Policy briefing

Improving care for patients who have catheters

RCN updates its guidance on using catheters and how to minimise associated risks

RCN updates its guidance on using catheters and how to minimise associated risks

Picture: Solent News Agency

Essential information

Continence is one of the fundamentals of nursing care and maintaining continence can help safeguard a patient’s quality of life. Many people may need catheters to help them manage everyday activities. Catheters can provide an effective way of draining the bladder, for both short and long-term purposes, however their use increases the risk of infection.

What’s new

Updated guidance to improve the use and safety of catheters in the NHS and independent healthcare sectors has been published by the RCN.

It aims to support a full understanding of the National Occupational Standards developed by the RCN and Skills for Health to improve the quality of catheter care.

The document deals with how to insert and secure urethral catheters, and how to monitor and help individuals to monitor urethral catheters. It covers management of suprapubic catheters, assessment of whether a patient is able to pass urine when a catheter is removed, and enabling individuals to carry out intermittent self-catheterisation. Ongoing care and how to review catheter care is also explained.

The RCN describes in detail the paperwork nurses should  complete in relation to the use and removal of catheters, and the anatomy and physiology knowledge nurses need to understand how to use catheters safely.

The updated guidance covers obtaining consent, and deciding when and why a catheter should be used. The importance of risk assessment, factors that increase the risk of infection and other complications, and the risks that catheter use can bring, are explained.

Aspects that should be covered in patient education, including good hand hygiene, are included.

Implications for nurses

  • Catheters should only be used after all alternatives have been considered.
  • It is essential that risk assessment is an integral part of catheter care in all care settings. Using any form of catheter has associated risks.
  • Obtaining consent is essential before carrying out catheterisation.
  • The document sets out detailed information on the records to keep, including checklists for drainage equipment documentation, catheter removal documentation and ongoing observations documentation.
  • Providing the patient with a urinary catheter passport supports consistency of catheter care.

Expert comment

Sharon Holroyd, lead clinical nurse specialist at Calderdale bladder and bowel service, Calderdale and Huddersfield NHS Foundation Trust, and guideline lead, says: ‘Good catheter care is essential, as a catheter is a high-risk device that disrupts the normal filling and emptying cycle of the bladder, leading to a higher risk of infection.

‘In some cases this can lead to sepsis and even be fatal. This new guideline is based on national and international latest clinical evidence for good practice.

‘It is a vital resource to help reduce risk to patients and a checkpoint for staff who may not have had any formal or recent updates in catheterisation.

‘All nurses need to know that hand hygiene is key, mimicking a normal fill and empty of a bladder can offer some protection and a greater chance of success when removing a catheter, and catheter fixation devices are a must to prevent tissue damage caused by catheter migration.’

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