Female intermittent Catheterisation

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Infection Prevention and Control

Procedure for Female Intermittent Catheterisation


Infection Prevention and Control Procedure for Female Intermittent Catheterisation Purpose To ensure all relevant staff are aware of the principles for female intermittent catheterisation and understand the rationale that informs the principle, to prevent cross infection between service users, staff and visitors and prevent Health Care Associated Infections.

Target Group This procedure is relevant to healthcare or care staff that have received specific training in female intermittent catheterisation.

Introduction

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Urinary tract infection (UTI) is the most common infection acquired as a result of health care, accounting for 19% of Health Care Associated Infections, with between 43% and 56% of UTI’s associated with a urethral catheter.

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This guidance has been formulated to give healthcare and care staff a step by step approach to female intermittent catheterisation with a rationale for each stage, based on the current national research and guidance. This guidance should be used in conjunction with other associated infection prevention and control policies and procedures such as Hand Hygiene, Waste Management, Use of Personal Protective Equipment (PPE), Aseptic Non-Touch Technique (ANTT). Only appropriately trained and competent healthcare or care staff should carry out female intermittent catheterisation using an aseptic non touch technique Guidance     

Intermittent catheterisation is considered to be the gold standard for urine drainage (NICE, 2006) as it carries a reduced risk of infection compared to indwelling urinary catheterisation Intermittent catheterisation can be indicated as treatment for voiding problems due to disturbances or injuries to the nervous system, non-neurogenic bladder dysfunction or intravesical obstruction with incomplete bladder emptying Intermittent catheterisation can be undertaken by a healthcare or care professional or by the service user or a carer (when the procedure is termed Intermittent Self Catheterisation (ISC) When undertaken by a healthcare or care professional the procedure must be done using aseptic non touch technique An assessment must be undertaken prior to commencement of intermittent catheterisation by the Urologist or Nurse specialist, who will decide the most appropriate size and type of catheter for the service user.

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Put on a disposable plastic apron

To reduce risk of cross-infection from micro-organisms on health care/carers clothing

Assist the service user to get into the supine position with knees bent, hips flexed and feet resting about 60 cm apart

To enable the genital area to be visible and accessible

If not possible consider suitable alternative position Protect bed from any spillages which may occur during the procedure

Using an aseptic non touch technique, open the packages of equipment onto the sterile field

To maintain sterility and reduce contamination

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Place waterproof/water repellent bed protection under the service user’s buttocks and thighs

Follow manufacturer’s instructions to activate lubricated coating if applicable (Note - some catheters require activating with water or gel, others are ready to use)

To ensure that device is adequately lubricated before insertion To reduce the risk of infection. Hands may have become contaminated by handling the outer packs

Put on 1st pair of sterile single use gloves

To reduce the risk of infection

Take the sterile towel, place across the service user’s thighs

To provide a sterile field

Using non-dominant hand clean the labia majora and then the labia minora with Sodium Chloride 0.9% using downwards strokes with a clean piece of gauze for each stroke

To reduce the risk of cross-infection and introduction of skin and meatal flora

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Cleanse hands with alcohol hand rub

Separate vulva using non-dominant hand Inadequate preparation of the urethral then swab urethral meatus using dominant orifice is a major cause of infection hand following catheterisation

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