Catheterisation

Understanding the Definition of Catheterisation

The main goal of catheterisation varies depending on the exact medical context. It ranges from aiding with urination to helping maintain blood flow through the vessels. The complexity of the procedure may also differ depending on the type and site of catheterisation.

Basics of Catheter Types and Uses

The following table lists some of the common types of catheters and their uses:

Understanding the different types of catheters and their uses is critical in ensuring that you as a nursing student deliver optimal care when performing or assisting in these procedures.

The Procedure of Catheterisation

Manual proficiency combined with well-rounded knowledge forms the heart of nursing practices, with catheterisation being no exception. Although the nuanced steps can differ according to patient gender and the type of catheterisation, some universal aspects remain consistent. These include the use of aseptic techniques, patient communication and appropriate aftercare.

Guidelines for Male Catheterisation

In male catheterisation, the procedure typically involves the insertion of a urinary catheter into the bladder via the urethra. The objective of this procedure is to aid in the drainage of urine which may be required for a variety of reasons such as postoperative care, severe urinary retention, or patient immobility.

Follow these crucial steps while performing male catheterisation:

• Explain the procedure to the patient and ensure informed consent.
• Wash hands thoroughly and wear sterile gloves.
• Position the patient with his legs slightly apart.
• Use a water-soluble lubricant to coat the catheter.
• Hold the penis at a 90-degree angle and slowly insert the catheter into the urethra.
• Once the catheter is in place, secure it to prevent displacement.
• Dispose of used materials appropriately and wash your hands.

Steps to Follow in Female Urinary Catheterisation

Female urinary catheterisation, although similar in objective to male catheterisation, differs slightly in practice due to anatomical differences. It involves the insertion of a catheter through the female urethra into the bladder to facilitate urine drainage.

Key steps in performing female catheterisation are:

• Obtain informed consent after explaining the procedure to the patient.
• Ensure hand hygiene and wear gloves.
• Position the patient on her back with knees bent and apart.
• Identify the urethra (it's important to remember that the female urethra is located above the vaginal opening and below the clitoris).
• Insert the lubricated catheter until urine flow is observed, then insert a little further.
• Secure the catheter and clean up disposal materials.

In conclusion, a keen understanding and implementation of catheterisation guidelines as a nursing student contributes significantly towards effective patient care, prevention of infections and enhancing patients' comfort level during the process.

Common Types of Catheterisation in Clinical Placement

As a nursing student in clinical placement, different types of catheters are used at varying frequencies depending on the patient’s conditions and necessity. The two commonly encountered types of catheterisation are Clean Intermittent Catheterisation (CIC) and Suprapubic Catheterisation (SPC). Each type requires a distinctive method of insertion and aftercare, contributing significantly to individual patient care plans.

The Process of Clean Intermittent Catheterisation

Clean Intermittent Catheterisation, frequently abbreviated as CIC, is widely used in temporary management of urological disorders. Predominantly, it's practised for conditions like urinary retention and neurogenic bladder, where the patient's bladder muscles fail to contract properly.

CIC is minimally invasive and generally carried out by the patients themselves or by carers. However, initial instruction and guidance are required. For a nursing student, knowledge of CIC focuses primarily in two arenas: patient education and technique reinforcement:

• Patient Education: Proper patient guidance is essential. This includes teaching the patient about the procedure, its benefits and potential risks.
• Technique reinforcement: Observing the patients performing CIC initially and correcting their errors is necessary. Timely reinforcement of the steps helps in forming and maintaining correct techniques.

A Closer Look at Suprapubic Catheterisation

Suprapubic Catheterisation, or SPC, is a procedure where a catheter is inserted into the bladder through a small cut in the abdomen, just above the pubic bone. It is broadly implemented in patients who require long-term catheterisation.

A nursing student's role in SPC primarily includes:

• Procedural Assistance: Nurses typically assist doctors during the SPC procedure. This includes patient positioning, ensuring sterile conditions and monitoring the patient's vitals throughout the process.
• Post-Procedure Care: After SPC, regular catheter monitoring and wound care become vital tasks. These can include cleansing the suprapubic site, inspecting for signs of infection, and measuring urine output for irregularities.

Potential Complications of Catheterisation

Just as in any medical procedure, catheterisation, too, comes with its clan of challenges and risks. Understanding these potential complications enables you to anticipate, prevent, and manage them effectively to ensure patient safety during and after the procedure.

Identifying Risks and Underlying Problems in Urinary Catheterisation

Urinary catheterisation, while invaluable in clinical healthcare, introduces a number of risks, primarily tied to infection and damage to the urinary tract. It is considered a significant cause of healthcare-associated infections, highlighting the need for careful practice.

Major complications of urinary catheterisation include:

• Urinary Tract Infections (UTIs): Long-term catheterisation can lead to UTIs due to bacteria climbing up the catheter tube.
• Bladder Damage: Bladder spasms or damage to the bladder walls can be triggered by catheter insertion.
• Urethral Injuries: Injuries can occur during catheter insertion, particularly if forced.
• Blood Infections (Septicaemia): Long-term catheterisation could potentially allow bacteria to enter the bloodstream, leading to serious infections.

The Best Practices to Avoid Complications of Catheterisation

Prevention is indeed better than cure! And it certainly applies when handling catheterisation. A blend of adhering to basic principles and tailoring care for individual patients ensures the reduction of associated risks. Let's take a look at these practices:

• Thorough Sterilisation: Ensuring that the catheter and the surrounding area are thoroughly cleaned will reduce the risk of infections.
• Proper Technique: Ensuring that the catheter is inserted correctly and gently can prevent traumatic injuries.
• Regular Monitoring: Keeping a regular check on the catheter and the areas around it can detect early signs of complications.
• Timely Catheter Changes: Scheduled replacements can prevent encrustations and blockages.
• Patient Hygiene: Regular personal hygiene can drastically reduce infection risks.

A nursing student's understanding of these complications and how to prevent them is an important component of mastering catheterisation. The very nature of catheters necessitates meticulous observation and hygiene, and an awareness of the potential risks helps to focus care where it's needed most.