Clinical Practice Guidelines for Urinary Continence Management of Stroke Survivors: Implement Intermittent Catheterizati

1. Thank you for your interest in implementing these clinical practice guidelines (CPGs) in your setting. This presentation is intended to help nursing educators provide meaningful information about these CPGs to nurses. It focuses on the recommending for implementing an intermittent catheterization protocol. The presentation notes are intended to act as a guide to provide supplementary information. You are encouraged to use and adapt these notes to meet the education needs of nurses in your setting. Thank you for your interest in implementing these clinical practice guidelines (CPGs) in your setting. This presentation is intended to help nursing educators provide meaningful information about these CPGs to nurses. It focuses on the recommending for implementing an intermittent catheterization protocol. The presentation notes are intended to act as a guide to provide supplementary information. You are encouraged to use and adapt these notes to meet the education needs of nurses in your setting.

2. If the stroke survivor is experiencing urinary retention, it is important to implement an intermittent catheterization protocol. It should, however, be noted that this is not an appropriate management plan for all patients. It may be necessary to use indwelling catheters in certain circumstances. Indwelling catheters should be limited to the following: stroke survivors with intractable urinary retention; urinary retention that causes persistent overflow incontinence, infection, and/or renal dysfunction; stroke survivors with urinary retention that cannot be managed with intermittent catheterization; stroke survivors experiencing pain during catheter insertion due to enlarged prostate; stroke survivors with skin breakdown, continuous wetness, and the need for urinary monitoring; and, stroke survivors with palliative diagnoses for whom clothing changes are uncomfortable or disruptive (American Medical Directors Association, 2005; Teasel, 2007).If the stroke survivor is experiencing urinary retention, it is important to implement an intermittent catheterization protocol. It should, however, be noted that this is not an appropriate management plan for all patients. It may be necessary to use indwelling catheters in certain circumstances. Indwelling catheters should be limited to the following: stroke survivors with intractable urinary retention; urinary retention that causes persistent overflow incontinence, infection, and/or renal dysfunction; stroke survivors with urinary retention that cannot be managed with intermittent catheterization; stroke survivors experiencing pain during catheter insertion due to enlarged prostate; stroke survivors with skin breakdown, continuous wetness, and the need for urinary monitoring; and, stroke survivors with palliative diagnoses for whom clothing changes are uncomfortable or disruptive (American Medical Directors Association, 2005; Teasel, 2007).

3. This sample voiding record may be used to keep track of the stroke survivor�s intake of fluid. Copies of this protocol are available through the online self-learning portal. This sample voiding record may be used to keep track of the stroke survivor�s intake of fluid. Copies of this protocol are available through the online self-learning portal.

4. This intermittent catheterization protocol will help to address and manage the stroke survivor�s urinary retention. It was developed by Mary Dunn, clinical nurse educator, St. Joseph�s Healthcare Group, Hamilton, Ontario. Copies of the intermittent catheterization protocol are included in the clinical practice guidelines and online self-learning portal. Intermittent catheterizations may be discontinued for patients experiencing 3 consecutive residuals < 150 ml. If PVRs remain > than 150 ml for three consecutive voiding attempts they are experiencing UR. Would anyone like to ask any questions about the intermittent catheterization protocol?This intermittent catheterization protocol will help to address and manage the stroke survivor�s urinary retention. It was developed by Mary Dunn, clinical nurse educator, St. Joseph�s Healthcare Group, Hamilton, Ontario. Copies of the intermittent catheterization protocol are included in the clinical practice guidelines and online self-learning portal. Intermittent catheterizations may be discontinued for patients experiencing 3 consecutive residuals < 150 ml. If PVRs remain > than 150 ml for three consecutive voiding attempts they are experiencing UR. Would anyone like to ask any questions about the intermittent catheterization protocol?