DK83 04 (HSC378)Insert and Secure Urethral Catheters and Monitor and Respond to the Effects

DK83 04 (HSC378)Insert and secure urethral catheters and monitor and respond to the effects of urethral catheterisation

Elements of competence

HSC378.1 / Insert and secure urethral catheters
HSC378.2 / 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 with 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.

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. If you are working with children and young people they can be found in the principles of Care Unit HSC34. If you are working with adults they can be found in HSC35. To achieve this Unit you must demonstrate that you have applied the principles of care outlined in either unit HSC34 or HSC35 in your practice and through your knowledge.

Evidence Requirements for the Unit

It is essential that you adhere to the Evidence Requirements for this Unit – please see details overleaf.

SPECIFIC Evidence Requirements for this unit
Simulation:

Simulation is NOT permitted for any part of this unit.

The following forms of evidence ARE mandatory:

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: for example, handwashing before during and after the activity; using personal protective clothing and additional protective equipment. 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/professional discussion: 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.
Expert Witness: A designated expert witness (maybe a nurse, first aider, other senior worker) may provide direct observation of practice, questioning, professional discussion and feedback on reflective accounts to provide evidence of specialist skills.
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.
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. These do not need to be included in your portfolio however they will form the basis of discussion with your assessor and need to be available for the IV to authenticate. Any products which are included and contain names of individuals must be anonymised.

GENERAL GUIDANCE

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 Health and Care Settings. 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.

Knowledge specification for 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.

You need to provide evidence for ALL knowledge points listed below. There are a variety of ways this can be achieved so it is essential that you read the ‘knowledge evidence’ section of the Assessment Guidance.

You need to show that you know, understand and can apply in practice: / Enter Evidence Numbers
Values
1A working understanding of adapting communication to meet individual’s needs.
2An in-depth understanding of the effects of catheterisation on the individual’s comfort and dignity, and ways of minimising any adverse effects.
3An in-depth understanding of the ethical issues surrounding catheterisation, as applied to males and females.
4A working understanding of the need for chaperones, individual awareness and consent.
Legislation and organisational policy and procedures
5A factual awareness of the current UK legislation, national guidelines and local policies and protocols which affect your work practice in relation to carrying out urethral catheterisation.
6A working understanding of your responsibilities and accountability in relation to the current European and National legislation and local policies and protocols.
Theory and practice
7A factual awareness of the importance of working within your own sphere of competence and seeking advice when faced with situations outside your sphere of competence.
8A working understanding of the importance of applying standard precautions and the potential consequences of poor practice.
9An in-depth understanding of the conditions and constraints which might denote who undertakes this procedure and why.
Anatomy and physiology
10An in depth understanding of the anatomy of the male and/or female genito-urinary system.
11An in-depth understanding of the physiology of the genito-urinary system.
Care and support
12A working understanding of potential adverse effects and appropriate actions.
13A working understanding of the importance of offering effective verbal and non-verbal support and reassurance to patients when you perform urethral catheterisation.
You need to show that you know, understand and can apply in practice: / Enter Evidence Numbers
14A working understanding of the effective methods of providing verbal and non-verbal support and reassurance to patients.
Materials and equipment
15An in-depth understanding of the types of catheters that can be used and why you should select the appropriate catheter.
16A working understanding of the local anaesthetic agents available.
Records and documentation
17A working understanding of the importance of keeping accurate and up to date records.
18A 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.

HSC378.1Insert and secure urethral catheters

Performance criteria
DO / RA / EW / Q / P / WT
1You apply standard precautions for infection control and take other appropriate health and safety measures.
2You comply with the correct protocols and procedures relating to urinary catheterisation.
3You insert the catheter safely and correctly, according to manufacturer’s instructions and with minimal trauma to the individual.
4You secure the catheter after insertion according to instructions and adjust it correctly.
5You 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.
6You make the individual as comfortable as possible following the procedure.

HSC378.2Monitor and record on urethral catheterisation of individuals

Performance criteria
DO / RA / EW / Q / P / WT
1You monitor the individual’s condition, promptly recognise adverse effects and take the appropriate action.
2You seek assistance promptly from an appropriate person should it be required.
3You record clearly, accurately, and correctly any relevant information in the necessary records.
4You check that all catheterisation equipment and materials are functioning correctly and take appropriate action to remedy any problems.
5You maintain cleanliness of the catheter and surrounding area through regular hygiene care.
6You empty drainage bags and measure and record urinary output whenever necessary and as instructed by the professional involved.
7You educate the individual as far as possible on the care of the catheter and attachments.

DO = Direct ObservationRA = Reflective AccountQ = Questions

EW = Expert Witness P = Product (Work)WT = Witness Testimony

To be completed by the Candidate
I SUBMIT THIS AS A COMPLETE UNIT
Candidate’s name: ……………………………………………
Candidate’s signature: ………………………………………..
Date: …………………………………………………………..
To be completed by the Assessor
It is a shared responsibility of both the candidate and assessor to claim evidence, however, it is the responsibility of the assessor to ensure the accuracy/validity of each evidence claim and make the final decision.
I certify that sufficient evidence has been produced to meet all the elements, pcS AND KNOWLEDGE OF THIS UNIT.
Assessor’s name: …………………………………………….
Assessor’s signature: ………………………………………....
Date: …………………………………………………………..
Assessor/Internal Verifier Feedback
To be completed by the Internal Verifier if applicable
This section only needs to be completed if the Unit is sampled by the Internal Verifier
Internal Verifier’s name: ……………………………………………
Internal Verifier’s signature: ………………………………………..
Date: ……………………………………..…………………………..

Unit: DK83 04 (HSC378) Insert and secure urethral catheters and monitor and respond to the effects of urethral catheterisation

[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”