Suprapubic catheterization: a suitable procedure for clinical nurse specialists in selected patients

To assess the feasibility and advantages of urology clinical nurse specialists (NSs) extending their professional role to include inserting initial suprapubic catheters in selected patients in the hospital and community setting.

A urology NS, who is also the district continence adviser, was formally taught by a consultant urologist how to insert suprapubic catheters using the 'Add-a-Cath' introducer technique (Femcare, UK). Once deemed competent, the NS was indemnified by the Trust to carry out the procedure in carefully selected patients using a safe and unequivocal protocol.

Over a period of 40 months, the NS undertook the procedure in 164 patients, with 64 being catheterized in the community. There were no serious complications in the series and during the period studied, only 17 patients were referred back to the urologists for catheterization under formal theatre conditions.

Initial suprapubic catheterization can be carried out safely by trained NSs in selected patients. This extended professional role has helped to improve the continuity and quality of care for patients who require long-term catheterization. The NS was also a valuable source of training for junior medical staff who have limited experience with suprapubic catheterization.