CC10 Assess residual urine by use of portable ultrasound

Overview

This standard covers assessing residual urine by use of portable ultrasound.  It involves setting up and operating portable ultrasound equipment to obtain readings of residual urine status.  It also involves working with the individual to obtain accurate readings and considering the findings of the assessment. 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 assessing voiding by use of a portable ultrasound device
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 applying standard precautions for infection control and the potential consequences of poor practice
4. 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
5. 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. bladder capacity and what influences this
3. normal micturition
4. the nervous system, including autonomic dysreflexia
5. the bowel and its links to bladder problems
6. the pelvic floor muscles/complex
7. the prostate gland, urethral sphincters and the urethra
6. The anatomy and physiology links of how urinary tract infection happens and the associated complications
7. How to obtain valid consent, that the individual has the ability to consent within the mental capacity act and cooperate, and how to confirm that sufficient information has been provided on which to base this judgement
8. The importance of respecting individuals’ privacy, dignity, wishes and beliefs and how to do so
9. Methods of enabling the individual to be as comfortable as possible during the procedure
10. How to identify the signs and symptoms associated with poor bladder emptying
11. How to identify individuals likely to have a voiding problem who would benefit from portable ultrasound assessment
12. Methods and associated risks of how to assess individuals with poor bladder emptying
13. The situations in which it is necessary to seek further opinion concerning the findings of an assessment of residual urine using a portable ultrasound device for an individual, refer on, and how this should be implemented
14. How to use portable ultrasound devices and equipment correctly and safely
15. How to identify false readings resulting from use of a portable ultrasound device to assess voiding, interpret and act appropriately
16. How to combine findings from a portable ultrasound with other baseline information to inform a differential diagnosis
17. Methods available to decontaminate ultrasound equipment prior to and post usage to minimise cross infection

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. identify high risk individuals who are likely to have voiding problems and proactively initiate ultrasound assessment to assess bladder dysfunction, associated risks and complications
3. obtain the valid consent of the individual for the assessment using a portable ultrasound device and agree the information which may be passed to others
4. ensure the portable ultrasound equipment and environment are clean and appropriate before conducting the investigation
5. provide individuals with appropriate instructions to assist in the assessment of residual urine by use of a portable ultrasound device
6. position the individual appropriately for the assessment of residual urine
7. operate the portable ultrasound machine in accordance with manufacturer instructions to effectively obtain a series of readings of residual urine status
8. identify any issues with the use of the portable ultrasound machine and act appropriately
9. maintain the portable ultrasound machine in accordance with manufacturer instructions
10. consider the findings from portable ultrasound assessment of residual urine with other baseline findings to inform a differential diagnosis
11. provide the individual and relevant others with information and advice concerning the implications of the assessment and how this may influence the next stages of their care
12. correctly document the findings from the ultrasound assessment of residual urine and maintain the security and confidentiality of individuals health 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: HWB6 Assessment and treatment planning This standard has replaced HCS_UD3