Beruflich Dokumente
Kultur Dokumente
Learning outcomes
By the end of the session students will be able to: Identify reasons for urinary catheterisation Discuss choice of catheter Understand the significance of maintaining asepsis Demonstrate an aseptic technique in urinary catheterisation Demonstrate care to prevent infection
Catheterisation
antihistamines, morphine, anaesthetic agents (atropine), botox, alcohol Genital herpes infection
Mode of catheterisation
Choices to be made:
Clean intermittent self catheterisation Suprapubic catheterisation Urethral catheterisation
Catheter Selection
Points to consider;
Size Balloon size 10ml for routine drainage, 30 ml for some urology procedures only Length Female = 27cm, paediatric = 30 cm, standard length = 40cm Charriere size (1Ch = 0.3mm) Material (consider latex allergy) Drainage system (closed / link system)
Catheter Materials
Short-term materials May stay in up to 3/52
Latex PTFE coated latex Siliconised latex PVC
Link system
Used for ambulant patients Leg bag stays attached to catheter for 7 days
and dont open this connection Attach overnight 2 litre bag to end of leg bag and open tap at night Remove overnight bag in the morning, empty and dispose of Overnight bags are never to be re-used the following night!
Catheter valves
No bag attached to catheter Bladder fills and stores urine, lifting
bladder tissue off catheter tip Discrete But:
Patient needs good manual dexterity Patient needs good cognitive ability to remember to empty the bladder
Procedure
Patient preparation - information - consent
Aseptic technique - to prevent the transmission of microorganisms either directly or indirectly, thus reducing risk of infection
Equipment
Catheter pack Two pairs sterile gloves Sachet of normasol (to clean round urethral
meatus) 10ml syringe Ampoule of sterile water for injections (if not in pack with catheter) Lubricant e.g. instillagel
6ml for females and 11ml for males
Documentation
Date inserted & date
due to be changed Rationale for catheterisation Any problems encountered Size inserted
Volume of urine
Care
Meatal hygiene Minimise handling Maintain asepsis Do not allow bag to become too full Keep drainage bag below level of bladder
Reading
Bissett L (2005) Reducing the risk of catheter-related
urinary tract infection. Nursing Times 101 : 12 64-65 Doherty W (2006) Male urinary catheterisation. Nursing Standard. 20: 35 57-63 NICE (2003) Infection control: prevention of healthcareassociated infection in primary and community care. Clinical guideline 2. NICE, London Pellowe CM, Pratt RJ, Loveday HP, Harper P, Robinson N, Jones SRLJ (2004) The EPIC project- updating the evidence base for National Evidence-based Guidelines for preventing healthcare-associated infections in NHS hospitals in England: a report with recommendations. Available from www.epic.tvu.ac.uk