From ClinicalSkills.net
We have two updated procedures in the Catheterisation
category for you this week, plus a new procedure on Safeguarding vulnerable
adults in care homes.
Changing a suprapubic catheter
The new editor of this procedure is Rachel Leaver,
Lecturer Practitioner-Urological Nursing at University College London Hospital
NHS Foundation Trust and London South Bank University. Rachel is also Editor of
the International Journal of Urological Nursing.
This procedure has been thoroughly overhauled following
peer review, and it now shows:
* Use of an aseptic non-touch technique to remove the old
catheter and insert the new one, while wearing a single pair of sterile gloves.
* It emphasises more strongly the need to insert the new
catheter speedily once the old one has been removed, to avoid the suprapubic
tract closing.
* It no longer shows instillation of saline into the
bladder via the old catheter before performing the change. Doing so is no
longer recommended as it breaks the closed urinary drainage system and may
cause blockage or symptomatic catheter-associated urinary tract infection.
Instead, the procedure recommends encouraging the patient to drink 30 minutes
before the change of catheter, or clamping the catheter or applying a catheter
valve.
* It recommends use of a catheter passport to record
details of the patient's catheter and when it needs changing.
Intermittent self-catheterisation
This procedure has also been reviewed and updated. It now
features:
* A wider range of catheters suitable for intermittent
self-catheterisation, including those with a cover that the patient has to pull
down in order to expose the catheter, and those with an integral gel sachet,
which the catheter is pushed through to lubricate.
* Greater emphasis on the hand-washing routine that the
patient has to follow before washing their genitalia, and again before
preparing the catheter.
* Use of the catheter passport to record details of the
catheter.
You can find both of these updated procedures by clicking
on the Adults section, then the Catheterisation category, and then the
procedure titles. Alternatively, on the Procedures page, just put a key word in
the Search field and click Apply.
Safeguarding vulnerable adults in care homes
This new procedure is by Vickie Wylde, Registered Nurse
Manager at MHA Homes. It explains what safeguarding involves and the
legislative background to safeguarding. It covers the different types of abuse
that can occur, and the signs to look out for. Three case histories, all based
on real events within a care home setting, help to relate safeguarding to
day-to-day practice, and how the principles of safeguarding provision work in practice.
You can find this new procedure in the Adults section, in
a new category called Safeguarding. We're planning additional procedures this
year on safeguarding in a hospital setting and safeguarding of children.
Access procedures via the Library resources page on the Trust intranet or off-site with an OpenAthens account at www.clinicalskills.net
