Af ix Patient Label Here
Name:
NHI:
Address:
TRIAL REMOVAL OF CATHETER
(TROC) CARE PLAN
DOB:
Age:
Telephone Number:
Procedure
Initials
District Nurse to:
• Confirm source of referral to proceed and refer to clinical record as to
why indwelling catheter (IDC) was put in (e.g. urinary retention,
convenience, post operatively) and when inserted. Record information in
notes and any previous history of TROCs
• Check if two failed TROCs – patient should be routinely referred to
urology –
do not proceed
• Identify previous IDC insertion for difficulty
LAN
P
• Check patient’s current condition risk factors against a successful TROC
ARE
i.e. medications, current health, cognitive ability, fluid intake, constipation
C
Oxybutynin/vesicare stop 24 hours prior to TROC
C)
If the patients is on any of the following medications, TROC at (days) specified
TRO
for a higher success rate of the TROC
•
Doxazosin – 21 days use to be at full affect
TER (
•
Finesteride – 6 weeks of use before ful strength
•
HE
Terazosin – 2-4 weeks – ful strength, 6/52 improvement seen
•
Tamsulosin - 2-4 weeks – full strength, 6/52 improvement
seen
F CAT
O
• Discuss with continence nurse clinical information and history to identify
degree of complexity or follow up required by the continence nurse
VAL
•
O
CNS will liaise with Urology Department as required
under Official Information Act
M
• District nurse and client set date for TROC
RE
AL
• Explain TROC procedure to patient
TRI
• Provide “Trial Removal of Catheter Fluid Balance Chart” to patient and
explain completion requirements
Released
• Advise patient or carer to maintain accurate measurement of overnight
-v1
volumes for two nights prior to TROC. Need to ascertain whether patient
produces more of their urine during night. Give chart two days before
-074
Q
trial of removal of catheter
0-CF
• Remove IDC at appropriate time, i.e. 09:00hrs – clinic or home visit as
required
202
Error! No text of specified style in document.Error! No text of specified style in document.Page 1 of 3
Af ix Patient Label Here
Name: NHI:
Address:
TRIAL REMOVAL OF CATHETER
(TROC) CARE PLAN
DOB: Age: Telephone Number:
Post IDC Removal
Initials
District nurse instructs patient to:
• Take oral flui ds – 1 glass/cup hourly or as per normal intake.
• Patients with controlled heart failure can drink their normal volumes.
• Record accurately on fluid balance chart.
• Void as sensation allows or attempt to void after four hours.
• Record each void SEPARATELY.
Act
POST IDC REMOVAL ASSESSMENT
District nurse to:
• Discuss voiding pattern- i.e. weak flow, straining, feeling of incomplete
LAN
emptying or pain.
P
ARE
• Refer to fluid balance chart re overnight volumes to consider nocturia.
C
C)
• Request patient to at empt to void then perform a bladder scan.
Information
TRO
•
• If large volumes passed and less than 100mls post void residual, no
TER (
intervention necessary. Discharge summary to both referrer and GP.
HE
• If no urethral voiding and 350 to 400mls residual, re-c
Official atheterised (record
insertion details and volume drained in patient notes).
F CAT
O
• If scan <200ml and post TROC voided volumes are more than 200ml on
two occasions, TROC successful.
VAL
O
under
M
• Multiple small voids (20 -70mls) does not indicate success.
RE
• If minimal urethral voiding, and post void scan under 300mls and history
AL
of nocturia, and patient comfortable do not re-catheterised. Assess the
TRI
following day.
• Contact continence nurse if unsure regarding interpretation and plan of
Released
care.
-v1
FAILED TROC
-074
Q
• Reinsert IDC, liaise with GP and contact CNS to refer to Urology.
Important note: The plan at this stage wil need to be individualised to the
0-CF
patient.
202
Error! No text of specified style in document.Error! No text of specified style in document.Page 2 of 3
Af ix Patient Label Here
Name: NHI:
Address:
TRIAL REMOVAL OF CATHETER
(TROC) CARE PLAN
DOB: Age: Telephone Number:
Date:
Catheter removed at
:
Record of overnight drainage volume (ml) for two previous nights
Night one (ml):
Night two (ml):
Drink hourly and record the types of drinks and amounts in column
2 of the table below
Measure all urine accurately – write urine output in column
3
LAN
Record any urinary leakage occurring over the time of trial – write in column
4
P
Act
1
2
3
4
ARE
Time
Fluid/drinks intake
Urine output (ml)
Leakage
C
C)
TRO
TER (
HE
Information
F CAT
O
VAL
O
M
Official
RE
AL
-v1
TRI
under
-074
Q
0-CF
202
Catheter inserted due to: ______________________________________________
Released
Post TROC Instructions (i.e. DN to catheterise if failed? ED for re-catheterisation?):
__________________________________________________________________
If you require to be seen prior to your bladder scan appointment please contact
today’s nurse on: ________________________DN name:____________________
They wil ensure that the clinic/ ED nurses are expecting you to arrive.
PLEASE ENSURE YOU BRING THIS FORM WITH YOU TO YOUR APPOINTMENT
Error! No text of specified style in document.Error! No text of specified style in document.Page 3 of 3
Document Outline
