard covers caring for individuals with urethral catheters following agreed local protocols, procedures and guidelines. It includes monitoring the individual’s condition relevant to the catheter care programme and recognising adverse effects and potential complications. It also covers monitoring hygiene and caring for the catheter. 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 care of individuals using urethral urinary 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 voiding problems
the endocrine system
sexual function and links to catheter usage
the prostate gland, urethral sphincters and the urethra
applied anatomy and physiology to voiding dysfunction and how a urethral urinary 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
how to obtain valid consent 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
those who may accompany the individual (e.g. carers, chaperones) and be present during the process and how to work with them
methods of offering effective verbal and non-verbal support to individuals when you perform catheterisation
the effects of urethral catheterisation on an individual’s comfort and dignity
the ethical issues surrounding urethral catheterisation as applied to individuals
the causative factors which determine the need for urethral urinary catheterisation
how to assess the function of a urethral catheter and the methods available to undertake this
the adverse effects and complications during urethral catheterisation and the appropriate actions to take
lifestyle advice and activity and how this impacts on the function of a urethral urinary catheter
how to advise individuals using catheters in relation to lifestyle advice, maintaining catheter function, reducing infection, what to do in the event of problems with equipment and how to deal with common complications
the short and long term risks and health implications associated with urethral urinary catheterisation
the reasons why individuals have planned catheter changes and how to initiate unplanned catheter changes because of blockage or other complications
how to minimise any unnecessary discomfort during and after the procedure
how to terminate the usage of a urethral catheter in an effective and safe manner
the types of catheters, urethral drainage bags, link systems, catheter valves, support methods, including garments, straps and stands that can be used with appropriate selection to meet individuals specific needs
how to obtain, store to maintain sterility, dispose of catheter care equipment and check is fit for purpose before usage
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 urethral catheters
the causes of urethral tract invasion from bacteria and how to minimise this in all care settings
the importance of applying standard precautions for infection prevention and 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
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
monitor the individual’s condition relevant to the catheter care programme, recognise any adverse effects and potential complications and take the appropriate action
observe and maintain cleanliness of the meatus through daily normal hygiene practices for individuals with urethral catheters
measure and record urethral output whenever necessary in accordance within local protocols and guidelines
enable the individual and relevant others as far as possible to:

care for their catheter
maintain hygiene practices
continue activities of daily living
use the urethral drainage system correctly
obtain and dispose of equipment safely and correctly
identify common complications and take the appropriate action

use catheter care equipment appropriately in line with manufacturers guidance
use and store equipment and materials safely to maintain sterility
dispose of catheter related equipment appropriately and safely in line with local guidance
appropriately report product related failure/malfunction in line with national and local guidelines
record clearly, accurately, and correctly any relevant information in the ongoing catheter care records

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