3417 Catheterization

  • The board authorizes that qualified staff provide for clean, intermittent bladder catheterization (CIC) of students or assisted self-catheterization in conformance to rules adopted by the state board of nursing.

    Catheterization is authorized under the following conditions: 

    1. A parent, legal guardian or other person having legal control over the student file a written, current and unexpired request that the district provide for the catheterization of the student; 

    2. A licensed physician of the student file a written, current and unexpired request that catheterization of the student be provided for during the hours when school is in session or the hours when the student is under the supervision of school officials; 

    3. A registered nurse provide written, current and unexpired instructions regarding catheterization which states which staff members are designated to provide for catheterization and a description of the nature and extent of any supervision that is required; and 

    4. Any staff member who is authorized to provide for catheterization must receive training from a registered nurse consistent with the rules of the state board of nursing. Licensed practical nurses (LPNs) are trained to provide catheterization as part of their professional preparation and are not subject to this training requirement.

    Employees (except licensed nurses) who have not previously agreed in writing to perform clean, intermittent bladder catheterization as a specific part of their job description may file a written letter of refusal to perform catheterization. The employee’s refusal may not serve as grounds for discharge, nonrenewal or any other action adversely affecting the employee’s contract status.

    The district and its staff and the staff member who provides for catheterization in substantial compliance with this policy and the rules of the state board of nursing will not be liable in any criminal action or for civil damages arising from providing catheterization. The district may discontinue catheterization service for a student without being liable so long as the affected parents/guardians are given advance oral/written notice.

    Cross References:
    Board Policy 2161      Special Education and Related Services for Eligible Students

    Legal References:  
    RCW 28A.210.255      Provision of health services in public and private schools – Employee job description
    28A.210.280                Catheterization of public and private school students
    28A.210.290                Catheterization of Public and Private School Students – Immunity from liability
    WAC 246-840-820      Provision for clean, Intermittent catheterization in schools

    Management Resources:  
    Policy & Legal News      December 2003     
    Policy & Legal News      June 2003
    Policy & Legal News      December 2014

    ADOPTED: 09/24/1992
    REVISED: 02/23/95; 6/25/02; 11/25/03; 2/26/04; 3/26/15

    rocedure No. 3417P Catheterization 

    1. The State Department of Health has established the following rules:

      1.  The student's medical file shall contain a written request from the parent(s) or guardian for the clean, intermittent catheterization of the student.

      2.  The student's medical file shall contain written permission from the parent(s) or guardian for the performance of the clean, intermittent catheterization procedure by the nonlicensed school employee.

      3.  The student's medical file shall contain a current written order for clean, intermittent catheterization from the student's physician and shall include written instruction for the procedure. The order shall be reviewed and/or revised each school year.

      4.  The service shall be offered to all disabled students and may be offered to the nondisabled students, at the discretion of the school Board.

      5.  A licensed registered nurse shall develop instructions specific for the needs of the student. These shall be made available to the nonlicensed school employee and shall be updated each school year.

      6.  The supervision of the self-catheterizing student shall be based on the needs of the student and the skill of the nonlicensed school employee.

      7.  A licensed registered nurse, designated by the school Board, shall be responsible for the training of the nonlicensed school employees who are assigned to perform clean, intermittent catheterization of the students.

      8.  The training of the nonlicensed school employee shall include but not be limited to:

          a.  An initial inservice training, of a length to be determined by the licensed registered nurse.

           b.  An update of the instructions and a review of the procedure each school year.

           c.  Anatomy, physiology and pathophysiology of the urinary system including common anomalies for the age group served by the employee.

           d.  Techniques common to the urinary catheterization procedure.

           e.  Identification and care of the required equipment.

           f.  Common signs and symptoms of infection and recommended procedures to prevent the development of infections.

           g.  Identification of the psychosocial needs of the parent/guardian and the students with emphasis on the needs for privacy and confidentiality.

           h.  Documentation requirements.

           i.  Communication skills including the requirements for reporting to the registered nurse or the physician.

           j.  Medications commonly prescribed for the clean, intermittent catheterization patient and their side effects.

           k.  Contraindications for clean, intermittent catheterization and the procedure to be followed if the nonlicensed school employee is unable to catheterize the student.

           l.  Training in catheterization specific to the student's needs.

           m.  Developmental growth patterns of the age group served by the employee.

           n.  Utilization of a teaching model to demonstrate catheterization techniques with return demonstration performed by the nonlicensed school employee, if a model is available.

           o.  The training of the nonlicensed school employee shall be documented in the employee's permanent file.

    2. The district will record the names of individuals receiving the catheterization training and the training dates. These records shall be kept available for audits.

    ADOPTED:  09/24/1992
    REVISED: 11/25/03


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