Catheters Resources

Intermittent catheterisation is considered the gold standard for urine drainage (Holroyd, 2018). It can be used 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 (Royal College of Nursing [RCN], 2018). Irrespective of the underlying cause, patients with voiding problems frequently find themselves having to make use of a catheter to drain their bladder when it fills and thereby undertake regular intermittent self-catheterisation (ISC). Intermittent catheterisation involves the introduction of a catheter into the bladder and its immediate removal when drainage stops, a process which needs to be repeated four to six times a day (Holroyd, 2018). The experience of performing ISC, while straightforward for some, can be both difficult and painful for others (Guinet-Lacoste et al, 2016; Rognoni and Tarricone, 2017)

The National Catheter Education Programme is a Health Education England-funded initiative to improve the care of patients with catheters. Part of this initiative is the Secret Life of Catheters programme. This article highlights the need for improvement in catheter care and explains the development of this project, which aims to drive improvements across primary and secondary settings through the large-scale delivery of a multiprofessional educational programme in catheter care. The programme explores key dilemmas that district nurses, community nurses, healthcare assistants and doctors can encounter with catheters, and provides approaches to address them. By standardising the teaching of clinical concepts and practice strategies, it is hoped that variations in practice and pockets of misunderstanding can be eliminated.

With over a million devices used in the NHS every year, indwelling urinary catheterisation is widely acknowledged as one of the most commonly used invasive healthcare procedures. Despite its widespread use, there is also extensive evidence of the risk of infection, blockage and bypassing associated with indwelling catheters, all of which can adversely affect patients’ health and quality of life, as well as placing a significant burden on the supportive health services that manage the caseloads of catheterised patients in both community and acute settings. This article looks at the reasons for the use of long-term catheters, the complications that can arise and the positive impact the use of a triclosan-based solution can have when instilled into the inflation balloon of the catheter. A selection of case studies highlight the use of Farco-fill® Protect (CliniMed) in complex patients whose only management option for effective bladder drainage is to use an indwelling catheter.

Community nurses’ caseloads may include a large number of catheterised patients and catheter-related infection is a significant problem, with up to 90–100% of those who are catheterised long-term going on to develop a catheter-associated urinary tract infection (CAUTI). For community nurses, ensuring that their skin and that of the patient has been cleansed before any catheter-related intervention is paramount. This article looks at the use of a new antimicrobial cleansing solution (octenilin®; Schülke) and whether its properties reduced the infection risk associated with catheterisation in the community.

Tim Sandle, Head of Microbiology, Bio Products Laboratory Limited, Watford

John Robinson gives a brief overview of his ongoing research projects into whether patients complain of pain on removal of catheters.

John Robinson RGN RMN, NDN (Cert) is a District Charge Nurse, Catheter Specialist, Bay Community NHS Trust, Morecambe.

Article accepted for publication January 2000

Ian Pomfret guides us thorugh the different types of catheterisation available.

Ian J. Pomfret RGN, NDN Cert, PWT, District Continence Adviser, Chorley & South Ribble NHS Trust.

Article accepted for publication November 2000.