Question
What are OT goals with catheterization?
Answer
Self-catheterization is an activity of daily living and directly follows the occupational therapy framework. The goal would be that the patient would be able to successfully complete self-catheterization. The other goals that you can focus on are fine motor coordination and control exercises, safe toilet transfers and items that are identified from the self-catheterization assessment. The main goal would be to be able to complete self-catheterization but that can be broken down more. For example, "the patient will be able to demonstrate correct sequencing for all steps of self-catheterization" or "the patient will be able to successfully complete 3 out of 5 steps of self-catheterization process."
There are different techniques for self-catheterization that can be included when writing goals. Also, the setting in which you are performing the self-catheterization is important. For example, the goal that patient is able to complete self-catheterization in hospital with minimal assist from hospital staff is different from the goal that patient be able to complete self-catheterization with modified independence in home setting.
Sterile technique is what is most commons in hospitals. This technique is to prevent infection and is best practice in hospitals. It involves genital disinfection which usually can be used with iodine or whatever sort of cleanser that is approved and used in the hospital. It is also performed with the use of sterile gloves, catheter insertions kits, and catheters. Sterile technique is also when you need to get a sample to make sure that it is not contaminated.
The clean technique is typically used with our patients at home. Clean technique is a daily practice after washing hands with soap and water. They can also use hand sanitizer. This is a little bit controversial, but you can use cleansed, re-used catheters, or single-use. Most catheters now say single-use. If there is an insurance problem or they are not able to get the amount of catheters they need (which is unusual these days), there are methods of cleaning catheters that can be learned. They need to cleanse the perineum of fecal matter or other waste, if it is present. It is also less expensive, more practical, and less time-consuming. This is why we teach this method to anyone who is going to be doing self-cath long-term.
