Intermittent catheterisation in children September 2016 Chapter 7 Summary of evidenced recommendations for practice The following table contain a summary of the guidance offered within this document using the levels and grading of evidence in Tables 1 and 2 in the introduction Table 6 Summary of Recommendations and evidence Recommendations LE GR CATHETERISATION Healthcare professionals should be appropriately trained (according to local protocol, and competent ) in performing catheterisation, as in passing on the responsibility of catheterisation to the healthcare user, as in recognising complications 4 B Be aware that social continence can only be achieved if both bladder and bowel function are treated, and discuss this with the child and caregivers 4 C Before starting catheterisation in a child, evaluate bowel function and where necessary apply additional interventions or consult a specialist 4 C Children and healthcare users learning CIC/CISC should be adequately instructed according to the guidelines 4 B Recommend catheter material and regime that is best suited to the child's lifestyle 3 B The frequency of CIC/CISC is determined individually in consultation with the urologist, paediatric urologist or nurse practitioner 4 B Ask the child or its parents to complete a voiding diary about fluid intake and bladder emptying 4 C Support for the child and its parents must be available during the entire catheterisation period 4 C If urethral catheterisation is not possible, discuss alternative options (catheterisable stoma, urostomy or Bricker deviation) 4 C TEACHING CATHETERISATION If teaching catheterisation or self-catheterisation is not possible in the home environment supported by suitable practitioners or there are specific anxieties around learning the process then it should take place in the hospital environment in the presence of a nurse practitioner or continence nurse, who, if necessary, can refer the child to the paediatric urologist, rehabilitation specialist, child psychologist or child physiotherapist. 4 B Assess cognition before teaching the technique. Does it match the child's age? Adjust your instruction to both age and cognition (pictograms), and where necessary arrange for additional support and aids (e.g. a watch with buzzer) 4 C Identify the psychological, emotional and practical needs of the patient, and provide them with effective service, instruction and support 4 C Ensure correct communication, information giving, and a positive attitude 4 C When teaching catheterisation to a care user, an instructional doll should be present 4 B CATHETER RELATED COMPLICATIONS When there are problems inserting a catheter, discuss and practice alternative options (deep breaths, changing position, applying light pressure to the sphincter, catheterising earlier, other catheter or other tip) 4 C
RkJQdWJsaXNoZXIy NjM1NTk=