378 INSERT AND SECURE URETHRAL CATHETERS AND MONITOR AND RESPOND TO THE EFFECTS OF URETHRAL CATHETERISATION

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1 Unit overview Elements of competence 378a 378b Insert and secure urethral catheters Monitor and record on urethral catheterisation of individuals About this unit For this unit you need to insert urethral catheters, including re-catheterisation, following agreed protocols and procedures. It also covers regular monitoring and care of the urethral catheter after insertion. It does not include suprapubic catheterisation. Scope The scope is here to give you guidance on possible areas to be covered in this unit. The terms in this section give you a list of options linked with items in the performance criteria. You need to provide evidence for any option related to your work area. Adverse effects may include: fear/apprehension; pain; failure to pass the catheter; lowered blood pressure; haematuria. Appropriate action includes reporting immediately to a person more competent to deal will the situation. Drainage system may include: drainage bag; night drainage bag; urometers; closed drainage systems. Equipment and materials may include: cleaning fluids; local anaesthetic agents; catheters; syringes; drainage bags; fluid balance charts; sterile gloves. Reasons for catheterisation may include: prior to surgery; to prevent skin break down; urinary retention; burns; diagnostic procedures; renal failure; acutely ill individuals. Relevant information may include: urine output; type of catheter used; method used for securing catheter in position; methods used for securing external tubing; recording documentation; written procedures and protocols. Standard precautions and health and safety measures including handwashing/cleansing before during and after the activity; the use of personal protective clothing and additional protective equipment; handling contaminated items; disposing of waste; safe moving and handling techniques and untoward incident procedures. OCR Level 3 NVQ in Health and Social Care 1

2 Unit overview (continued) Your knowledge and understanding for this unit will relate to legal requirements and codes of practice applicable to the scope of your work and others with whom you work; the nature of the work you are undertaking; your role and level of responsibility within your organisation (eg whether you have responsibility to support the work of others); the individuals, key people 1 and others with whom you are required to work and the degree of autonomy you have for the management of your own work activities. Values underpinning the whole of the unit The values underpinning this unit have been derived from the key purpose statement 2, the statement of expectations from carers and people receiving services, relevant service standards and codes of practice for health and social care in the four UK countries. To achieve this unit you must demonstrate that you have applied the principles of care outlined in either unit 35 in your practice and through your knowledge. 1 If you are working with children and young people the term individuals covers children and young people and key people covers parents, families, carers, friends and others with whom the child/young person has a supportive relationship 2 The key purpose identified for those working in health and social care settings is to provide an integrated, ethical and inclusive service, which meets agreed needs and outcomes of people requiring health and/or social care OCR Level 3 NVQ in Health and Social Care 2

3 Key words and concepts This section provides explanations and definitions of the key words and concepts used in this unit. In occupational standards it is quite common to find words or phrases used which you will be familiar with, but which, in the detail of the standards, may be used in a very particular way. Therefore, we would encourage you to read this section carefully before you begin working with the standards and to refer back to this section as required. Additional protective equipment Contaminated Individual Personal protective clothing Protocol Standard precautions and health and safety measures Includes: types of personal protective equipment such as visors, protective eyewear and radiation protective equipment Includes: items contaminated with body fluids, chemicals or radionucleatides. Any pack/item opened and not used should be treated as contaminated The individual is anyone who has been assessed as requiring urethral catheterization, in the context of this unit the individual will always be an adult Includes items such as plastic aprons, gloves - both clean and sterile, eyewear, footwear, dresses, trousers and shirts and all in one trouser suits and gowns. These may be single use disposable clothing or reusable clothing A set of guided instructions on the action to be followed in relation to catheterization, usually developed and quality assured through and by your employing organisation A series of interventions which will minimise or prevent infection and cross infection; including handwashing/cleansing before during and after the activity and the use of personal protective clothing and additional protective equipment when appropriate OCR Level 3 NVQ in Health and Social Care 3

4 378a Insert and secure urethral catheters Performance criteria You need to show that: 1 You apply standard precautions for infection control and take other appropriate health and safety measures 2 You comply with the correct protocols and procedures relating to urinary catheterisation 3 You insert the catheter safely and correctly, according to manufacturer s instructions and with minimal trauma to the individual 4 You secure the catheter after insertion according to instructions and adjust it correctly 5 You attach the catheter correctly to the appropriate drainage system, confirm it is functioning correctly and measure and record the amount of urine collected immediately after insertion 6 You make the individual as comfortable as possible following the procedure OCR Level 3 NVQ in Health and Social Care 4

5 378b Monitor and record on urethral catheterisation of individuals Performance criteria You need to show that: 1 You monitor the individual s condition, promptly recognise adverse effects and take the appropriate action 2 You seek assistance promptly from an appropriate person should it be required 3 You record clearly, accurately, and correctly any relevant information in the necessary records 4 You check that all catheterisation equipment and materials are functioning correctly and take appropriate action to remedy any problems 5 You maintain cleanliness of the catheter and surrounding area through regular hygiene care 6 You empty drainage bags and measure and record urinary output whenever necessary and as instructed by the professional involved 7 You educate the individual as far as possible on the care of the catheter and attachments OCR Level 3 NVQ in Health and Social Care 5

6 Knowledge specification for the whole of this unit Competent practice is a combination of the application of skills and knowledge informed by values and ethics. This specification details the knowledge and understanding required to carry out competent practice in the performance described in this unit. When using this specification it is important to read the knowledge requirements in relation to expectations and requirements of your job role. Values 1 A working understanding of adapting communication to meet individual s needs 2 An in-depth understanding of the effects of catheterisation on the individual s comfort and dignity, and ways of minimising any adverse effects 3 An in-depth understanding of the ethical issues surrounding catheterisation, as applied to males and females 4 A working understanding of the need for chaperones, individual awareness and consent Legislation and organisational policy and procedures 5 A factual awareness of the current European and national legislation, national guidelines and local policies and protocols which affect your work practice in relation to carrying out urethral catheterisation 6 A working understanding of your responsibilities and accountability in relation to the current European and national legislation and local policies and protocols Theory and practice 7 A factual awareness of the importance of working within your own sphere of competence when and seeking advice when faced with situations outside your sphere of competence 8 A working understanding of the importance of applying standard precautions and the potential consequences of poor practice 9 An in-depth understanding of the conditions and constraints which might denote who undertakes this procedure and why Anatomy and physiology 10 An in depth understanding of the anatomy of the male and/or female genito-urinary system 11 An in-depth understanding of the physiology of the genito-urinary system Care and support 12 A working understanding of potential adverse effects and appropriate actions 13 A working understanding of the importance of offering effective verbal and non-verbal support and reassurance to patients when you perform urethral catheterisation 14 A working understanding of the effective methods of providing verbal and non-verbal support and reassurance to patients OCR Level 3 NVQ in Health and Social Care 6

7 Knowledge specification for the whole of this unit (continued) Materials and equipment 15 An in-depth understanding of the types of catheters that can be used and why you should select the appropriate catheter 16 A working understanding of the local anaesthetic agents available Records and documentation 17 A working understanding of the importance of keeping accurate and up to date records 18 A working understanding of the importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff OCR Level 3 NVQ in Health and Social Care 7

8 Evidence requirements for this unit Prior to commencing this unit you should agree and complete an assessment plan with your assessor which details the assessment methods you will be using, and the tasks you will be undertaking to demonstrate your competence. Evidence must be provided for ALL of the performance criteria, ALL of the knowledge and the parts of the scope that are relevant to your job role. The evidence must reflect the policies and procedures of your workplace and be linked to current legislation, values and the principles of best practice within the Health and Social Care Sector. This will include the National Service Standards and/or KSF for your areas of work and the individuals you care for. All evidence must relate to your own work practice. Simulation is NOT permitted for any part of this unit. The following forms of evidence are required: Direct observation: your assessor/expert witness must observe you in real work activities which provide evidence for a significant number of the performance criteria for both elements of this unit. You should be observed while working with individuals who need urethal catheters, including how you take all the necessary standard safety precautions to do this: the observation should also include how you relate to individuals and communicate with them. Reflective accounts/professional discussion: these will be descriptions of your practice in inserting catheters and subsequently monitoring and recording this. You should include how you assessed any possible risk to the individual, and how you communicated with individuals at all times to reassure them. Competence of performance and knowledge could also be demonstrated using a variety of evidence from the following: Questioning: may be used to provide evidence of knowledge, legislation, policies and procedures which cannot be fully evidenced through direct observation or reflective accounts. In addition the assessor/expert witness may also ask questions to clarify aspects of your practice. It is highly unlikely that the knowledge for this unit could be covered without additional questioning, as many of the knowledge points ask for in-depth understanding. Witness testimony: can be a confirmation or authentication of the activities described in your evidence which your assessor has not seen. This could be provided by a work colleague or service user. Work products suggestions: organisational policy and procedures in relation to prescribed procedures for this unit, any reports or entries in the care plans of individuals detailing any specific instructions re their catheteristation. APL/assignment/project: you may have already completed a project or assignment from vocationally related qualification, you may also have evidence form other training eg moving and handling, health and safety, infection control, personal protective clothing/equipment, pressure area care course, reporting and recording. COSHH, communication. NB Confidential records are not required in your portfolio, they can remain where they are normally stored and be checked by your assessor and internal verifier. If they are included they must be anonymised. OCR Level 3 NVQ in Health and Social Care 8