B

CC02 Insert and secure urethral catheters

Overview

This standard covers the insertion and securing of indwelling urinary catheters via the urethra following agreed local protocols, procedures and guidelines.  It does not include suprapubic catheterisation, intermittent catheterisation or trial without catheter which are covered by separate competences.

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 inserting and securing urethral 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 voiding problems
    5. the endocrine system
    6. sexual function and links to catheter usage
    7. the prostate gland, urethral sphincters and the urethra
    8. applied anatomy and physiology to voiding dysfunction and how a urethral urinary catheter could be used to relieve this
    9. 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. How to obtain valid consent and how to confirm that sufficient information has been provided on which to base this judgement.
  7. The importance of respecting individuals’ privacy, dignity, wishes and beliefs and how to do so
  8. Those who may accompany the individual (e.g. carers, chaperones) and be present during the process and how to work with them
  9. The methods of offering effective verbal and non-verbal support to individuals when you perform urethral catheterisation
  10. The effects of urethral catheterisation on the individual’s comfort and dignity
  11. The ethical issues surrounding urethral catheterisation as applied to individuals
  12. The causative factors which determine the need for a urethral urinary catheter
  13. The reasons why individuals have planned catheter changes and how to initiate unplanned catheter changes because of blockage or other complications
  14. How to assess the function of a urethral catheter and the methods available to undertake this
  15. How to minimise any unnecessary discomfort during and after the procedure
  16. When not to proceed or abandon urethral catheterisation for an individual and what actions to take
  17. The adverse effects and complications during urethral catheterisation and the appropriate actions to take
  18. 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
  19. The short and long term risks and health implications associated with urethral urinary catheterisation
  20. Why a risk assessment prior to the decision to catheterise is important and what contributes to this assessment
  21. The types of catheters, urinary 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
  22. How to obtain, store to maintain sterility, dispose of catheter care equipment and check is fit for purpose before usage
  23. The types and use of lubrication and anaesthetic gels
  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. obtain equipment and materials for individuals that meet their needs and the needs of local protocols and guidelines
  2. apply standard precautions for infection prevention and control and take other appropriate health and safety measures
  3. check equipment and materials to ensure they are safe and fit for purpose before usage
  4. ensure that the environment is suitable for catheterisation to take place, and that comfort and dignity are maintained during and post procedure
  5. obtain the individual’s valid consent for the procedure
  6. comply with the relevant protocols, procedures and guidelines relating to urethral catheterisation, product failure, malfunction or serious harm caused by product usage
  7. remove the old catheter correctly and safely, check that the tip is intact and observe the level of encrustation
  8. ensure the genital area is socially clean prior to cleansing
  9. observe the meatus for any abnormalities and aseptically clean it for insertion of the urethral catheter
  10. administer the appropriate lubrication or anaesthetic gel following manufacturers instructions
  11. insert the catheter safely, aseptically and correctly, according to manufacturer’s instructions and local protocols, with minimal discomfort to the individual and record the volume of urine drained
  12. ensure that the catheter is in the correct position using the appropriate indicators before balloon inflation
  13. inflate the balloon according to manufacturers instructions
  14. attach the catheter correctly to the appropriate drainage system or catheter valve, and confirm it is secure and functioning correctly
  15. dispose of the used catheter and associated equipment and materials safely and correctly
  16. provide the individual and relevant others with the necessary information and support
  17. 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: HWB7 Interventions and treatments
CC02 Insert and secure urethral catheters
Final version approved June 2010 © copyright Skills For Health
For competence management tools visit tools.skillsforhealth.org.uk
Logo