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Infection Prevention and Control
Standard Operating Procedures (Trial Without Catheter )
Standard Operating Procedure (SOP) Trial without Catheter (TWOC) Purpose To ensure all relevant staff are aware of the principles of undertaking a trial without catheter for a service user and understand the rationale that informs the principle, which is 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 undertaking a trial without catheter for a service user. Introduction
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Epic 3 National Evidence Based Guidelines for preventing Healthcare- Associated Infections in NHS Hospitals in England (2013) states that quality improvement systems used to support the appropriate use and management of short term urethral catheters and ensure their timely removal should be employed. This includes reminders to review the continuing use or prompt the removal of catheters.
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Epic 3 guidance also recommends that no service user should be discharged or transferred with a short – term indwelling urethral catheter without a plan documenting the: Reason for the catheter Clinical indications for continuing catheterisation; and Date for removal or review by an appropriate clinician overseeing their care
The catheter should be removed by deflating the balloon with a syringe (do not aspirate water out of the balloon; allow the deflation to occur spontaneously). The balloon valve should NEVER BE CUT OFF. If you are unable to remove a catheter seek advice. This guidance should be used in conjunction with other associated infection prevention and control policies and procedures such as Hand Hygiene, Waste Management, and use of Personal Protective Equipment (PPE) etc. Only appropriately trained and competent healthcare or care staff should undertake trial without catheter using a clean technique. Equipment
Single use gloves Disposable plastic apron Sterile syringe for deflating balloon Hand sanitizer Clinical waste bag
Client Name Start Date: 00/00/0000 End Date: 11/11/1111 1 of 4 - Trial without Catheter
Procedure
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medical help Clear away equipment and dispose of waste in to the correct waste streams Remove single use gloves and plastic apron and perform hand hygiene
To prevent environmental contamination and ensure appropriate disposal To reduce the risk of infection
Record all information in service users To ensure effective and accurate record records including any untoward events keeping is maintained and caused by removal documentation is complete
Following removal of catheter
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Encourage the service user to drink 2-3 litres a day of fluids Service users should be asked to pass urine into bottles or bed pans so accurate fluid balance charts can be maintained and monitored to ensure service user is passing satisfactory amounts of urine Consider a bladder scan to check for residual urine Ensure the service user has sufficient equipment should the trial without catheter fail and re-catheterisation is required.
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Client Name Start Date: 00/00/0000 End Date: 11/11/1111 3 of 4 - Trial without Catheter
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