IMC vs IDC

IMC vs IDC presented by SSN Jocelyn Loke from GeriCare.

1. Tele-Continuing Nurse Education conducted by GeriCare Topic: IMC vs IDC Date: 10 Jun 2019 Speaker: SSN Jocelyn Loke GeriCare Palliative Care Nurse

2. Administrative Send your nursing home attendance and any feedback to: [email protected] Attendance with SNB No. Within 1 week Next Tele-CNE Presentation will be: Theme: Dementia Series 8 Jul (Mon) 2019 @ 2.00 – 3.00 pm By: Dementia Care Unit ( Khoo Teck Puat Hospital)

3. IMC vs IDC Indications of catheterization

4. Objectives Give an overview of urinary incontinence and retention of urine Identify appropriate cases for intermittent catheterization Determine cases not appropriate for IMC Follow the recommended guidelines on the insertion of IMC or IDC Provide nursing care plan

5. What Is Urinary Incontinence? The involuntary leakage of urine. It is the inability to hold urine in the bladder because voluntary control over the urinary sphincter is either lost or weakened. What causes Urinary Incontinence? When the pelvic floor muscles are weakened and cannot keep the urethra completely closed, stress incontinence occurs. Sudden pressure on the bladder may cause urine to leak out of the urethra. A cough or sneeze can trigger it

6. What is Urinary Retention? is the inability to empty the bladder What causes Urinary Retention? Obstructive Non-obstructive Stroke Cancer Pelvic injury or trauma Kidney or bladder stones Vaginal childbirth Enlarged prostate (BPH) in men Impaired muscle or nerve function due to medication or anesthesia Accidents that injure the brain or spinal cord

7. Intermittent Catheterization The use of IMC is not appropriate for the following: h ave significant lower limb or truncal contractures hindering proper access to the perineum have significant behavioral problems preventing the procedure to be carried out smoothly and safely are terminally ill with difficult anatomy and/or poor perineal hygiene Prior to initiation of IMC, discuss with the NH DR e xclude stool impaction

8. Requisites Disposable dressing set Sterile kidney dish Appropriate size catheter ( Nelaton or Foley) Sterile gloves and Non sterile gloves Lubricant Gel Antiseptic solution 10mls syringe and WFI plastic ampoule Drainage bag Micropore tape Disposal bag

9. General Guidelines

10. Nursing Care Plans When on IDC: Provide daily cleansing of the urethral meatus with soap and water or perineal cleanser (following NHs policy) Ensure a closed drainage system Ensure no kinks or blockage occur in the tubing Secure the catheter tube to prevent urethra damage Urine bag should be emptied 3 to 4hourly or when 2/3 full Ensure clear bowels before trial off catheter

11. Nursing Care Plans When off catheter or IMC: Monitor intake and output ( urinary frequency & bowel movement) Provide 2-4hourly potting Place call bell within reach at all times Instruct to call nurse when there is urge to void Limit fluid and caffeine intake 2-3hours prior to bed time Maintain skin integrity over perineal region

12. Purple Urine Bag Syndrome

13. THANK YOU