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Questions and Answers
Which of the following patients would typically require an indwelling urinary catheter due to their health status?
When assessing a patient for the need for an indwelling urinary catheter, what should the RN do if the criteria are not met?
What is a critical step for the RN to follow after removing an indwelling urinary catheter?
In what situation can an RN write an order to continue the use of an indwelling urinary catheter despite not meeting CDC criteria?
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What does the RN need to document after performing a bladder scan following catheter removal?
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What is an appropriate indication for the use of an indwelling urinary catheter?
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Which condition would result in a bladder scan reading of greater than 350 ml, indicating acute urinary retention?
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What is one inappropriate use of an indwelling urinary catheter identified by the CDC?
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Which of the following is a primary goal of the Bladder Management/Urinary Catheter Alleviation Navigation Protocol (UCANP)?
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Which type of patients are excluded from catheter removal guidelines according to the CDC?
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What is the primary reason for using an indwelling catheter in a patient with a stage III sacral wound?
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What is an essential factor to assess when determining the need for intermittent catheterization?
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Which guideline must be followed for discontinuing an indwelling urinary catheter?
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What should be done if a patient experiencing urinary retention has a bladder scan showing a volume greater than or equal to 400 mL?
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After a patient spontaneously voids, when should the post void residual (PVR) be measured?
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What action should be taken if the PVR is greater than 100 mL but less than 400 mL?
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In what scenario should a provider be notified regarding continued intermittent catheterization (IC) at Henry Ford facilities?
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What should be done if, after 12 hours, the bladder scan still shows a volume less than or equal to 400 mL?
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What is the protocol for patients at HF Jackson who require continuous straight catheterization for 24 hours?
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What is the maximum volume a patient can have during a bladder scan before intermittent catheterization is indicated?
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What should be assessed before initiating Clean Intermittent Catheterization (CIC) teaching for the patient?
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Study Notes
Indwelling Urinary Catheter Management
- The CDC recommends evidence-based criteria for using and removing indwelling urinary catheters.
- The policy encourages the removal of unnecessary indwelling urinary catheters, using the Bladder Management/Urinary Catheter Alleviation Navigation Protocol (UCANP).
- The policy lists appropriate and inappropriate applications of indwelling urinary catheters.
- Patients with indwelling urinary catheters placed by urology services are excluded from the removal guidelines.
Procedure
- Nurses will assess patients for indwelling urinary catheter criteria and continue monitoring if criteria are met.
- If criteria are not met, nurses will determine if there is a valid reason for the catheter.
- Nurses will discontinue the indwelling urinary catheter following the CDC guidelines and order "Bladder Management/UCANP" in EPIC.
- The protocol follows a bladder management algorithm (UCANP) and includes a bladder scan and interventions for patients unable to void, experiencing urinary retention or catheter removal without voiding within 4 hours.
- Continued intermittent catheterization (IC) use for more than 48 hours at Henry Ford Hospital, HF West Bloomfield, HF Macomb, and HF Wyandotte requires provider notification.
- Continued IC use for more than 24 hours at HF Jackson requires provider notification and a urology consult.
Bladder Management/Urinary Catheter Alleviation Navigation Protocol (UCANP)
- The bladder scan will be used to assess patient's bladder volume.
- The algorithm includes steps for post-void residual (PVR) measurement.
- If PVR volume is less than 100 ml, the pathway stops.
- If PVR volume is greater than 100 ml but less than 400 ml, the pathway restarts in 4 hours.
- If the PVR volume is greater than or equal to 400 ml, the bladder scan will be repeated in 4 hours, and patients will be encouraged to void.
- If there is no void within 8 hours, the bladder scan will be repeated every 4 hours and patients will be encouraged to void (total of 12 hours).
- If the bladder volume at 12 hours remains less than or equal to 400 ml, notify the provider.
- If at any time in the pathway the patient becomes symptomatic (suprapubic pain, tenderness, or discomfort), a bladder scan will be performed to avoid bladder injury.
Clean Intermittent Catheterization (CIC)
- Clean intermittent catheterization (CIC) teaching may be initiated if appropriate.
- Assessment will be performed to assess the physical and cognitive ability of the patient and family support.
- Collaboration with providers and case managers will be initiated for home CIC supplies.
- Outpatient urology follow-up will be arranged as applicable.
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Description
Test your knowledge on the management of indwelling urinary catheters based on CDC guidelines. This quiz covers the appropriate protocols for assessment, monitoring, and discontinuation of catheters. Learn about the criteria for use and removal as well as the specific applications outlined in the policy.
