PATIENT URINARY CATHETER PASSPORT

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1 n PATIENT URINARY CATHETER PASSPORT A guide on how to look after your Catheter NHS Hertfordshire Patient Experience Team Charter House Parkway Welwyn Garden City Hertfordshire AL8 6JL Telephone: Fax: Web: If you would like a copy of this document in LARGE PRINT, Braille or audio tape, or would like this information explained in your own language, please contact For further copies of this booklet, please contact the Patient Experience Team on Produced by the Patient Experience Team, NHS Hertfordshire. January Review date: January ADULT BLADDER & BOWEL CARE IN HERTFORDSHIRE Advice on how to look after your catheter

2 This booklet has been designed to provide you with advice on how to look after your catheter. If you have any appointments at your GP practice, at the hospital, or if you have an in-patient stay at a hospital, be sure you take this booklet with you. You will see that the second part of this booklet is to be completed by the nursing/medical staff looking after your catheter. This is to make sure that everyone looking after your catheter is aware of your care, including any action that has been taken and is due to take place. Patient details Name: Address: What is a urinary catheter? A catheter is a thin, hollow tube that drains urine from the bladder into a drainage bag; it can be inserted on a long term or a temporary basis. If a catheter remains in the bladder it is known as an indwelling catheter. Telephone: Reason for catheter insertion:

3 How do I look after my catheter? Empty your catheter bag when it is two thirds full of urine. If you have a valve attached to your catheter instead of a leg bag open the valve when: You feel your bladder is full, Before you go to bed, On waking, During the night, if necessary, Every 3-4 hours during the day, Before opening your bowels. Replace the leg bag and/or valve once a week. Only disconnect the leg bag or valve weekly when it is replaced with a new bag/valve. Attach a NEW night bag to the leg bag or valve every night. Remove the night bag every morning, close the leg bag tap and/or catheter valve and dispose of the night bag. For advice on how to dispose of your used drainage bag please read further on in this booklet. What do I do if I am in pain or discomfort? When a catheter has first been inserted it is normal to feel some lower abdominal (tummy) pain. If the pain continues contact your Community Nurse. How often will the catheter need changing? Between 4-12 weeks depending on the type of material your catheter is made from. This information will be written in the back of this booklet. What should my urine look like? Your urine should be a light yellow colour but is largely dependent on the amount you drink. Remember that you should be aiming to drink around 1½ - 2 litres of fluid a day, or 8 mugs. If your urine is cloudy and does not improve after drinking more, always contact your Community Nurse or GP. How do I help prevent infection? The most common complication associated with a catheter is infection. Taking the following steps will reduce this risk. 1 Always wash your hands before and after touching your catheter. 2 Always make sure that the area around the insertion area is clean. You can do this by washing it with mild soap and water at least twice a day. 3 Women need to make sure that the genital area is washed from front to back. This will prevent spreading any infection from your back passage on to the actual catheter. 4 Men should carefully wash under the foreskin (unless you have been circumcised). Remember to replace the foreskin over the end of the penis after drying. 5 To prevent irritation it is best to avoid talc, antiseptic, bubble bath or bath salts and creams. 6 When you have a bath or shower do not remove your leg bag, if you are using one. 7 Always ensure that if your care giver is changing your catheter drainage bag or valve, he/she is wearing gloves. What do I do if my catheter is not draining or is leaking? Check that the drainage bag is below the level of the bladder, particularly when sitting in a low chair. Make sure that the catheter tubing is not kinked. Make sure that the drainage bag is connected properly. The urine will not drain into the bag if it is full. Empty the bag when it is two thirds full. If possible try and walk around and change position. Constipation can prevent the catheter from draining. If you do experience urine leakage, contact your Community Nurse. How do I dispose of used catheter bags? Empty the contents into the toilet. Double wrap the bag (either in newspaper or a plastic bag). Place in your household waste bin then wash your hands.

4 Can I have sex? Having sexual intercourse with an indwelling urethral catheter in place is not recommended as there is potential for infection, discomfort and possible trauma. For those with an active sex life it is recommended that discussions take place with your GP and/or Specialist about other forms of catheterisation. For example: Suprapubic - this is an indwelling urinary catheter inserted via a small hole in the lower abdomen (tummy) or Intermittent catheterisation - this is when a catheter is inserted periodically throughout the day to empty the bladder. It only remains in the bladder until urine has finished draining then it is removed. When should I ask for help? Your catheter should always be comfortable and should not cause you any pain. Always ask for help if you experience any of the following: If you experience sharp, intense lower stomach pain. If the urine is not draining and you have already followed the guidance in this booklet. If your catheter falls out and you are unable to pass urine. If your urine is smelly, cloudy or if you have a burning sensation, which does not get better after drinking more fluids. If urine is leaking around your catheter and making your clothing wet. There is blood in your urine. Useful contact numbers Watford General Hospital Phone: Hemel Hempstead General Hospital Phone: Lister Hospital Phone: / GP Out Of Hours Service Phone: NHS Direct Phone: Adult Bladder and Bowel Care Service Phone: GP details Name: Address: Telephone: Community Nurse Name: Address: Telephone: Clinic/Hospital Name: Address: Telephone:

5 Records To be completed by nursing staff Please refer to your local policies and guidelines for further information. Best Practice Guidance for Care Staff Catheterisation - useful tips Catheterisation should only be carried out by an appropriately trained person. Aseptic technique should be used. The meatus should be cleaned with saline before insertion of the catheter. A single use local anaesthetic lubricant should be used. Monitor drainage of urine, colour of urine, signs of debris in urine. When recatheterising the patient observe the tip of the removed catheter and look for signs of encrustation. If this is present the frequency of catheter changes may need to be reviewed and advice sought from the Specialist Teams (i.e. Continence Team WHHT or Bladder and Bowel Team HCT) on catheter maintenance solutions. Catheters should be changed according to manufacturer s recommendations. Catheter size, balloon volume, batch number and expiry date should be documented in this catheter passport and nursing care notes. Urine samples must be obtained from the needle-free sampling port using a non-touch technique. Catheter Care - useful tips Wash hands and put on non sterile gloves before handling catheter or drainage bag and wash hands after the procedure. Daily hygiene care of genital area. A leg bag should be worn during the day and secured with straps or catheter bag leg sleeve. A link system should be used at night by adding a night bag to the leg bag or catheter bag leg sleeve. Urinary drainage bags should be positioned below the level of the bladder and should not be in contact with the floor. Night drainage bags must be supported by a stand. Remember the following To check if the patient has any moisture lesions. To check the patient for any indication of a pressure ulcer/s. To prevent falls check any loose bags/stands etc. MRSA If the patient has a history of MRSA in their urine Gentamicin (1.5mg/kg iv/im single dose) OR Doxycycline (200mg Orally) should be given 30 minutes prior to catheterisation or recatheterisation. If during insertion or removal of the catheter there is a possibility of trauma to the urethra or if bleeding occurs please call for a medical review urgently and gentamicin should be considered. Date of positive result for MRSA in the urine: Date gentamicin given prophylactic prior to insertion/change of catheter: NB Patients with MRSA in other sites, for example nose, wounds, do not need antibiotic cover but will need to be monitored for signs and symptoms of infection.

6 Information on first catheter insertion Urethral or Suprapubic catheter: Reason for catheter insertion: Where insertion took place i.e. home or hospital: (please state ward or department) Future plans regarding catheterisation: Name of Hospital Consultant involved with care: (please state speciality) Details of final removal Name: Address: NHS number: Date of birth: Location: Acute Hospital c Community Hospital c Patient Home c Residential/Nursing Home c GP Practice c Details of site/ward: Reason for catheter insertion:

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