CC06 Enable individuals to carry out intermittent catheterisation

Overview

This standard covers enabling individuals to carry out intermittent catheterisation.   It involves assessing the individual’s ability to perform intermittent catheterisation and explaining the relevant aspects of catheterisation.  It also involves helping individuals to develop the necessary skills to carry out intermittent catheterisation. Intermittent catheterisation may be performed by individuals on themselves, or by carers of the individuals requiring intermittent catheterisation. 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 enabling individuals to carry out intermittent catheterisation
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 an intermittent catheter could be used to relieve this
9. anatomy and physiology links of how common catheter related complications occur
10. anatomy and physiology of the formation of a continent stoma and how a catheter is needed for voiding
11. anatomy and physiology links of how common catheter related complications occur
5. how to advise individuals in the use of intermittent catheters in relation to their anatomy, its function and sensation
6. the causative factors which determine the need for urinary catheter usage
7. why a risk assessment prior to the decision to catheterise or use an intermittent catheter is important and what contributes to this
8. how to advise individuals who undertake intermittent catheterisation
9. the effects of intermittent catheterisation and dilatation on the individual’s comfort and dignity, and ways of handling this
10. the adverse effects and potential complications during urinary catheterisation/dilatation and appropriate actions to take
11. the short and long term risks and health implications associated with intermittent catheterisation/dilatation and how to resolve or minimise these
12. the clinical decisions and method/s required to terminate the usage of intermittent catheterisation/dilatation in an effective and safe manner
13. how individuals should risk assess themselves and how this will influence their self care
14. when to not proceed or abandon catheterisation for an individual and what actions to take
15. the types of intermittent catheters and associated equipment that can be used and how to advise the individual to choose an appropriate type to meet their specific clinical needs and lifestyle
16. how individuals will need to obtain, store to maintain sterility, dispose of intermittent catheter equipment and check it is fit for purpose before usage
17. how to avoid substances which affect the intermittent catheter and its function
18. the indications, mode of action, side-effects, cautions, contra indications and potential interactions of medication, antibiotics, analgesia, anaesthetic agents and associated solutions used for individuals undergoing intermittent catheterisation
19. how to obtain valid consent, that the individual has the ability to consent within the mental capacity act, cooperate and comply with intermittent catheterisation/dilatation, 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. those who may accompany the individual (e.g. carers, chaperones) and be present during the process and how to work with them
22. the importance and methods of offering effective verbal and non-verbal support and reassurance to individuals when they perform intermittent catheterisation/dilatation
23. the ethical issues surrounding intermittent catheterisation as applied to individuals
24. the advice and support that should be provided to individuals undertaking intermittent catheterisation
25. the causes of urinary tract invasion from bacteria and how to minimise this in all care settings
26. the importance of applying standard precautions for infection control and the potential serious life threatening consequences of poor practice
27. how to meet standards of environmental cleanliness in the area where catheterisation is to take place to minimise the infection risk
28. 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 the individual’s valid consent for intermittent catheterisation and ensure they are aware of the rationale, benefits and associated complications
3. enable the individual to complete a risk assessment prior to the decision to proceed with intermittent catheterisation
4. assess the individual’s ability to perform intermittent catheterisation
5. ensure that the environment is clean and suitable for the individual to carry out intermittent catheterisation
6. explain and demonstrate the relevant aspects of intermittent catheterisation
7. enable the individual to develop the necessary skills and actions to carry out intermittent catheterisation safely and correctly
8. ensure the individual and relevant others know how to obtain the necessary equipment and materials to meet the individual’s frequency of catheterisation and dilatation needs
9. provide the individual and relevant others with lifestyle advice including fluid intake, type of fluid, activity, travel and holidays to minimise catheter associated complications
10. maintain the comfort and dignity of the individual during and post procedure
11.  monitor and follow up the individual’s condition as part of planned catheter care reviews, recognise adverse effects and complications and take the appropriate action
12. review the continued need and frequency of intermittent catheterisation with all its associated risks with the symptom improvement, quality of life indicators and volumes drained
13. 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