Catheterisation for children and young people boys

1
Catheterisation for children and young people
(boys)

• Teaching pack 5
• Liz Herd

2
Introduction
What do you know
about catheterisation?
3
Do you have any concerns

• about catheterising a child?

4
Ground rules

• We value the young people we care for we would
  never put them or you at risk
• Always ask any questions when they occur to you,
  weve all asked questions that may seem
  silly-there is no such thing as a silly question!
• Stop me if you dont understand- the chances are
  others dont either
• Tell me if you need a break

5
110

• The children and young people rely on the
  assessors to ensure we deliver high standards of
  care-the assessors take this responsibility very
  seriously
• These high standards protect you as well as the
  young people
• We are incredibly privileged to be part of their
  lives we owe them 110

6
Parent Experts

• All parents know their child/young person best
  They care for them daily
• Listen to them-act on what they say!!
• As a resource they are second to none Use
  Them-get to know the child as the parent does

7
Patient dignity

• Always ask child/young person for consent when
  considering interventions
• Ask how they would like it done
• Catheterisation is an extremely intimate
  procedure be aware of this at all times
• Treat children/young people as you would like to
  be treated, respecting their beliefs and values

8
Patient Privacy

• This procedure invades privacy!!!
• Think of ways to try and support child/young
  person through this
• Privacy means that the family including the child
  may not be discussed with people who do not need
  to know or with whom you have no consent to share
  information.

9
Definition of intermittent catheterisation

• IC (intermittent catheterisation)
• IC means passing a thin hollow tube into the
  bladder to drain urine (Simpson 2002)
• Simpson does not add then removing the tube when
  the bladder is empty but in IC we remove the
  catheter when bladder is drained

10
Abbreviations relevant to catheterisation

• IC intermittent catheterisation
• means the catheter is passed by a carer till the
  bladder is empty then removed

• ISC intermittent self catheterisation
• means the catheter is passed as across but it is
  passed by the patient themselves

11
History of catheterisation

• Been done by ancient civilisations for thousands
  of years
• Used gold, silver and reed, Ouch!
• ISC and IC first introduced Lapides 1972

12
Urinary system anatomy (male)

• System includes
• 2 kidneys
• 2 ureters
• 1 bladder
• 1 urethra

13
Transverse view of male anatomy

• Blue area anus
• Yellow area bladder and urethra
• Tan area prostate

14
ISC/IC procedure

• This is a clean not a sterile procedure
• It can be done in many positions and we will
  always support patient preference where possible
• It can be done directly into the toilet but this
  may not always be possible
• It is about promoting patient choice and dignity

15
Hand hygiene

• As with all care hand hygiene is extremely
  important
• Please follow the 8 point plan and repeat steps 5
  times
• Wash hands as required through out the procedure

16
Hand hygiene

• You may use alco gel if required but this must be
  on clinically clean hands only!

17
Equipment required

• Appropriate catheter, correct size, in date and
  packaging intact
• Lubricant if required
• Hand washing facilities
• Area that affords privacy
• Toilet or receptacle for urine
• Swabs for cleaning genital area before and after
  catheterisation
• Clean pad if required

18
Procedure IC

• Ask patient for consent at a time appropriate to
  them
• Collect equipment
• Help patient to undress if required
• Lubricate catheter as per manufacturer
  instructions

19
Male Catheterisation

• Ensure the tip of the penis is cleaned well prior
  to insertion of catheter
• Patients may have a preference for position
• Hold the penis as picture to straiten urethra

20
Insert catheter

• Following catheter manufacturers guidelines
  insert catheter slowly
• Stop if you feel resistance
• Pass the catheter only till urine is obtained as
  this is the bottom of the bladder and will ensure
  complete emptying of the bladder
• Pre lubricated catheters may be slippery!!!

21
Use Gravity!

• Drain urine into toilet or jug-by lowering the
  end of the catheter
• Observe the urine for
• Colour
• Smell
• Sediment
• Amount

22
Completing procedure

• Leave to drain till urine stops flowing
• Withdraw the catheter slowly to ensure all urine
  has drained
• Clean tip of penis to ensure all lubricant
  removed

23
Following catheterisation

• Ensure patient comfortable
• Help patient to dress if required
• Record any thing unusual
• Dispose of equipment

24
Disposal of equipment

• Place catheter in bin provided with all used
  equipment that has been in contact with body
  fluids

25
Record keeping specific to catheterisation

• Any observation of urine that is different from
  normal
• Colour
• smell
• Amount
• Sediment
• cloudy

• Time procedure was done
• Difficulty in passing catheter
• Advice given i.e. drink more fluid
• Difficulty in obtaining urine
• Any signs of trauma to penis or urethra

26
Record keeping specific to catheterisation

• Any observation of urine that is different from
  normal
• Colour
• smell
• Amount
• Sediment
• cloudy

• Time procedure was done
• Difficulty in passing catheter
• Advice given i.e. drink more fluid
• Difficulty in obtaining urine
• Any signs of trauma to penis or urethra

27
Concerns
Any
questions
???
28
References

• Guide to intermittent catheterisation for
  healthcare professionals (2006) Dolman M
• White M Astra Tech Ltd
• ERIC water is cool Campaign 2003
• Nice guidelines DH 2002
• Essence of care DH 2001
• Coventry PCT Hand Hygiene Policy 2006
• Coventry PCT Consent Policy 2004