Safe long-term intermittent self-catheterisation technique

Abstract

Introduction: Intermittent self-catheterisation is a safe and effective way of managing patients with urinary retention. It provides periodical drainage of urine from the bladder when normal bladder function is impaired or absent. The nurses usually provide patients with adequate information about clean or aseptic self-catheterisation techniques. The research aims to determine whether there is evidence for recommending an optimal intermittent self-catheterisation technique. Methods: A systematic literature review of current procedures undertaken was employed. The search was conducted in data bases of CINAHL, Medline, ProQuest, COBIB.SI and the Cochrane Library. The time frame covered in the search was from 1972, when the technique was first described, to 2016. Sixty-seven sources filtered by the research purpose were selected from the initial 350 identified. Results: Using CASP quality appraisal tools, eighteen references were selected. Six randomized clinical trials, five cohort studies, six systematic reviews and one critical review were published between 1992 and 2015. The analysis of the data gathered focuses on three self-catheterisation procedure details: catheter sterility, lubricant type and periurethral area hygiene. Discussion and conclusion: As none of the techniques proved to be optimal for all patients, it is important that the health care professional enables the patient to make an informed choice when choosing the best method and product for their individual needs. Due to the lack of evidence and in accordance with the Slovenian chronic patients' rights, the recommended technique should include sterile disposable material (catheter and lubricant), periurethral area hygiene with sterile swabs and solution, and a no-touch technique.