CC07 Review catheter care

Overview

This standard covers the specialist review of individuals using any form of urinary catheter following agreed local protocols, procedures and guidelines.  It also covers carrying out the necessary observations and tests to support the review. The review will consider a wide range of factors from continued usage of the catheter through to the functioning of the catheter and the individual’s general health and well-being. 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 reviewing catheter care
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. pelvic floor muscles/complex
5. the bowel and its links to voiding problems
6. the endocrine system
7. sexual function and links to catheter usage
8. the prostate gland, urethral sphincters and the urethra
9. applied anatomy and physiology to voiding dysfunction and how a urethral urinary catheter could be used to relieve this
10. anatomy and physiology links of how common catheter related complications occur
5. Why to review the general and bladder health status of an individual using a urinary catheter, how this links to the need for ongoing usage
6. How to assess the function of a urinary catheter and the methods available to undertake this
7. The adverse effects and complications associated with urinary catheter usage, the severity and if of a serious nature and the appropriate advice to give and actions to take
8. How to review the psychological impact of catheterisation, level of ability of individuals, dependence status and reliance on others
9. How to review bowel function and ascertain its impact on catheter function
10. How to review an individual’s catheter care related practices, lifestyle and quality of life impact
11. Why a catheter care review needs to identify current treatments and interventions
12. The importance of fluid intake, the 24 hour output, the types of fluid being drunk and appropriateness in a review of an individual using a urinary catheter
13. The roles of healthcare workers and how to review the appropriateness of those involved in an individual’s catheter care
14. The short and long term risks and health implications associated with urinary catheter usage
15. The localised and meatal conditions, genital abnormalities, skin reactions and how to observe for and treat appropriately
16. The influences on urine production and changes and how to act appropriately
17. How meatal hygiene and general hygiene practices impact on catheter function, associated complications and act appropriately
18. Why incontinence (urinary and faecal) and associated containment product usage impact on the catheter function, genital health, associated complications
19. Catheter equipment and how to relate this to the review of an individual’s catheter and drainage equipment usage
20. How to observe urinary catheters, drainage and support systems in situ to ensure they are appropriate and act appropriately
21. How to carry out a medication review to identify medication related to the management of urinary tract symptoms which may impact on catheter care
22. The indications, mode of action, side-effects, cautions, contra indications and potential interactions of medication, antibiotics, anaesthetic agents and associated solutions used for individuals using urinary catheters
23. How to obtain valid consent and how to confirm that sufficient information has been provided on which to base this judgement
24. The importance of reviewing an individuals’ privacy, dignity, wishes and beliefs in relation to urinary catheter usage and how to do so
25. The those who may accompany the individual (e.g. carers, chaperones) and be present during the process and how to work with them
26. The ethical issues surrounding ongoing urinary catheter usage as applied to an individual
27. The causes of urinary tract invasion from bacteria and how to minimise this in all care settings
28. The importance of applying standard precautions for infection control and the potential serious life threatening consequences of poor practice
29. How to meet standards of environmental cleanliness in the area where catheterisation is to take place to minimise the infection risk
30. How to assess an individual using a urinary catheter to ascertain their multi resistant bacteria status
31. 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. obtain valid consent from the individual for a catheter care review
3. ensure privacy and dignity are maintained during the review
4. assess the general health status of the individual
5. conduct the catheter care review in accordance with the individual’s needs, the catheter care plan and organisational policy
6. carry out the relevant observations and tests to support the review
7. make any necessary adjustments to the catheter care plan based on the review and arrange any necessary follow up
8. record clearly, accurately and correctly any relevant information in the ongoing catheter care records
9. communicate the findings of the review to the individual and relevant others involved in the individual’s care
10. make any necessary arrangements for referral based on the review

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: HWB2 Assessment and care planning to meet people's health and wellbeing needs