Suprapubic catheterization: A suitable procedure for nurse-practitioners' in selected cases

Introduction: Urinary catheterization can be associated with significant morbidity and should only be undertaken by fully trained personnel. Traditionally, female urethral catheterization has been within the domain of general nurse practice and, more recently, male urethral catheterization and suprapubic catheterization (SPC) changes have become incorporated into their practice. Initial SPC has remained in the hands of medical staff, many of whom have limited experience. The feasibility of SPC being undertaken by a dedicated nurse-practitioner (NP) was assessed. Methods: NPs now have opportunities to extend their roles for the benefit of their patients. Initial SPC was deemed to be such a role by the senior NP who was formally trained in the procedure by the urology consultant. A joint protocol was developed once the NP felt confident with SPC. Bladder ultrasonography and needle aspiration were mandatory in all cases. Senior medical cover was readily available when requested. Results: In 14 months, 40 SPCs, including 23 within the community, were performed successfully by the NP. Eight other patients were referred back to the urological surgical team by the NP, as they did not fulfil the protocol requirements. Several junior surgical trainees were taught SPC by the NP. Conclusions: First-time SPC has been a useful addition to the NP's professional role, enhancing the continuity of patient care and providing a source of training for junior medical staff who are now on shorter structured rotations.