Contents
1 Aim
To provide staff with best practice guidelines for performing male 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
3.1 Links to associated documents
3.2 Links to relevant policies or procedures
4 Procedure
4.1 Catheterisation
Catheters should only be used after all alternatives have been considered. When catheterisation is being discussed as a treatment option or intervention, intermittent catheterisation should always be considered for incomplete emptying as a first option rather than indwelling catheterisation, providing this is safe and acceptable alternative for the individual and carer(s). It is therefore essential that a urethral catheterisation assessment is performed before carrying out the catheter procedure. Reason for catheterisation must 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 Catheterisation associated risks
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.
4.3 Catheter choice
Please refer to appendix J for choice of catheter and equipment. Male patients must only be catheterised with a standard length. The choice of catheter and equipment used must be clearly documented within the catheter IPOC within SystmOne and catheter passport.
4.4 First time male catheterisation
First time male catheterisation can only be performed in the community setting by the Unplanned Care team for acute retention only. However for end of life patients if the registered nurse is competent in male catheterisation and they have attended the catheter study day and have completed the relevant scope package, they may perform catheterisation.
A first time male catheterisation is classed as someone who has never been catheterised before or has not had a catheter in place for 2 years.
A registered nurse within the Unplanned Care team may carry out first time male catheterisation for acute retention when they have completed the management of acute painful retention In men (MAPRIM) training, completed the relevant competency package and attended the catheter study day training provided by the specialist continence service. Please refer to appendix K management of acute and chronic retention in males first time male catheterisation pathway (MAPRIM pathway).
4.5 Male re-catheterisation
A registered nurse may carry out uncomplicated male re-catheterisation when they have completed the catheterisation CAST competency package and attended catheter study day training provided by the specialist continence service.
4.6 Catheter clinic
Non-house bound patients with catheters can be referred to the specialist continence catheter clinic for routine catheter change.
Catheter change
Catheter change should be a planned event according to the type of catheter selected and the patient’s previous history where a catheter is already in situ. Monitoring catheter change history can establish a pattern for any recurrent problems such as encrustation leading to blockage, and can allow changes to be planned prior to problems developing.
4.7 How to perform male catheterisation
Please follow link to the Royal Marsden manual (opens in new window)
After catheterisation it is essential that the health care professional performing the catheterisation ensures that the foreskin is replaced, this is to prevent paraphimosis occurring (the foreskin becomes trapped behind the glans penis and cannot be reduced). If this condition persists for several hours or there is a lack of blood flow it must be classed as a medical emergency. Please refer to the trouble shooting with catheters procedure, continence manual advise the patient or carer to use alternate legs when attaching the catheter bags each day to reduce the risk of developing a split in their meatus.
Nurses should ensure that the patient is aware of basic catheter care and how to order catheter equipment.
4.8 How To remove a catheter
Please follow link to the Royal Marsden:
4.9 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 carer should be given a ‘my catheter’ passport document. This document provides the patient with written information about their catheter management (please see appendix Q).
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
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 K Management of acute painful retention in men pathway
- Appendix P My catheter passport
Document control
- Version: 2.
- Unique reference number: 517.
- Date ratified: 7 April 2023.
- Ratified by: Clinical policies review and approval group.
- Name of originator: Senior continence specialist sister.
- Name of responsible individual: Executive director of nursing and allied health professionals
- Date issued: 26 May 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 group.
Page last reviewed: April 24, 2024
Next review due: April 24, 2025