An Introduction to Catheterisation: Online Training for Residential Care Home Workers

When people in your care are unable to empty their bladder – perhaps they have an injury, are bed bound, or have had an operation – they may need to use a catheter. Our one-hour catheterisation online training course is for residential care workers who need to know what a catheter is, why it is used, how to avoid the risks associated with catheters, and the infections that can be caused by using a catheter.

Read on to find out more about catheterisation.

What is a catheter?

A urinary catheter is a hollow tube that collects urine from the bladder and leads to a drainage bag. Urinary catheters come in many sizes and can be made of rubber, plastic, or silicone. 

When is it used? 

Catheters are needed when someone cannot empty their bladder. Elderly people or those with a severe or permanent injury may use catheters for a long period of time, or even permanently. 

Urinary catheters may be used because a person has:

  • kidney stones, an enlarged prostate or blood clots,
  • swelling of the scrotum/penis (scrotal/penile edema or as a result of neurological disease/medication)
  • had an operation
  • needs to have their hourly urine output measured
  • is incontinent, and has perineal or sacral wounds which could become infected
  • to be immobilised following trauma or surgery
  • hospice/comfort care, palliative (end of life) care

What are the risks of not emptying your bladder? 

If a person’s bladder is not emptied, urine can build up and put pressure on the kidneys. The pressure can cause kidney failure, which is dangerous and
can cause permanent damage to the kidneys.
 

What are the risks associated with urinary catheters? 

The longer a catheter is used, the greater the risk of infection. It is important that catheters are routinely cleaned to prevent infection. 

Urinary catheters cause up to 40% of hospital-related infections. These infections are known as known as urinary tract infections (UTIs) as are found in the
bladder, urethra, or kidneys. They are usually treated with antibiotics.
 

Catheters may also cause other problems such as leakages, blockages, damage to the urethra, or bladder spasms. Additional complications may include
an allergic reaction to the material used in the catheter, bladder stones,blood in the urine, or kidney damage (with long-term indwelling catheters). 

What are the symptoms of a Urinary Tract Infection (UTI)?

Symptoms may include:

  • Pain low down in the stomach or around the groin
  • High temperature
  • Feeling cold or shivery
  • Confusion
  • Headache
  • Burning of the urethra or genital area

How is a UTI diagnosed and treated?

 A UTI is diagnosed by a urinalysis performed by a nurse, doctor or lab. This can be through:

  • a visual exam (checking for colour and clearness)
  • a dipstick test (dipping a thin, plastic stick with strips of chemicals on it, into the urine – the colours change if something is abnormal).
  •  sending urine off to a lab for a microscopic exam (checking for things that can’t be seen with the naked eye) using a urine culture to determine if any bacteria or fungi are in the urine 

A doctor will usually prescribe an antibiotic for a UTI, as well as encourage the patient to stay hydrated by drinking plenty of fluids, if the person is able. 

What are the types of urinary catheter? 

There are two main types of urinary catheter: 

Intermittent Catheter: This is temporarily inserted into the bladder through the urethra or through a hole created in the lower abdomen and removed once the
bladder is empty. It may also be called an “in-and-out” catheter. In a home setting, people can be trained to apply the catheter themselves or with the
help of carer.  
 

Indwelling Catheter: This is placed in the bladder and is sometimes known as a Foley catheter. It can be used for short or long periods of time. A
tiny balloon at the end of the catheter is then inflated with water to prevent the tube from sliding out of the body and it is deflated when the catheter
needs to be removed. These catheters can stay in place for days to weeks and are convenient and avoid repeated insertions. However, indwelling catheters are more likely to cause infection.
 

Suprapubic Catheter: This is used when the urethra is damaged or blocked, or if a person can’t use an intermittent catheter. It is inserted under general anaesthetic, epidural anaesthetic, or local anaesthetic, through a hole in the abdomen and then directly into the bladder. Once in place, the catheter is secured to the side of the body and attached to a collection bag strapped to the leg. A valve can also be placed that allows urine to be drained into the toilet, allowing
the bladder to fill until drainage is convenient. The catheter is changed every 4-12 weeks.

Urinary catheter care – for health and social care workers

  • Cleaning: Reusable catheters should be clean prior to entering the body. Single use catheters come in sterile packaging and do not need to be cleaned. The area where the catheter enters the body should be cleaned with soap and water prior to insertion to reduce the risk of a UTI.
  • Hydration: If the person is able, they should be encouraged to drink plenty of water to keep their urine clear or only slightly yellow to help prevent infection.
  • Emptying the bag: the drainage bag is emptied at least every eight hours or when the bag is full.

Urinary catheter care – for patients

To minimise the risks of living with a catheter, the person should:

  • Wash the skin area where the catheter enters the body with mild soap and water daily
  • Wash hands with soap and water before and after touching catheter equipment
  • Stay well hydrated and avoid constipation
  • Avoid having bends or kinks in the catheter, as well as keeping the collection bag below the level of the bladder

A person with a catheter can participate in most of their usual activities, including sexual intercourse in most cases. 

If you’d like your residential care staff to gain a full understanding of this topic and earn their CPD point, visit the catheterisation online learning course page.

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