The aim of this assignment is to critical analyse and evaluate a primary piece of evidence within the author’s clinical practice.
Prior to analysing the literature the author will give a brief description of the term clean intermittent self-catheterisation, identify various conditions where this procedure may be undertaken and the assessment process which is necessary for patients before they can carry out this procedure.
Due to word limitations the term Clean intermittent self-catheterisation will be abbreviated as CISC.
Clean intermittent self-catheterisation provides a safe and effective alternative for patients who require bladder draining or in the management of urethral strictures. The insertion of a catheter into the bladder can be performed by the patient or a care and its considered the gold standard treatment for people who have a number of reasons while they are unable to avoid or empty the bladder completely (Pomfret and Winder 2007).Evidence suggests that this method of bladder emptying is viewed as the safest method of managing patients with these problems Winder (2008).
NICE (2012b) also supports the benefits of using intermittent catheterisation is considered the gold standard treatment for people who are unable to void or empty their bladder completely.
This procedure can also be undertaken by patients who have neurological conditions such as multiple sclerosis, Parkinson disease, cerebral vascular, Spinal injuries and also spina bifida patients. However patients with dexterity problems, visual or physical impairment may find it difficult to undertake so a thorough assessment should be carried out prior to the procedure.
In some cases emotional psychological aspects, such as embarrassment at exposing the genitals, fear of pain, discomfort and self-image could become barriers to CISC (McConville 2002).
Working as clinical nurse specialist in the outpatients department for a number of years the author has been deemed competent and experienced in teaching patients CISC. Knowledge and experience in teaching CISC is very important to avoid the patient having a detrimental experience in the hands of an inexperienced practitioner, which may lead to the patient abandoning the procedure, with lasting consequences for the bladder (Colpman 2011)
Prior to teaching the procedure patients are given writer information which includes a diagram of their anatomy and also a digital video disc to reinforce the technique. Considerations is also given to the handling, manipulation, lubrication and also the patient will manage to grasp and hold the catheter to ensure a non-touch technique to prevent the risk of a urinary tract infections. Following the procedures the patients is discharged home with the support and contact details if a problem arises.
Through implementing the assignment the author felt that this was opportunity to challenge her clinical practise, highlight the psychological impact on patients performing CICS and…