Contents
1 Aim
To provide staff with best practice guidelines for performing intermittent catheterisation.
2 Scope
This procedure applies to all clinical staff including agency, locum and bank staff working in both the Doncaster mental health care group and Doncaster physical health care group of RDaSH who deliver or provide continence or catheter care to adult patients over the age of 18. For staff working in Rotherham and Scunthorpe, they will need to refer to their local guidelines.
It is recognised that primary care practitioners are also part of the organisation and as such this policy is offered for use by them to adapt to their own practices and organisations as appropriate.
The author of the policy is available to offer help and support to primary care practitioners who wish to use and implement this policy.
As part of good employment practice, whilst undertaking work for RDaSH.
Agency workers are also required to abide by the RDaSH policies and procedures, as appropriate, to ensure their health, safety and welfare.
3 Link to overarching policy, and or procedure
3.1 Links to relevant policies or procedures
4 Procedure or implementation
4.1 Intermittent catheterisation
Intermittent catheterisation should always be considered for incomplete emptying as a first option rather than indwelling catheterisation (NICE 2019), providing this is safe and acceptable alternative for the individual and carer(s). It can be used as treatment for voiding problems due to disturbances or injuries to the nervous system, non-neurogenic bladder or obstruction with incomplete emptying.
It is therefore essential that a urethral catheterisation assessment is performed before carrying out the catheter procedure. Reason for catheterisation should be clearly documented within the catheter integrated pathway of care (IPOC) within SystmOne and catheter passport. Please refer to appendix H for urethral catheterisation assessment guidance.
4.2 Female re-catheterisation
Band 3 healthcare assistants who have attended the female catheterisation study day provided by the specialist continence service and have completed the relevant clinical skills package may perform simple female re-catheterisation with an intermittent catheter on uncomplicated female patients who have been assessed by a registered nurse.
4.3 Risk of catheterisation
Using any form of catheterisation has associated risks. Therefore it is essential that a risk assessment is an integral part of catheter care. Please refer to appendix I for risk assessment.
Though intermittent catheterisation has a reduced infection rate when compared to indwelling catheters, there is still a risk.
Intermittent catheterisation should not be commenced solely on the residual urine. Before commencing a patient on intermittent catheterisation, their symptom severity, renal function, risk assessment, psychological and physical ability to perform intermittent catheterisation and residual urine must be considered.
4.4 Catheter choice
Male patients can only be catheterised with a standard length. The choice of catheter and equipment used should be clearly documented within the catheter IPOC within SystmOne and catheter passport.
Please refer to appendix J for choice of catheter and equipment.
4.5 Teaching intermittent self-catheterisation (ISC)
For further advice on patients performing ISC contact the specialist continence service who will carry out a full assessment and the patient’s ability to manage the procedure. It should also be noted with the patient’s consent a carer or spouse can be taught to perform ISC.
4.6 Frequency
The frequency and continued usage of intermittent catheterisation is based on the following:
- symptom severity improvement
- quality of life and life style indicators
- volumes drained related to times of urinary output (please refer to appendix L for frequency guide)
- clinical requirement
- renal function
Intermittent catheterisation may need to be increased during periods of urinary tract infections.
For further advice regarding frequency and continued usage of intermittent catheterisation, please contact the specialist continence service.
4.7 12 month review
All patients who perform intermittent self-catheterisation will be reviewed every 12 months by the specialist continence service.
4.8 Performing female intermittent catheterisation
Please follow link to the Royal Marsden manual:
4.9 Performing male intermittent catheterisation
Please follow link to the Royal Marsden manual:
- intermittent self‐catheterization patient guidance, male, Royal Marsden manual (opens in new window)
4.10 Documentation
The catheter integrated pathway of care (IPOC) found within SystmOne provides a framework for best practice and follows RCN guidelines for nurses on catheter care (2019). The IPOC supports the assessment process and should be followed by the healthcare practitioner to meet all the clinical and legal requirements for record keeping.
Each individual patient or carers should be given a ‘my catheter passport’ document. This document provides the patient with written information about their catheter management.
There are 2 distinct sections within the passport, patient and clinical. The patient section supports effective care of the catheter in order to reduce the risk of infection and the clinical section includes essential information around the catheterisation itself and should contain the plan of care; reason for catheterisation and plans for trial without catheter. There is also a catheter maintenance section which can be completed by the health care professional, carer or patient themselves.
5 References
- National Institute for Heath and Care Excellence (2019) London: NICE (opens in new window).
- Royal College of Nursing (2019) Catheter Care RCN Guidance for Health Care Professionals. London (opens in new window).
6 Appendices
Please see continence manual webpage for appendices attached to this procedure.
- Appendix H Urethral catheterisation assessment guidance
- Appendix I Risk assessment
- Appendix J Choice of catheter and equipment
- Appendix L Intermittent catheter frequency guide
Document control
- Version: 2.
- Unique reference number: 516.
- Approved by: Clinical policies review and approval group.
- Date approved: 7 March 2023.
- Name of originator or author: Senior continence specialist sister.
- Name of responsible individual: Executive director of nursing and allied health professionals.
- Date issued: 26 March 2023.
- Review date: 31 March 2026.
- Target audience: All clinical staff.
- Description of change: Review, updated scope to make it explicit that the procedure only applies to staff within the Doncaster care groups.
Page last reviewed: April 24, 2024
Next review due: April 24, 2025