Urinary Catheter Management: NDIS High Intensity Daily Personal Activities
Published: 01 September 2021
Note: This article is intended for NDIS workers and providers. For an explanation of the catheterisation procedure (intended for health practitioners), see Caring For a Urinary Catheter.
National Disability Insurance Scheme (NDIS) support workers may need to care for NDIS participants who are using a urinary catheter.
This article will outline the catheter management responsibilities of workers under the NDIS.
What is a Urinary Catheter?
A urinary catheter is a hollow, flexible tube inserted into the bladder that drains urine into an external collection bag (Healthy WA 2014; Cafasso & Stephens 2018).
Generally, urinary catheters are required by people who are unable to urinate on their own or are immobile, as if the bladder cannot be emptied, urine may accumulate and cause pressure in the kidneys, which may lead to kidney failure (Cafasso & Stephens 2018).
The process of inserting a catheter, known as catheterisation, is invasive and poses a significant risk of infection or trauma. Therefore, catheterisations must only be performed by appropriately qualified personnel (RCHM 2020).
Types of Catheters
NDIS support workers might assist in the care of three different types of catheters: indwelling, suprapubic and intermittent.
Indwelling catheters are inserted through the urethra and remain inside the bladder for a prolonged period of time. They are kept in place by a water-filled balloon that is inflated once the catheter has been inserted.
Suprapubic catheters are a type of indwelling catheter that is inserted through the wall of the abdomen, a few inches below the navel and above the pubic bone, into the bladder.
Intermittent catheters, also known as in-out catheters, are inserted through the urethra to drain the bladder and then removed once the bladder has been drained. Each time drainage is required, a new catheter is inserted and then taken out.
(NHS 2020; Better Health Channel 2018)
Indwelling and suprapubic catheters must only be inserted by an appropriately trained health practitioner. Intermittent catheters can be inserted by support workers, but only with high intensity support and supervision by a health practitioner (NDIS 2018).
Urinary Catheter Management in the NDIS Practice Standards
This Practice Standard aims to ensure that NDIS participants who require a catheter receive appropriate catheter management that is relevant and proportionate to their individual needs (NDIS 2020).
Under these standards, NDIS providers must meet the following quality indicators:
Participants are enabled to engage in the assessment and development of a catheter plan. This plan identifies possible risks, incidents and emergencies, and what actions need to be taken to manage these situations, including an escalation of care, if necessary. The participant’s health status is reviewed regularly (with their consent)
Workers who provide catheter management are informed by appropriate policies, procedures and training plans. These relate to the supports being provided to each participant
Workers who provide catheter management have received all necessary training that relates to each specific participant, either from a qualified health practitioner or another appropriately qualified individual.
Responsibilities of NDIS Workers
NDIS workers who are involved in catheter management may be responsible for:
Following infection control procedures
Replacing and disposing of catheter bags
Maintaining the participant’s charts and records
Monitoring the position of the catheter
Monitoring the condition of skin surrounding the catheter insertion site
Identifying and responding to or reporting catheter blockage, dislodgement or deteriorating health.