Prior to the LoFric Elle webinar in September, we had a great opportunity to talk to Susanne Vahr Lauridsen about the barriers related to intermittent self catheterisation (ISC) and dignity. We also asked for her opinion on LoFric Elle’s potential to provide new opportunities for women facing challenges when performing ISC.
Susanne Vahr Lauridsen is a clinical nurse specialist at the University hospital in Copenhagen. She is a professional researcher and lecturer, working with nurses who train patients in intermittent self catheterisation . Susanne is also co-author of the European Association of Urology Nurses Guidelines.
Special guidance needed
Susanne started by pointing out that nursing education is a general education, but many of us have a common perception that all nurses are good at doing everything. This is a challenge when you talk about very complex procedures, such as intermittent catheterisation. Studies have shown that the main obstacle is a lack of uptake in learning the procedure – if you are interested and motivated almost anyone can learn ISC. Adherence to catherisation after 12 month is only 50%, which in fact is a very low figure, but is comparable to the adherence of taking medications in general.
"Catheterisation is achievable for everybody" says Susanne.
Your life – your solution
Of great importance is finding out how ISC can fit into your daily routine. We’ve learned from studies that maintaining a hygienic procedure and avoiding urinary tract infections can be difficult when it comes to ISC. Above all, you need to find ways to fit the procedure into your working life, as much as your every-day private life. Studies have also shown that if patients are recommended to catheterise more than 3-4 times a day, the majority adhere to the recommendations. This is probably because they will have huge complications and renal failure if they catheterise fewer times per day.
Shortcuts to overcoming barriers
Before starting to teach ISC, the nurse needs to learn what is important to her patient and accommodate their priorities when seeking to integrate ISC as part of the patient’s lifestyle. According to Susanne’s own experience, the main solutions to overcoming the barriers of ISC are:
- Having access to the right catheter that fits your needs
- Having a competent nurse to educate you, who knows how important it is that you feel safe
- Having a catheter material that does not cause discomfort, bleeding, pain or UTIs.
To me, dignity means having access to the right catheter that enables easy catheterisation, without pain and complications.
Choice of product matter
Susanne also informs us that studies and daily practices demonstrate that the choice of product is very important for a successful result. It is important that patients feel comfortable and confident. For example, a “non-touch” technique is an effective way to avoid UTIs and maintain hygiene. It assures the patient to know where to put their hands without contaminating the catheter. Susanne insists it is important to show the patient a range of different products to find out what fits the individual.
We often advise our patients to use one product when they are at home and another while travelling, since there can be different demands
It takes patience and support
Susanne also emphasises the importance of patient follow-up after the initial training is completed. We know that long term on-going support is important, as is following up once the procedure is integrated in the daily routine. After a while, when things go a little faster, the hygienic procedure may suffer instead. Sometimes the habits of maintaining non-touch, sterility and cleaning have to be re-introduced.
The handle that changes everything
Susanne thinks that the use of LoFric Elle really can help many women to successfully perform ISC. She reveals that she has met nurses that are impressed with the handle as well as the possibility of putting it back in the packaging and disposing of it when convenient. The handle will be a great aid in helping women to perform ISC, especially women that are obese, but also many others. Says Susanne;
Even though you, as a nurse need to discuss life-style changes, nobody loses weight over-night. It’s important to never blame these patients, just address the issue and advise, but as a nurse you have to focus on how to integrate the catheterisation right here and right now. The handle can be one way for this.”
Susanne shares her thoughts and at Wellspect webinar: