Symptoms can be patient-specific
Symptoms can be patient-specific
Patient and family education about the care of an indwelling catheter is critical, says Gayle Lovato, RN, MS, infection control practitioner at Inova Loudoun Hospital in Leesburg, VA, and a member of the Association of Infection Control Professional's communications committee.
Make sure that patients know the symptoms of an infection, Lovato suggests. Potential symptoms include a burning sensation; a change in the appearance or smell of the urine; redness, swelling, or drainage at the insertion site; increased confusion; pain in the flank; or nausea or vomiting. "Fever is also a symptom, but not all patients have a fever," she explains.
Because symptoms can vary from patient to patient, it is important to determine the pattern of symptoms for each patient, suggests Lisa Gorski, MS, APRN, BC, CRNI, FAAN, clinical nurse specialist at Wheaton Franciscan Home Health & Hospice in Milwaukee. "Teach nurses to look back in the chart to see what symptoms led to treatment of a previous urinary tract infection," she recommends. Use that pattern of symptoms to teach the family how to recognize the early stages of an infection, Gorski says. This education gives the family members an opportunity to contact the nurse at a point when the patient can be treated at home, she adds. Emphasize the importance of calling immediately, Gorski says. "Some patients and families are reluctant to call the home health nurse and believe it is easier to go to the emergency room," she explains.
Basics of hygiene
Keep patient and family education simple and emphasize good hygiene, recommends Lovato. "Make sure they use soap and water only to clean the area twice a day and pat dry with a towel after cleaning," she says. "The bag should be changed when it becomes one-half to two-thirds full," she says. Have family members wear gloves if they change the bag in case there is splash, she adds.
In addition to stressing the importance of washing hands before catheter care, be sure to tell family members and patients that they must wash hands afterward, even if they wore gloves, says Lovato. "We have health care personnel who believe that gloves eliminate the need for hand washing, so we have to make sure we teach everyone to wash hands regardless of the use of gloves," she adds.
When teaching, the nurse must watch a return demonstration by the patient or family caregiver, points out Lovato. "Don't rely upon verbalization or a repetition of the information," she says.
Schantz says, "There's a lot of information about bladder catheter care, so there's no need to reinvent the wheel when developing protocols. Home care is a unique health care setting, so it's important to look to other home health agencies for ideas and tools."
Patient and family education about the care of an indwelling catheter is critical, says Gayle Lovato, RN, MS, infection control practitioner at Inova Loudoun Hospital in Leesburg, VA, and a member of the Association of Infection Control Professional's communications committee.Subscribe Now for Access
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