Impaired bladder function will affect up to 90% of patients with multiple sclerosis (MS) at some point during the course of the disease. Prompt evaluation to determine the etiology of a neurogenic bladder and early treatment is necessary to prevent complications such as urinary tract infections (UTIs), renal failure, pyelonephritis, sepsis, and death. Patients found to have urinary retention may be advised to perform clean intermittent catheterization (CIC) as part of their treatment plan. CIC facilitates complete emptying of the bladder thus reducing the risk of infection and subsequent serious complications. Due to the long-term necessity of CIC for bladder dysfunction, patients often need reinforcement teaching on proper technique in order to maintain a continual reduction in UTIs and other adverse events.
To demonstrate, through case vignettes, that nursing education develops a better understanding of the rationale for CIC, increases adherence of proper technique, reduces the frequency of UTIs, and improves quality of life.
Patients at high risk for UTIs were identified by the healthcare provider and referred to the clinic nurse for CIC education. Patients’ current catheterization regimen and catheterization technique were assessed. Factors contributing to the limitations in adherence were identified (i.e. financial, lack of knowledge, immobility, and self-image). Individualized treatment plans were given to the patient and caregiver regarding proper catheterization technique and frequency, type of catheter implemented, and use of cranberry supplementation to decrease risk of developing infections. Phone interviews were completed following the educational session to verify understanding and continued adherence to objectives that were taught.
Through clinical experience, nursing education is expected to demonstrate patient-perceived benefit and UTI reduction.
Individualized nursing education is crucial in teaching patients to successfully perform CIC to reduce the risk of infection while perhaps significantly improving quality of life.