Urinary Management Preferred Product List. Dorset Bladder and Bowel Continence Service. A Guide for Staff about Continence Products

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1 For more information please contact: Dorset Bladder & Bowel Continence Service (West) Telephone: (Mon Fri 8.30am 4.30pm) or by post to: The Atrium Health Centre No 7.Weymouth Avenue Dorchester Dorset DT1 1QR Dorset Bladder & Bowel Continence Service (East) Telephone: (Mon Fri 8.30am 4.30pm) or by post to: 11 Shelley Road Bournemouth Dorset BH1 4JQ Dorset HealthCare University NHS Foundation Trust. All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright owner. Urinary Management Preferred Product List Dorset Bladder and Bowel Continence Service Produced: Updated April 2017 Author: Sarah Cheeseman Dorset HealthCare University NHS Foundation Trust Sentinel House 4 6 Nuffield Road Poole, Dorset BH17 0RB Tel: A Guide for Staff about Continence Products

2 These continence products on the preferred product list have been chosen and developed by a group of health professionals from the commy health services, in conjunction with Dorset County hospital, Royal Bournemouth hospital and Poole general hospital. The intention is that this preferred product list must be used for all new patients and for current patients when re-assessment is due. We are relying on all healthcare professionals to provide feedback and suggestions for any alterations or additions that seem necessary. This preferred product list does not include intermittent catheters, as these should be provided on an individual patient basis after assessment and taking note of patient choice. Prices correct June 2016 (It has been approved by Dorset CCG for acceptance on to the Pan Dorset Formulary)

3 Products: Vaginal dilators Company Product and Codes Price per Femmax De-smit Vaginal dilators Code : To be prescribed by specialist nurses and physios only. Owenmumford Ameille Comfort Care Vaginal dilators SM2100 SM To be prescribed by specialist nurses and physios only Product: Sheaths Each patient should be professionally assessed for: A. Correct length sheath style 1 standard, style 2 pop on (shorter length), style 3 wide band adhesive standard length. B. Size use measurement guide to ensure correct fit and comfort. C. Drainage system adjustable tube leg bags must be used. Sheaths should be changed daily to allow for pressure relief, personal hygiene and assessment of skin integrity. Soap and water is normally adequate for removal. In the event of a problem consider the use of an adhesive remover i.e. Appeel. If more than one sheath is used daily, reassess. There are other types of appliances that may be more suitable, please contact the Bladder and Bowel Continence Service for details. Company Product codes and sizes Price per Bard Clear Advantage Spirit 1.66 Sizes - 24mm(43),28mm(83),32mm (Box of (23),36mm(63) & 40mm(03) 30) Codes Standard 5243,5283,5223,5263 & 5203 Pop on 7243,7283,7223,7263,7203 wide band 9243,9283,9223,9263,9203 Good instructions, starter packs are available from the company. Great bear Libra Sizes - 24mm, 28mm, 31mm, 35mm, 40mm. Codes Standard GBLSS + Size of sheath Pop on GBLSP + Size of sheath Wide band GBLSW + Size of sheath 1.56 (Box of 30) No collar, so sticks directly to skin and flat to the surface. Starter packs are available from the company.

4 Product: Specialist sheaths Company Codes and sizes Price per Manfred Sauer P-sure sheath Latex Free Sizes 18mm paediatrics 20mm, 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 35mm, 37mm, 40mm. Codes 97 + Size (e.g for size 20mm) Product: Adjustable leg bags (for sheath user) Leg bags for sheath users 1.55 (Box of 30) For use of patients with large diuresis, where other sheaths have fallen off. Can be worn for dribbling with a valve, hold approx. 100mls Prescription 10 per box enough for a 10 week supply A) All these leg bags have adjustable tubes, which can be cut to length, so must only be used for sheath users. B) Place bag on lower leg and cut tube to size to ensure there is no excessive loop in the tube, but allowing for when the patient is seated. C) There are other bags available for patients with specialist needs e.g. wheelchair users, so contact the Bladder and Bowel Continence Service for advice. Company Codes and sizes Price per Coloplast Adjustable bag 2.91 Simpla Profile 500mls/750mls (Box of 10) Codes For sheath use only. Safety lock tap and anti-kink tubing. Specialist products Products: Male urinals Company Product and codes Price per Beambridge Male Funnel (6 35) Medical Male Mini Funnel (6 35 M) Other products available for both male and females, and some can be prescribed by the GP. Contact the DBBCS / for advice or Beambridge web site (beambridge@ntlworld.com). Product: Male drainage pouch Retracted penis pouch For men who Spray when passing urine. Mini will fit in pocket. One Supplied. Prescription 10 per box, could last between days depending on wear time These can be useful where an ordinary sheath cannot be used, such as a retracted penis. The site has to be shaved before application. Both leg and bed bags can be attached. The hydrocolloid skin barrier provides aggressive adherence and is designed for more than one day wear time. Hollister recommend that initially the site is checked after the first day; if all is fine, the next one can be left for two to three days. Company Product Price per Hollister Urinary pouch Code: GVC Specialist Item. Retractable penis area would need to be shaved.

5 Products: Catheter maintenance solutions Prescription amount will depend on frequency of catheter irrigation A) These should only be used after an assessment of need has taken place. Suby G & solution R should only be used once it has been established that encrustation is the cause. The only real way to find this is to cut open the catheter down its length. B) NaCl for the washing of debris (blood, mucus, pus) from the catheter. C) Always use according to manufacturer s instructions. D) The use of the two chambered Braun product ensures that the closed system is only opened once. E) All Catheter maintenance solutions should be prescribed. Company Product Price per B Braun Linc Medical Uro Tainer NaCI 0.9% %: 50mls Uro Tainer Twin Suby G: 2 x 30mls Uro Tainer Twin Solution R 2 x 30mls Bladder Infusion Kit MC1/ (Box of ) Preferred product as solution needs to drip in to catheter. For Suby G and R solutions catheters need to be inspected for encrustation, by cutting down the length of the catheter after removal. These are for administrating Catheter maintenance solutions if used more than once a week. The solution can be administered via the sample port rather than removing the bag every time, and reducing the need to use more than one bag per week. Product: Adhesive remover Company Product codes Price per Clinimed Sterile Adhesive remover spray Appeel no 100mls 1x1 sting medical Code: adhesive Sterile wipes 1x30 pack of single use remover. wipes Code: Leg bags Prescription 10 per box enough for a 10 week supply When assessing patients, it is important to consider the following points: A) Bag capacity (mls) 350ml are available, but generally are not in common use. B) Tube length (short, for wearing bag on thigh, maybe more suitable for females; long, for wearing on knee or calf). C) Tap design for ease of use. D) Patient choice. E) All leg bags can stay in place for 5 7 days, always check manufacturer s recommendations. F) Ensure bags are not changed unnecessarily as it is important to maintain the closed system to prevent infection. G) When used in conjunction with 2 litre night bags, patients should always attach night bag to bottom of the leg bag. This ensures unnecessary breaking of the closed system. H) All boxes of 10 bags contain one pair of leg bag straps. These adhesive removal products can be used to help remove sheaths. I) Specialised bags are available for wheelchair bound patients with greater capacity (700 and 1300ml) which are worn across the knee, details are from the continence advisory service.

6 Night bags single use Prescription 3 packs of 10 for a 1 month supply A) These bags must be used by all patients unless bed bound where a drainable night bag is used instead. B) Single use night bags can help to reduce urinary tract infections. C) The chosen bags have single use taps, once opened cannot be reused, this ensures safer opening for patients/carers, rather than tearing or cutting of bags. Night bags drainable A) These must only be used on patients who remain in bed where the bag is attached directly to the catheter. B) All night bags should be placed on a stand so the tap is clear of the floor. C) All bags can stay in place for 5 7 days, always check Manufacturer s recommendations. Special products: Fixation devices These items may be used instead of retaining straps as may keep catheter in position better than retaining straps. Company Product code Price per Optimum Ugo Gentle Code: Box of Really gentle and moveable and re-sticks well. Clinifix Code: Box of 10 (110mm x 25mm) Box of 10 (140mm x 40mm) 1.71 small 1.88 large Good size variety. Kind to skin can be placed on fragile skin. Stat Loc Code: FOLO102DT Box of Sticks well but can be tough on skin. Products: Catheterisation packs Cath-it (including catheter removal pack) Company Product Codes Price per Richardson Health Sizes: Small Medium Gloves Medium Large Gloves each Contains 3 pairs of gloves.

7 Products: Retaining straps Catheter retaining straps Prescription G-strap 5 per box, washable, so use is dependent on this and wear time Clinifix 10 per box, single use, dependent on wear time and cleansing need A) These are a necessity for all standard length indwelling catheters to ensure that any traction from the leg bag or tubing is absorbed by the strap and is not transmitted to the bladder itself. B) All products are washable and have a good variety of sizes. Company Great Bear Optimum Product Codes and Sizes Short Adult Abdominal Adjustable Ex-short 35cm Short 45cm Medium 80cm Long 130cm Ex-long 180cm Price per 2.79 short/adult 2.99 abdominal 3.52 Adjustable 2.50 small/short 2.76 med 3.36 Long 3.76 Ex long Good variety of sizes. Comes with good instructions and wash bag. Products: Catheter leg bags and night bags Company Product codes Price per Convatec/ unomedical Qufora Day Bags: Available in short & long tubes, & 500mls and 750mls. T-tap 500mls SVCG- short LVCG- long Lever tap 500mls SVCG-short LVCG-long Night Bags: 47-60=LBH (single use) IDCG (drainable) Day Bags: Sizes 350mls, 500mls, 750mls Are available in lever tap and t-tap, Short and long tubes Codes Lever Tap 500mls short long T-Tap 500mls short long Night bags Codes (drainable) (single use) 2.57 (box of 10) (Box of 10) 2.24 (Box of 10) Supplied by local hospitals to patients on discharge. Easy use taps, good instructions and sample port. Variety of taps and gloves with sterile bags. Good for N/H & R/H Liked the bed clip, good instructions, nice tap. Also have a 3 litre bag with range.

8 Product: Specialist bags Specialist product for mobile or wheelchair-dependent patients, worn around the waist. 1 Litre capacity. A night bag can be attached. This product can be used for 28 days. Company Product codes: Price per Teleflex/Rusch Belly Bag Great bear B1000 Chambered Bag Lever action Tap. Sizes 500mls and 750mls, short and long Q-S 10115R-L (one bag) 2.87 (Box Of 10) Products: Leg bag support straps Company Product codes: Price per One Bag lasts for 28 days. For use with all catheters. Also can order separately extendable drainage tube and replacement belt. Tap can be turned to avoid accidental opening. For use for patients who find the sloshing sound in ordinary bags an issue. Unomedical Ex 1.42 Box of 10 (straps last a week) Qufora Box of 10 Great bear 10622C Box of 10 Products: Catheter valves Catheter valves Prescription 5 per box, enough for a 5 week supply A) Ideally these should be considered as first choice as opposed to free drainage via a urine drainage bag, unless a medical reason is stated or by patient choice. B) Ensure comprehensive assessment including patient choice may be advantageous in maintaining bladder tone. C) Medical opinion should be sought before the use of catheter valve due to the following contraindications: a) ureteric reflux b) renal impairment c) uncontrolled detrusor over activity d) impaired cognitive function e) reduced bladder capacity f) lack of bladder sensation D) Need to be changed every 5 7 days. E) A night bag can be attached directly to the valve outlet for free drainage at night. Company Product Codes Price per Qufora Box of 5 Linc Medical CF Box of 5

9 Products: Catheter bag sleeves Catheter bag support sleeves Prescription 4 per packet, usage will depend on wear time and washing regime A) These in many cases can be more comfortable than the leg bag straps. B) It is important that the leg is measured before ordering. C) The all in one is designed to be placed directly onto the leg, it does not require folding over onto itself to enclose the leg bag. D) All sleeves are washable in 40 degree wash and the optimum comes with a wash bag and instruction leaflet. E) We would not recommend the use of a tumble dryer. Company Product Codes and Sizes Price per Optimum Sizes Codes 1.82 Good Small: 3005 instructions Medium: 3006 with product. Large: 3007 Comes with Extra-large: 3008 wash bag. Good size variety. Clinisupplies Sizes Codes Soft to touch Small: PL and washable. Medium: PL53904 Large: PL53928 Night bag stands Not available on prescription, may be supplied by company, if not these can also be purchased by patients, details from each company. Coloplast Simpla Catheter bag stand plastic flat pack, freely available if using Coloplast products, tel Careline via Light weight wire catheter bag stand Rochester Medical Ltd, free if using Script Easy home delivery Service, tel Catheter stands via Nghtingale Home Delivery available in Plastic or metal. Tel Products: Indwelling catheters Prescription Individual item, prescribe 2 to ensure 1 is available for change at any time Long term catheters (maximum of 12 weeks) A) These catheters can be used for up to a maximum of 12 weeks, always check manufacturer s recommendations. PTFE coated latex (short term catheters) A) Note, these include latex, so all patients must be checked for latex allergy. B) Average length of use is 1 3 weeks only, always check Manufacturer s recommendations. C) For urethral use only. D) May be a viable alternative for long-term catheterised patients who regularly block due to encrustation within 3 weeks. It is paramount that this is documented accurately, to ensure the product does not remain in place beyond 3

10 Catheters guidelines A) Careful patient assessment is essential before deciding to catheterise. B) Take note of patient choice and local policy. C) All catheter balloons should be inflated with no more than 10ml of water. D) Wherever possible always use the smallest size catheter i.e. size 12 14ch for urethral catheters in adults. Suprapubic catheters are larger, often 16 20ch. E) Standard length catheters for use in men, Supra-pubic, and can be useful for female wheelchair users (less prone to being pulled out on transferring). F) Female length catheters for use in females only. G) Ensure documentation is completed accurately. Company Product codes and sizes Price per Teleflex/ Rusch Standard and female sizes 12ch 24ch All silicone (Long term 12 weeks) Standard: DA3101+ Catheter Size Female: DA Catheter Size Sympacath Hydrogel (long term 12 weeks) Standard: DH Catheter size Female: DH Catheter size PTFE (Short term 1 3 weeks) Standard: DP Catheter Size Female: DP Catheter + Size Rusch catheters include sterile water filled syringe and empty syringe for balloon deflation. Products: Specialist catheters Company Product codes and sizes Price per Qufora Bard Standard and Female sizes 12ch 24ch Silicone Long term (12 weeks) Standard: Catheter Size Female: catheter Size Open tipped Long Term (12 weeks) Standard: Catheter size Bardex IC silver catheter Standard sizes 12ch 22ch Female sizes 12ch 16ch Standard D236512s D236522s (highlighted numbers = size) Female D236912s D236916s Sizes in standards and female, 4.29 also paediatrics and can be used for suprapubic as well as urethral catheters. Has integral balloon so can reduce the risk of the balloon cuffing on removal Open tipped catheter is licensed for supra-pubic catheterisation only, please contact service for open tipped catheter for indwelling catheterisation 9.66 The silver coating lasts for 28 days, however the catheters are long term catheters (12 weeks) To be recommended by specialist