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presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN
Financial - Lisa Gorski receives compensation from MedBridge for the production of this course. She also receives compensation from BD Medical, Genentech, ivWatch, and Saxe Communications.
Nonfinancial - Lisa Gorski is a Chairperson, Infusion Nurses Certification Corporation and Infusion Nurses Society Standards of Practice Committee.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
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Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN
Lisa Gorski has worked for more than 30 years as a clinical nurse specialist (CNS) for Wheaton Franciscan Home Health & Hospice, now part of Ascension at Home, in Milwaukee, Wisconsin. As a CNS, she has developed and oversees the home infusion therapy program, provides staff education, and is involved in agency quality assessment, performance…
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1. Catheter Care and Management
Proper ongoing catheter care and management is essential in minimizing the risk of complications and is a vital component of patient and family education. Aspects of care addressed in this chapter include routine perineal care, catheter irrigation, and drainage bag care. The etiology and significance of the uncommon phenomenon of purple urine bag syndrome are also explained.
2. Complications: Urinary Tract Infection
Catheter-associated urinary tract infection (CAUTI) is an ongoing risk for patients with indwelling urinary catheters. It is important for nurses to understand the difference between infection and colonization, the role of biofilm in the development of infection, and the emerging problem of antimicrobial resistance. The role that home care nurses play in antimicrobial stewardship is described in this chapter. Attention to proper urine sampling procedures and catheter replacement in the context of CAUTI is addressed. CAUTI prevention is summarized, along with identification and interventions, including the importance of accurate specimen collection in the event of suspected UTI. Case examples are included in this section, and key patient education points are addressed.
3. Complications: Obstruction/Encrustation and Catheter Leakage
Catheter leakage, catheter blockage due to encrustation, and bladder spasms are common complications faced by patients with indwelling urinary catheters. These complications are explored in the context of case examples and the nurse's critical thinking process to analyze signs/symptoms, causative factors, appropriate interventions, and preventive strategies.
4. Patient/Caregiver Education and Support
Key topics for patient education are summarized in this chapter. Beyond the technical aspects of catheter care, acknowledging the challenges of living with a catheter and understanding the patient’s needs and the impact of the catheter on the patient's lifestyle are essential aspects of home care nursing. The important role that the nurse plays in supporting the patient and caregiver is highlighted.
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