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Teaching Self Catheterization (102.106)

Teaching Self Catheterization (102.106) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Patient Education

102.106

1
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: TEACHING SELF CATHETERIZATION

Effective Date: August, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed October, 2003 April, 2005 May, 2008 May 2009 March 2012


PURPOSE: To provide guidelines for teaching self-catheterization at UWMF Clinics.

DEFINITION: Self-catheterization enables the patient who no longer has voluntary bladder control to
independently maintain urinary continence. Long term self-catheterization is taught to patients requiring
intermittent straight catheterization as an alternative to an indwelling Foley catheter. It can be used in patients
who can void on their own, but who have incomplete emptying. Self catheterization can also be used short term
to retrain the bladder in a patient with `temporary retention or incomplete emptying after surgery, injury, or
child birth.



POLICY: The clinical staff will utilize the following guidelines to teach self- catheterization to UWMF
patients.

SUPPLIES: *Provider’s order
Appropriate size and type of catheter, Lubricating jelly
Toilet or collection basin for the urine
A mirror for the woman to use to find her urethra (optional)
Appropriate patient education teaching materials
Record keeping (log) of residual urines

*For scheduled frequency of catheterizations & written guidelines for modifying scheduled frequency of
catheterizations.


PROCEDURE:
1. Wash hands and gather equipment.
2. Introduce yourself. Identify the patient by full name and date of birth.


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3. Assess patient to determine:
Learning needs. What does patient need to know about self-catheterization?
Readiness to learn. Does patient want to learn to perform this skill?
Current Knowledge. What does client already know about procedure?
Ability to learn. Developmental stage, cognitive status, and physical attributes.
Learning environment. Choose setting where patient can focus on learning.

4. Explain procedure to the patient.
NOTE: Explanations may need to be in a simple step by step format.

5. Provide good light and privacy while teaching.

6. Have patient demonstrate or discuss the following procedural steps:
Proper handwashing for good infection control
Identify proper equipment and supplies used for the procedure
Cleansing the urethral area correctly before catheter insertion
State how far the catheter should be inserted
Care for equipment before, during and after it is used
Proper lubrication of catheter (2 to 4 inches for male, 1 to 2 inches for female)
Explain suitable positions to assume for insertion
For men - holding the penis at the 45 degree angle to the stomach
Insertion of catheter into bladder
Inserting the catheter slowing as one relaxes, deep breathes
After bladder is empty remove catheter

7. Have patient discuss the following:
Signs and symptoms of urinary infection
Burning with catheterization
Pain with catheterization
Blood in the urine
Fever over 100.4 F
Foul-smelling urine
Pain in the lower back or lower abdomen

NOTE: Patients with spinal cord injuries may be unable to perceive pain associated with urinary tract
infections.

8. Have patient discuss appropriate times to call the clinic/provider:
When there is little or no urine after a catheterization
Blood in the urine
Foul-smelling urine

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Sediment (sandlike material in urine)
Urine leakage between catheterizations
Pain in the lower back or lower abdomen
Trouble inserting the catheter
Increasing pain when inserting the catheter
Fever over 100.4 F

9. Document in the patient's chart the patient teaching completed, care given and the
patient's response to the procedure and the teaching.

WRITTEN BY:
Ronnie Peterson, R.N., M.S., Manager of Clinical Support

REVIEWED BY:
Donnette Kelly, R.N., Department of Urology, 2012
Carol Decker, RN, MSN, Clinical Staff Educator, 2012

REFERENCES:
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby
Elsevier.

AUTHORIZATION:

Department of Surgery, Urology Date


Medical Director Date