Intermittent Catheterization Education Toolkit and Competency Checklist

Background: Patients with neurogenic bladder have dysfunction to the bladder wall and urethral sphincter causing the loss of bladder function and the need for some form of bladder management. Intermittent catheterization is the gold standard of treatment but has poor compliance. Purpose: This scholarly project implemented an intermittent self-catheterization (ISC) toolkit to increase confidence in self-catheterization resources and increase confidence in employee and patient abilities, and knowledge of long-term benefits and needed resources. Methods/Measures: This project was completed on an inpatient rehabilitation unit in a teaching hospital located in Salt Lake City, Utah. Current knowledge, teaching practices and available resources of ISC were assessed through a pre- and post-survey. The ISC toolkit comprised a competency checklist and educational resources developed using survey responses and current evidence to increase employee ability and confidence. The self-catheterization toolkit was implemented after a series of educational videos delivered to staff over several weeks. Staff were instructed on how to deliver effective and comprehensive self-catheterization teaching. Results: No statistically significant differences were noted in pre-survey to post-survey responses in nursing knowledge, teaching practices and available resources. Trends after introduction of the toolkit showed limited improvement to staff confidence in resources available, abilities to adjust teaching and understanding of patient barriers. However, trends noted a decrease in staff confidence in level of involvement in teaching self-catheterization, in ability to discuss with the team, and confidence that early education sets the patient up for success. Conclusions: The implementation of the self-catheterization toolkit showed increased staff confidence in resources to teach self-catheterization. Areas of decreased confidence are thought to be related to initial overconfidence of nursing staff. As nursing gains experience teaching ISC efforts should be evaluated and reinforced as needed. The toolkit is feasible to use within other units of the hospital as well as for patients who are struggling with adherence to ISC.