Urinary Catheterisation and catheter care

Question 1

Equipment for catheterisation

Answer 1

1. Trolley that has been wiped clean
2. Catheterisation pack
3. Two pairs of sterile gloves
4. Cleaning solution- saline sachets sufficient
5. Lubricant
6. Sterile water to inflate the balloon
7. Appropriate catheter
8. Appropriate drainage system

Question 2

Why should you use sterile water for balloon inflation

Answer 2

• Latex catheter balloon is porous and some water will leave the balloon via osmosis.
• Therefore non sterile solutions increase the risk of CAUTI.
• Saline should also not be used as there is a risk that salt crystals could deposit and block the inflation channel causing problems with balloon deflation

Question 3

What is the purpose of using a lubricant prior to catheter insertion?

Answer 3

sterile, single use lubricant to lubricate the urethra prior to catheterisation will reduce trauma on insertion, thereby reducing damage to the urethral lining and reducing pain on catheter insertion.

Question 4

For females what should be lubricated

Answer 4

the female urethra should be lubricated. Gel applied to a catheter will often wipe off at the urethral meatus and not enter the urethra. The female urethra is a flattened, convoluted tube and inserting a gel into the urethra will perform and dilate the urethra making it easier to insert a catheter

Question 5

What information must the patient understand before consenting to undergo catheterisation?

Answer 5

• the patient must understand the rationale,
• the alternatives
• the consequences of not being catheterised

Question 6

What specific information does the patient require in relation to the rationale for catheterisation?

Answer 6

The patient must be informed of the reason why catheterisation is being recommended for them, e.g. to drain the bladder or to monitor urine output, but they should also understand that the catheter will be removed as soon as possible

Question 7

What specific information does the patient require in relation to catheter selection?

Answer 7

The patient should understand the types of catheters available, e.g. intermittent, suprapubic or indwelling urethral, and should be involved in the decision making process wherever possible

Question 8

What specific information does the patient require in relation to the risks of urinary catheterisation in order to make an informed decision?

Answer 8

• Infection - increasing with duration of catheterisation
• Pain and trauma - including the potential long-term risk of urethral erosion if relevant
• Blockage - reasons why catheters block, including constipation, blood clots and encrustation
• Bypassing