Long term catheters

Reminder of the basic principles of good catheter care

Catheterisation should only be used as a last resort in the management of incontinence. An indwelling catheter may be inserted into the bladder via the urethra or a supra pubic cystostomy. Catheterisation is associated with a number of potential complications, which in the case of supra pubic catheterisation includes bowel perforation. It should also be remembered that of the 1-4% of patients develop bacteraemia from a catheter acquired urinary tract infection (CAUTI) which can be life threatening. There are, however, some patients for whom long-term catheterisation is the most appropriate form of care.

The aims of catheter management are:

  1. To relieve and manage urinary dysfunction
  2. To recognise and minimise risk of secondary complications
  3. To promote patient dignity and comfort and to assist patients reach their own potential in terms of self-care and independence
  4. To provide a cost-effective service

Before carrying out long-term catheterisation the nurse should:

  • carry out a holistic assessment of the patient
  • discuss with GP
  • gain informed consent. This should be a joint decision with the patient, health professional and if appropriate with the carer/relative (see local policy on consent)
  • select the appropriate type and size of catheter
  • have the appropriate knowledge and skills to carry out the procedure
  • discuss sexuality as appropriate to the individual patient
  • give verbal and written information about the catheter and its care
  • provide appropriate leg bags and night bags for the 24 hours link system
  • provide the appropriate suspension system
  • plan individualised care

Catheterisation is an aseptic procedure. The genitalia or meatus should be cleansed prior to insertion with sterile or normal saline. Further information can be obtained from the relevant local policy.

The nurse responsible for the catheterisation will carry out the relevant documentation. This will include:

  • patient consent to be gained and documented
  • the date and time of the procedure
  • site of catheter: urethral or supra pubic
  • the type, size and batch number of the catheter
  • the residual volume of urine drained if first time catheterisation
  • the date the catheter is due to be changed
  • complete care plan

Catheter retainer devices

These retainer devices are for extra support and comfort, and help to keep the catheter in place. The leg or abdomen should be measured to ensure the correct size is ordered. Abdominal straps may be cut to fit the leg.

Bard Statlock® stabilisation device
  • FOL0102DT (£12.67 = 5)
GB Fix-It Strap (Great Bear Healthcare Ltd)
  • Short - 10646C (£14.20 = 5, £2.84 each)
  • Adult – 10644A (£14.20 = 5, £2.84 each)
  • Abdominal – 10645B (£15.54 = 5, £3.11 each)

 

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