Catheter Care 101: A Breakdown Of Catheters and How They Work

There are many misconceptions about urinary catheters, how they work, and who may need them. One of the main issues around catheters is incorrect insertion which can lead to infection and other health complications.

Sometimes, people with disability may need to use catheters because they may not be able to urinate on their own, which can cause concerns such as kidney failure. If this is the case, support workers and carers are needed to provide support with catheters.

What is a catheter?

A catheter, or urinary catheter, is a tube that is inserted into the bladder to help with urine drainage. 

The tube is then attached to a drainage bag, which is made of plastic and is usually strapped to a person’s thigh to keep it in place. Since the process of inserting a catheter is quite invasive, only qualified health professionals, such as doctors or nurses, can do this.

Urinary catheters are used for many reasons, including empowering individuals to have more control over their bodies and relieving painful urinary retention.

Most support workers and carers are required to have some knowledge of the anatomy involved in catheter care.

This means the urinary tract which consists of:

• The upper urinary tract that contains the

• Kidneys, and
• Ureters.

The lower urinary tract that has the

• Bladder,
• Urethra, and
• Internal and external urethral sphincters.

Indicators for use of catheters

There are some indicators that suggest a person may need or use a catheter. The indicators of a catheter vary by person and depend on their unique support needs.

Some examples of indicators of catheters include:

• Management of the bladder during surgery
• The promotion of skin integrity
• The measurement of urinary output
• The support of a dying person
• The management of haematuria (the presence of blood in the urine) with bladder irrigation (the process of flushing out or cleaning the bladder)

Types of catheters

Contrary to popular belief, catheters are known to have existed as early as 3000 B.C. Today, the most common types of catheters are:

• Intermittent ‘in and out’ urethral catheters: these sometimes require daily or weekly insertions. In some cases, those who use the catheters may even be trained in inserting and removing them
• Indwelling urethral catheterisation (short term and long term): these catheters are used for an extended period of time and vary by person to person
• Suprapubic catheterisation: this is used when a person is unable to maintain urine function and is the preferred long-term form of catheterisation

Catheter care for support workers

As mentioned above, support workers and carers are sometimes required to provide support to people with disabilities who use catheters. Where this happens, they must know how to appropriately care for someone with a catheter.

This means they have to ensure that:

• The person takes in enough fluids
• They practise effective hand hygiene
• They maintain meatal hygiene—this means they ensure that the site where the catheter is inserted, i.e. the opening of male or female urethra
• Drainage bags must be emptied if they are ⅓ or ⅔ full
• Catheters must be secure to minimise trauma to the person 
• They practise proper skin care so as to avoid any pain, discomfort, or infection to the person
• They always follow a doctor’s orders regarding catheter and bag changes

The main thing when it comes to catheter care is ensuring the person is not in pain and is comfortable, while maintaining hygiene— hygiene is crucial.

Note: support workers and carers should only insert or remove catheters if they are trained to do so by a doctor or nurse. Usually, doctors and nurses are the ones who insert or remove them.

The role of the support worker under the NDIS

Under the NDIS Practice Standards, support workers must be reasonably trained in providing catheter care including changing and management under the direction of a qualified health professional.

Service providers must also have appropriate policies and procedures in place related to the provision of catheter support. It is reasonably expected that support workers follow these policies and procedures to ensure continuity of supports and to meet compliance.

etrainu has partnered with Essential Skills Training to deliver the Complex Care eLibrary, a suite of courses aimed at providing training under key concepts of the NDIS Practice Standards. The Catheter Care course provides support workers with a detailed understanding of how catheters work and how to support someone who needs one.

Conclusion

Urinary catheters and those who use them require complex care needs. Knowing this, support workers and service providers must be able to meet those needs by being trained in the care and management of catheters. 

Above all else, support workers and carers must ensure they always follow the advice and direction of health professionals involved in the care of people with disability. 

References

The Royal Australian College of General Practitioners (RACGP): Ins and outs of urinary catheters

Essential Skills Training RTO: Catheter Care