Leeds Urinary Catheter Complications Pathway

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1 Background Information / Scope of Pathway

Quick info:
This pathway has been developed jointly by the Leeds CCG planned care leads, Continence Urology and Colorectal Service (CUCS)
and consultants from Urology, Urogynaecology and Elderly Medicine within LTHT.

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2 Information Resources for Patients and Carers

Quick info:
Patient Information:
Catheter Passport Patient Information Leaflet
Catheter Care Patient Information Leaflet

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3 Development & Updates to this Pathway

Quick info:
Developed November 2014

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4 Referral Forms

Quick info:
Continence, Urology and Colorectal Service (CUCS) Referral Form

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5 Urinary Catheter

Quick info:
Risk assessment should be performed in patients with catheters. If high risk, patients should be prescribed prophylaxic antibiotics as per guidance on Leeds Health Pathways. Wherever possible within Primary care use Doxycycline. If required GPs are asked to put on repeat prescription in quantities of 10 to allow a number of catheter changes.

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6 Trial Without Catheter (TWOC)

Quick info:
Every patient with an indwelling urinary catheter should we considered for a trial without a catheter (TWOC) Exclusions:

  • Under consultant guidance for catheter to remain
  • Urological surgery within the last 6 weeks

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9 Bypassing / Blockage

Quick info:
Patient Information:
Catheter Care Patient Information Leaflet

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10 Existing Intermittent Self Catheterisation (ISC)

Quick info:
For patients requiring ISC please see Leeds Intermittent Self Catheterisation pathway. Patients experiencing problems with existing ISC can be referred to CUCS.

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11 Other Catheter Related Problems

Quick info:
Including:

  • MRSA positive
  • Difficult catheter changes
  • Recurrent catheter related admissions

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12 Assess Red Flags and Severity Assess for Signs and Symptoms, Perform Observations

Quick info:
GP Information:
Red flags

  • Fever
  • Loin pain
  • Immunosuppression
  • Confusion

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13 Assess For Causes

Quick info:
For example constipation

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14 Refer to Continence, Urology and Colorectal Service (CUCS)

Quick info:
Continence, Urology and Colorectal Service (CUCS) Referral Form

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17 Refer to Continence, Urology and Colorectal Service (CUCS)

Quick info:
Continence, Urology and Colorectal Service (CUCS) Referral Form

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18 Refer to Continence, Urology and Colorectal Service (CUCS)

Quick info:
Continence, Urology and Colorectal Service (CUCS) Referral Form

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19 Refer as Emergency Admission

Quick info:
If using LTHT, refer to Surgical Assessment Unit via PCAL.

Primary Care Access Line (PCAL)
Telephone: 0113 2065996

Operational Hours
Monday - Friday: 7.00am - 10.00pm
Weekends and Bank Holidays: 8.00am - 10.00pm

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21 UTI Manage Accordingly

Quick info:
If UTI is suspected please see LHP guidance

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22 Any Other Causes

Quick info:
GP Information:
Majority of patients can have catheter changed by district nurse. However, some patients (e.g. post radical prostatectomy) will need admission.
Refer into Surgical Assessment Unit via PCAL.

Primary Care Access Line (PCAL)
Telephone: 0113 2065996

Operational Hours
Monday - Friday: 7.00am - 10.00pm
Weekends and Bank Holidays: 8.00am - 10.00pm

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24 Systematically Unwell or High Risk Patient Refer as Emergency Admission via PCAL

Quick info:
Primary Care Access Line (PCAL)
Telephone: 0113 2065996

Operational Hours
Monday - Friday: 7.00am - 10.00pm
Weekends and Bank Holidays: 8.00am - 10.00pm

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25 Attempt to Establish Cause, e.g. Trauma, UTI

Quick info:
If UTI is suspected please see LHP guidance

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26 Refer to Community Nursing Service for Catheter Change

Quick info:
Risk assessment should be performed in patients with catheters. If high risk, patients should be prescribed prophylaxic antibiotics as per guidance on Leeds Health Pathways. Wherever possible within Primary care use Doxycycline. If required GPs are asked to put on repeat prescription in quantities of 10 to allow a number of catheter changes.

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27 Start Antibiotic Treatment and Refer to Community Nursing for CSU and Catheter Change

Quick info:
Risk assessment should be performed in patients with catheters. If high risk, patients should be prescribed prophylaxic antibiotics as per guidance on Leeds Health Pathways. Wherever possible within Primary care use Doxycycline. If required GPs are asked to put on repeat prescription in quantities of 10 to allow a number of catheter changes.

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31 Refer to Continence, Urology and Colorectal Service (CUCS)

Quick info:
If appropriate the Continence, Urology and Colorectal Service (CUCS) may refer on to Urology. Continence, Urology and Colorectal Service (CUCS) Referral Form

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34 If Worsens, Refer to Urologist via PCAL

Quick info:
Primary Care Access Line (PCAL)
Telephone: 0113 2065996

Operational Hours
Monday - Friday: 7.00am - 10.00pm
Weekends and Bank Holidays: 8.00am - 10.00pm

Key Dates

Published: 18-Dec-2014, by Leeds
Valid until: 01-Jun-2016

 

 

 

 

 

Leeds Health Pathways