Adult urinary catheterisation and catheter care

Table of Contents

1. Introduction
2. Equipment required for Catheterisation
   1. Cleaning solutions
   2. Sterile water for balloon inflation
   3. Use of lubricants for male and female catheterization
3. Gaining consent for urinary catheterisation
   1. Support and information required
4. Summary
5. References

Gaining consent for urinary catheterisation

Urinary catheterisation is an invasive and embarrassing procedure and nurses must be sensitive to the issues around this procedure. Catheterisation of both males and females should only be performed when absolutely necessary and if the procedure is in the patient's best interests (RCN, 2008).

Informed consent must be obtained prior to beginning catheterisation and if the patient withdraws their consent at any time during the procedure catheterisation must be stopped immediately.

Task 6

1

Written consent needs to be obtained prior to performing urinary catheterisation. True or false? Select your choice and then select Check answer. a) True b) False Yes, verbal consent is needed for urinary catheterisation in most cases, but the nurse must document that this has been obtained.It's false. Verbal consent is needed for urinary catheterisation in most cases, but the nurse must document that this has been obtained.Your answer has been saved.

Task 7

2

For consent to be lawful, what conditions need to be satisfied? Enter your answer in the box below and then select Check answer. Consent must be given freely, by someone with the mental capacity to consent after they have been given sufficient information regarding the need for and risks and benefits of the procedure (RCN, 2008).

An adult is assumed to have the capacity to consent unless proven otherwise and no adult can give consent to a procedure for any other adult. Capacity to consent is governed by the Mental Capacity Act (Department for Constitutional Affairs, 2005).

While patients who lack capacity may be catheterised in their best interests, catheterisation of people who are agitated or cognitively impaired should be avoided if at all possible (RCN, 2008). Patients who are cognitively impaired may perceive the catheter to be a noxious stimulus, but be unable to fully understand the source of this irritation and are at increased risk of pulling the catheter out, causing significant trauma and bleeding.

As urinary catheterisation is an invasive and potentially embarrassing procedure, some care settings advocate the use of a Chaperone if the patient is being catheterised by a health care professional of the opposite sex. This is more common if the patient is female and the professional performing the procedure is male.

Task 8

3

The patient's consent is required for a chaperone to be present. True or false? Select your choice and then select Check answer. a) True b) False Yes - the patient must consent to all aspects of the procedure, including who will be present during the catheterisation.It's true. The patient must consent to all aspects of the procedure, including who will be present during the catheterisation.Your answer has been saved.

Task 9

4

What are the potential consequences of this nurse's actions for the patient? Enter your answer in the box below and then select Check answer. The patient has been placed at risk of the complications of catheterisation and it is likely that the therapeutic relationship between the patient and the nurse / other healthcare professionals is irreparably damaged. Trust has been breached, with potential long-term psychological harm and an adverse effect on future health care episodes.

Task 10

5

What are the potential consequences of this nurse's actions for the nurse? Enter your answer in the box below and then select Check answer. Any nurse who carries out a procedure against the express wishes of a patient, even if the procedure is beneficial, has committed professional misconduct and is likely to be suspended from the register and referred to the NMC for a fitness to practice hearing. The nurse is also at risk of facing charges for assault or facing litigation from the patient and/or their family.

There have been cases in the past where nurses have catheterised patients against their will (Pozgar, 2007) including the case of Roberson v Provident House (1991). In this case the nurse was removed from the register.

Task 11

6

What actions should you take if a patient reports a similar incident to you, i.e. that they have been catheterised against their will, when they have the capacity to consent? Enter your answer in the box below and then select Check answer. The NMC have issued guidance for nurses on raising and escalating concerns. As a nurse or nursing student, you have a duty to protect the public and a "professional duty to report any concerns from your workplace which put the safety of the people in your care at risk" (NMC, 2010: p4). If you witness or suspect a patient in your care is at risk of harm, including in situations where you suspect misconduct, you should report this to an appropriate person immediately. Normally this will be a line manager, but if this is not possible or appropriate then you should report your concerns to the designated person nominated in your employer's whistle blowing policy.