Docstoc

CLEAN INTERMITTENT SELF CATHETERISATION CISC

Document Sample
CLEAN INTERMITTENT SELF CATHETERISATION CISC Powered By Docstoc
					    GMCT UROLOGY NETWORK - NURSING



C L E A N I N T ER M I T TE N T
             SELF
   C AT H ET E R I SAT IO N
            ( C I SC )
GUIDELINES AND PATIENT INFORMATION
            TEMPLATES
    The following pages provide examples of clinical guidelines and patient information booklets to
 enable clinicians to develop their own resource material relevant to their hospital and Area Health
Service. They have been compiled by clinicians for clinicians. If you wish to use this material please
acknowledge those that have kindly provided their work to enable use by others. Revise all material
            with colleagues before using to ensure it is current and reflects best practice.⋅



    ⋅
      Disclaimer: The information contained herein is provided in good faith as a public service. The accuracy of any
  statements made is not guaranteed and it is the responsibility of readers to make their own enquiries as to the accuracy,
currency and appropriateness of any information or advice provided. Liability for any act or omission occurring in reliance
    on this document or for any loss, damage or injury occurring as a consequence of such act or omission is expressly
                                                        disclaimed.


               Adapted by GMCT Sept 2008                    2
            CLEAN INTERMITTENT SELF
             CATHETERISATION (CISC)
                   GUIDELINES AND PATIENT INFORMATION TEMPLATES


                                                                        CONTENTS




CLEAN INTERMITENT SELF CATHETERISATION (CISC)
GUIDELINES ..................................................................................................... 4
Expected Outcome ............................................................................................................................ 4
Background.......................................................................................................................................... 4
Policy statement.................................................................................................................................. 4
Indications for intermittent catheterisation.................................................................................... 4
Equipment .......................................................................................................................................... 5
Session One......................................................................................................................................... 5
Session Two and Three ..................................................................................................................... 6
References............................................................................................................................................ 6

STAFF COMPETENCIES ................................................................................ 7
Unit of Competency: Teaching Female Clean Intermittent Self Catheterisation (CISC)....... 7
Unit of Competency: Teaching Male Clean Intermittent Self Catheterisation (CISC) ........... 9

PATIENT INFORMATION (CISC) ..............................................................11
What is CISC? ................................................................................................................................... 11
What do you need to know?........................................................................................................... 11
What is A Urinary Tract Infection (UTI)?.................................................................................... 11
When to seek medical advice? ........................................................................................................ 11
Helpful Hints: ................................................................................................................................... 12
Types of catheters............................................................................................................................. 12
How often should I catheterise? .................................................................................................... 12
Care of Equipment and Catheter................................................................................................... 12

CLEAN INTERMITTENT SELF CATHETERISATION (FEMALE) 13

CLEAN INTERMITTENT SELF CATHETERISATION - MALE .......14

CATHETER CARE...........................................................................................15

SUPPLY OF EQUIPMENT AND FUNDING BODIES .........................16
Program of Appliances for disabled people (PADP) ........16
Continence Aids assitance scheme (CAAS) ........................16
PARAQUAD...........................................................................17
Department of Veterans’ Affairs (DVA).............................17

Adapted by GMCT Sept 2008                                                          3
         CLEAN INTERMITENT SELF CATHETERISATION (CISC) GUIDELINES


                                            EXPECTED OUTCOME

    Bladder emptied with minimal risk of complications

    NB: Other policies to refer to Urethral Catheter Insertion, Bladderscan


                                                 BACKGROUND ⋅

    Intermittent catheterisation has been identified as the optimal treatment for persons who have
chronic urinary retention or incomplete emptying of the bladder. Ideally patients/clients should be
taught clean intermittent self catheterisation (CISC) once and supervised to do the procedure several
times to ensure competency.

    Total fluid intake for adults should be between 1500 to 2000mls daily unless fluid restricted.
Frequency of catheterisation should be based on maintaining drained volume of less than 600mls.


                                             POLICY STATEMENT

    •    Medical Officer’s order for intermittent catheterisation documented in clinical notes.

    •    Patient handout or video (if available) to be used prior to session

    •    In hospital setting, use new catheter for each catheterisation to avoid nosocomial infections

    •    Consider manual dexterity vision and motivation, mental ability as well as cultural issues

    •    Patients/clients, who are in complete retention of urine should be taught ISC in a hospital
         setting

                     INDICATIONS FOR INTERMITTENT CATHETERISATION

    •    Conditions which include spinal injuries/ Multiple Sclerosis/ tumours/lesion and spina
         bifida as well as acontractile/ hypocontractile bladder caused by nerve deficit resulting in
         high residual of urine.

    •    Post operatively after dilatation of urethral stricture to maintain patency of urethra

    •    Manage incomplete bladder emptying following surgery e.g. Sling procedure, TURP etc.

    •    Prevent or management of ascending infection in hydronephrosis, reflux nephropathy,
         pyelonephritis and renal failure or scarring.


    ⋅
      The above is based on the policy of the Liverpool Health Service. Thank you to Selvi Naidu (CNC Continence
Liverpool Health Service) for allowing it to be accessed. Adapted by GMCT Sept 2008



               Adapted by GMCT Sept 2008                  4
    •    Some medications can contribute to incomplete emptying or retention of urine


                                                                   .
                                                 EQUIPMENT

    •    12-14F intermittent catheter (male or female length)

    •    Water-based lubricant sachet

    •    Kidney dish to measure residual urine

    •    Disposable cloths or baby wipes


                                                  SESSION ONE

    •    Ensure patient’s understanding of procedure and reasons for CISC

    •    Allow time for discussion of basic anatomy and concerns

    •    Provide patient video to watch before commencing procedure

    •    Allow time for patient time to discuss ISC after viewing video

    •    If patient is anxious allow time for debriefing

    •    Show patient equipment required for use at home

    •    Catheter

    •    Lubricant

    •    Moist towelettes or soap and water for meatal toilet

    •    Emphasise importance of undressing appropriately

    •    Demonstrate hand washing technique and turning tap off without contamination of hands.

    •    RN demonstrates meatal toilet with patient observing. ( RN supervises patient on meatal
         cleaning)

    •    RN performs first catheterisation whilst patient is observing (RN supervises patient on
         lubrication and insertion of catheter).

    •    Allow time again for questions and patients reaction to procedure

    •    Encourage patient to consume adequate amount of fluids.

    .
      The above is based on the policy of the Liverpool Health Service. Thank you to Selvi Naidu (CNC Continence
Liverpool Health Service) for allowing it to be accessed. Thanks to Virginia Ip, Melissa O’Grady and the GMCT Urology/
Continence Education Working Group for compiling this information. Adapted by GMCT Sept 2008



Adapted by GMCT Sept 2008                                 5
                                       SESSION TWO AND THREE

    •    Assess patients concerns, motivation and level of learning

    •    Patient/client performs CISC with RN supervising

    •    Allow time for questions.

    •    Discuss problem solving strategies.

    •    Encourage patient to consume adequate amount of fluids.

    •    Discuss purchase of some equipment.

    •    Link patient with appropriate resources e.g. PADP./CAAS or Paraquad

    •    Give patient a week’s supply of catheters

    •    Educate patient to catheterize at appropriate times according to their post-void residuals and
         record urine volume and comments for review.

    •    Sessions may need to be repeated depending on patient’s level of competency.

Point to note

Neo Bladder – Urinary bladder reconstruction using part of the bowel after cystectomy.
Patient/client needs to know that Neo bladder (bowel) normally produces mucus which is excreted
in the urine. ®

                                               REFERENCES

    1. Joanna Briggs Institute for Evidence Based Nursing, Clinical Practice Manuals, Intermittent
       Urethral catheter management. February 2002
    2. King RB, Carlson CE, Mervine J, Wu Y, Yarkony GM: Clean and sterile intermittent
       catheterisation methods in hospitalised patients with spinal cord injury. Archives of Physical
       Medicine and Rehabilitation




    ®  The above is based on the policy of the Liverpool Health Service. Thank you to Selvi Naidu (CNC Continence
Liverpool Health Service) for allowing it to be accessed. Adapted by GMCT Sept 2008



              Adapted by GMCT Sept 2008                6
                                         S TA F F C O M P E T E N C I E S



        UNIT OF COMPETENCY: TEACHING FEMALE CLEAN INTERMITTENT SELF
                           CATHETERISATION (CISC)


Name of Individual:                        Date of Assessment:
Name of Assessor:                          Signature of Assessor:
Ward:

Critical Elements       Performance Criteria                                            Yes      No       N/A

                        Check patient history

Organisation            Identifies reason for teaching CISC

                        Organises equipment

Patient                 Addresses patient by name
Preparation
                        Provides clear & relevant information to patient regarding
Task Skill              procedure & obtains consent.
                        Discuss with the patient in what position they want to
                        perform CISC
                        Encourage patient to try to void

                        Show patient the correct hand washing technique

                        Show patient the equipment required to perform CISC
                        Ensures patient dignity and privacy maintained
                        Show patient how to set up equipment, lubricate catheter
                        and ensure their clothes are out of the way.
                        Assist patient to position a mirror if they need to visualise
                        urethra.
                        Ensure patient washes hands.

                        Advise patient that their dominant hand now becomes
                        their “clean” hand and must not touch anything except
                        the cloth that they wash their genitals with and the
                        catheter.
                        Help patient assume the position that they have chosen to
                        catheterise.
Critical Elements       Performance Criteria                                            Yes      No       N/A




  These staff competencies were written by Melissa O’Grady (RPAH) and based on the CISC patient education procedures
from St George Hospital (thank you to Jeannettee Werda CNC Continence), Liverpool Health Service (thank you to Selvi
Naidu CNC Continence), Royal Prince Alfred Hospital and Balmain Hospital (thank you to Melissa O’Grady CNC
Continence and Loretta Scarselletta RPAH CNE Urology) and Karina So (CNC Urology Support and Continence
Management CRGH) Adapted by GMCT Sept 2008


Adapted by GMCT Sept 2008                                7
Supervise and         Open labia with non-dominant hand then use 3 separate
guide the patient     swabs to swab each side of urethra then the urethra itself.
to do the following

                      Pick up the 5cm from the end of the catheter with the
                      dominant hand
                      Gently insert catheter into urethra until urine drains.

                      Remove catheter when urine stops draining.

                      Swab any residual lubricant from genitals.

                      Measure post-void residual.

Education:cathete     Give patient one week’s supply of catheters
r care and supply

                      Link patient with appropriate resources eg PADP, CAAS,
                      Paraquad
Trouble Shoots        Gets patient to relax and imagine they are voiding if
                      catheter difficult to insert.
                      Gets patient to bear down if catheter cannot be inserted.

                      If catheter is inserted into vagina leave it there as a guide
                      and insert another catheter into the urethra.
                      Contacts MO if catheter can not be inserted.

                      Give patient advice about signs and symptoms of UTI
                      and when to contact MO.
Occupational          Maintains Standard Precautions & patient safety at all
Health & Safety       times
                      Disposes of Equipment

                      Complies with manual handling regulations ergonomic
                      principles and OH&S Acts
Legal                 Documents events including any problems with insertion,
Accountability        size of catheter used and recommended CISC frequency.




             Adapted by GMCT Sept 2008                  8
             UNIT OF COMPETENCY: TEACHING MALE CLEAN INTERMITTENT SELF
                              CATHETERISATION (CISC)



      Name of Individual:                     Date of Assessment:

      Name of Assessor:                       Signature of Assessor:

      Ward:


Critical Elements     Performance Criteria                                         Yes   No   N/A

                      Check patient history

Organisation          Identifies reason for teaching CISC

                      Organises equipment

Patient               Addresses patient by name
Preparation
                      Provides clear & relevant information to patient regarding
                      procedure & obtains consent.

                      Discuss with the patient in what position they want to
                      perform CISC

                      Encourage patient to try to void.
Task Skill
                      Show patient the correct hand washing technique

                      Show patient the equipment required to perform CISC

                      Ensures patient dignity and privacy maintained

                      Show patient how to set up equipment, lubricate catheter
                      and ensure their clothes are out of the way.

                      Ensure patient washes hands.



                       Advise patient that their dominant hand now becomes their
                      “clean” hand and must not touch anything except the cloth
                      that they wash their genitals with and the catheter.

                      Help patient assume the position that they have chosen to
                      catheterise.

Supervise and          Hold penis with non-dominant hand, retract the foreskin
guide the patient     then use 3 separate swabs to swab from meatus to shaft of
to do the following   penis 3 times in a circular direction.




  Adapted by GMCT Sept 2008                               9
Critical Elements      Performance Criteria                                             Yes   No   N/A

                       Point penis to the umbilicus.

                       Pick up the 5cm from the end of the catheter with the
                       dominant hand

                       Gently insert catheter until there is resistance then lower
                       penis until parallel to the thigh.

                       Continue to insert catheter until urine drains.

                       Remove catheter when urine stops draining.

                        Swab any residual lubricant from genitals and replace the
                       foreskin.

                       Measure post-void residual.

Education re           Give patient one week’s supply of catheters
catheter care and
supply

                       Link patient with appropriate resources eg PADP, CAAS,
                       Paraquad

Trouble Shoots         Gets patient to relax and imagine they are voiding if catheter
                       difficult to insert.

                        Use firm gentle pressure and the urethral sphincter will
                       fatigue.

                       Gets patient to bear down if catheter cannot be inserted.

                       Contacts MO if catheter can not be inserted.

                       Give patient advice about signs and symptoms of UTI and
                       when to contact MO.

Occupational           Maintains Standard Precautions & patient safety at all times
Health & Safety
                       Disposes of Equipment

                       Complies with manual handling regulations ergonomic
                       principles and OH&S Acts

Legal                  Documents events including any problems with insertion,
Accountability         size of catheter used and recommended CISC frequency.




                 Adapted by GMCT Sept 2008              10
                                   PA T I E N T I N F O R M A T I O N . ( C I S C )



                                                 WHAT IS CISC?

Clean Intermittent Self Catheterisation is a method which may be used by people who are unable to
empty their bladder completely. When a bladder does not empty completely and regularly four to five
times a day, problems may develop. Common problems include urinary tract infection, stone
formation, reduced bladder tone and sometimes incontinence of urine.



                                     WHAT DO YOU NEED TO KNOW?

Patient, carer and nursing staff need to:
1. Understand the reason for CISC for the patient. It can be done for symptom control or used                       as
a temporary or long term treatment.

2. Know what the Urologist or Specialist Nurse recommends for the following:
   • Frequency and duration of CISC
   • Type and size of catheter
   • Any specific instructions
   • Care of catheter and equipment
   • Drug therapy related to bladder activities
   • Supplier of equipment
   • When and how to contact family doctor or specialist

3.       Know the name and contact number of a medical or nursing specialist who can assist them
         with any questions.



                           WHAT IS A URINARY TRACT INFECTION (UTI)?

Urinary tract infection is a condition when bacteria or other organisms grow in the urinary tract.

Usually you will experience one or more of the following signs and symptoms.
   • Burning sensation on passing urine
   • Pain in lower abdomen.
   • Feeling unwell, with or without a temperature
   • Cloudy urine with or without strong odour
   • Blood in urine
   • Confusion



                                   WHEN TO SEEK MEDICAL ADVICE?

     •   If there is any abnormal discharge from the urethra +/- vagina in women.

.The above patient information is based on the Concord Repatriatrion General Hospital (CRGH) patient information.
Thank you to Karina So (CNC Urology Support and Continence Management CRGH) for allowing it to be accessed.
Adapted by GMCT Sept 2008


Adapted by GMCT Sept 2008                                11
•   If there is any itchiness, soreness or redness around your urethra.
•   If you have frequent loss of urine from the bladder.
•   If you have signs or symptoms of UTI.
•   If you have problems in inserting the catheter.
•   If no urine drains when you insert the catheter.


                                      HELPFUL HINTS:

•   Drink about 2 litres of fluid a day unless advised otherwise by your nurse or doctor.
•   Avoid constipation.
•   If you drain more than 500 mls, catheterize your bladder more often.



                                   TYPES OF CATHETERS

•   Single use catheters : Nelaton, self lubricating catheters

•   Reusable catheters : Cliny for male and female

                          Glass and stainless steel ( female only)



                         HOW OFTEN SHOULD I CATHETERISE?

Unless advised differently by the medical team:

•   If you can’t pass urine at all catheterise 4 times a day

•   If the amount that drains from the catheter after you do a wee is between 200-400mls
    catheterise twice a day

•   If the drainage from the catheter is 50-200mls catheterise once a day

•   If the drainage from catheter is less than 50mls for four catheterisations stop catheterising.

•   If you drain more than 600mls from your bladder you should start catheterising more often.

•   Often catheterisation is not required for 8hrs overnight.


For further information contact …………………



                         CARE OF EQUIPMENT AND CATHETER

• You need to store the catheter and equipment in a clean dry area away from direct sunlight.
 Do not fold catheter for prolonged periods.
• You should inspect catheter for debris or cracks.
• Discard catheter if in doubt.

         Adapted by GMCT Sept 2008             12
               CLEAN INTERMITTENT SELF CATHETERISATION (FEMALE)`




          1. Empty bladder (if possible).

          2. Ensure you have a rubbish bin close by

          3. Wash hands.

          4. Lay out equipment -lay plastic sheet on a flat surface

          5. Place wet washer/”Wet Ones” onto sheet

          6. Open pack that catheter is in without touching catheter and place catheter on the sterile
             inside of its packaging.

          7. Pour some lubricating jelly on the rounded end of the catheter.

          8. Remove clothing

          9. Wash hands thoroughly- use liquid soap and dry well with paper towel.

          10. Sit comfortably on chair, toilet, bed or stand to do catheterisation.

          11. Open labia with left hand (if right-handed) or right hand (if left-handed).

          12. Wipe between labia using washer/”Wet Ones” in a downward movement -do not return
              with same cloth back to urethral area as the cloth will be contaminated.

          13. Ensure you have a container or toilet for the urine to flow into.

          14. Hold catheter 7cms from the tip and ensure that the first 3cms of the catheter are
              covered with lubricant.

          15. If the tip of the catheter touches anything other than the urethra it must be discarded
              and a new catheter used.

          16. Gently insert the catheter into the urethra. If resistance is felt stop and relax and then
              the catheter will often insert easily.

          17. Continue to insert the catheter until urine flows or until most of the catheter has been
              inserted.

          18. Gently press on abdomen near your pubic bone to ensure bladder is empty.

          19. When urine stops flowing remove catheter in a downward motion.


`The above procedure is based on the patient instruction sheets used at St George Hospital (thank you to Jeanette Werda
CNC Continence), Royal Prince Alfred Hospital and Balmain Hospital (thank you to Melissa O’Grady CNC Continence)
and Karina So (CNC Urology Support and Continence Management CRGH) Adapted by GMCT Sept 2008


Adapted by GMCT Sept 2008                                  13
    20. Wash genital area to remove excess jelly.

    21. Record the post-void residual.




           CLEAN INTERMITTENT SELF CATHETERISATION - MALE



1. Provide adequate lighting and privacy.

2. Undress from the waist down exposing the genitals.

3. Empty bladder if possible.

4. Wash hands with soap and running water for one minute, dry hands with a clean towel.

5. Arrange equipment.

6. Wash hands again.

7. Hold penis and pull back foreskin.

8. Clean the head (glan) of the penis using washer or ”Wet Ones” starting at the tip and working
    towards the base. Use each “Wet Ones” once only to avoid contaminating the opening of
    the water pipe (Urethra).

9. Hold the catheter 7 cm from the tip and lubricate the first 3 cm of the catheter tip.

10. Insert the catheter gently into the urethra.

11. If you feel resistance during catheter insertion, stop, adjust position of the penis so that it is at
     90 degrees to the body (This will straighten the angle along the urethra to the prostate).

12. Continue to insert the catheter until it enters the bladder and urine begins to flow.

13. When urine is completely drained from the bladder, remove catheter in a downward motion.
    Replace foreskin.

14. Tidy up and wash hands.

15. Measure amount of urine drained, record amount and any problems on chart.



            bladder




                                           Urethra
         Adapted by GMCT Sept 2008                 14
                                                                 catheter
                                              CATHETER CARE



         •    At the completion of each catheterisation, single use only catheters must be discarded.
              Explanation and or options regarding re-use of catheters should be discussed with
              patient/client.

         •    If a glass or stainless steel catheter is used, clean thoroughly with a pipe cleaner and
              soapy water (sunlight soap), rinse under cold running water and place in a sterilising
              solution such as Milton as per manufacturer’s instructions. The catheter must remain in
              the solution for a minimum of 1 hour.

         •    OR glass / stainless steel catheters may be boiled for 12 minutes

         •    Container for these catheters can be cleaned and sterilized using the same method

         •    Cliny Catheter Care :


                   o    Wash catheter in warm soapy water after each use (use a non-perfumed soap).

                   o    Fill container with glycerine or Milton solution and store catheter in this
                        solution between uses.

                   o    If stored in glycerine wash container in warm soapy water once a week, boil in
                        boiling hot water for 10 mins and then refill with glycerine or change Milton
                        solution daily.

                   o    Once a week boil catheter in boiling water for 10 mins.

                   o    Change the catheter every 4 weeks or earlier if deteriorating.

                   o    Change container every 3 months or earlier if deteriorating

NB if you have MS or any other condition that compromises your immune system you may need to
do self catheterisation using a sterile technique during times of exacerbation of your condition.




 Catheter Care was written by Virginia Ip (RPAH Urology Clinical Care Co-ordinator). Thank you to Sally Shand (CNC
Continence NSCCAHS) for her input. Adapted by GMCT Sept 2008


Adapted by GMCT Sept 2008                                15
                     S U P P LY O F E Q U I P M E N T A N D F U N D I N G B O D I E S



An assessment by a continence nurse advisor is recommended to ensure the most appropriate
continence product, including the correct fit and application of the product


                 PROGRAM OF APPLIANCES FOR DISABLED PEOPLE (PADP)

Program of Appliances for Disabled People ( PADP ) provides a subsidy towards the cost of
equipment covering disposable and re-usable continence aids for people living in the community
who:

    •   Have a permanent or indefinite disability
    •   Have a Health care Card, Health Care Interim Voucher or Pensioner Concession Card
    •   Are ineligible for assistance from other programs
    •   Have not received compensation for their injuries or disability, including not being on a
        Commonwealth Rehabilitation Program or being supplied with aids and appliances under
        the Motor Accident Act
    •   Are State Wards or children in foster care who have a disability

Continence aids are available to people discharged from hospital or acute care. The person must be
discharged for at least one month and not be under outpatient treatment.

Subsidy is decided by product quota rather than by financial amount. Clients are required to make a
$100 co-payment each year in which an item is received. In the case of continence products, where
the supply is generally ongoing, the client would contribute $100 each year. At times this may leave
the client with residual out –of –pocket expenses.

 Assessment is required at least annually by a medical practitioner to obtain a prescription for
appropriate aids and apply to a regional Lodgement Centre in the client’s Area Health Service.

Information regards PADP policy is available on the NSW Health website:
http://www.health.nsw.gov.au/policies/pd/2005/PD2005_563.html


                       CONTINENCE AIDS ASSITANCE SCHEME (CAAS)

This is a federal government scheme available to people aged five years and over, with permanent
and severe incontinence due to:
    • neurological conditions such as paraplegia, cerebral palsy, multiple sclerosis, spinal bifida or
    • permanent and severe intellectual impairment: or
    • other causes such as autism, cancer, prostate disease or dementia and holds a Pensioner
         Concession Card ( if they are under 16 years of age, their parent / guardian holds a
         Pensioner Concession Card

Applicants will need to provide a Health Report from an appropriate health professional such as their
medical practitioner or continence nurse about their condition.

Eligible CAAS clients receive a subsidy of $470 per year on continence products

Someone that is NOT eligible for CAAS if their incontinence is one of the following types:
             Adapted by GMCT Sept 2008             16
    •   transient incontinence ( not permanent);
    •   incontinence that can be treated with an existing conservative treatment regime; medication
        or surgery;
    •   They are a high care resident in a Australian Government funded aged care home
    •   They are eligible for assistance with continence aids under the Rehabilitation Appliances
        Program ( RAP )n which is available through the Department of Veterans’ Affairs
    •   You receive an Australian government funded Extended Aged Care at Home Package
        (EACH) or an extended Aged Care at Home Dementia Package ( EACH D package )

Further information on eligibility and to obtain an application form:
       CASS Helpline: 1300 366 455
       http://www.intouchdirect.com.au / healthcare/caas.htm
       http://www.bladderbowel.gov.au/doc/CAAS%20fact%20sheet.pdf


                                             PARAQUAD

This organisation is the main supplier of continence aids including urinary catheters.

Address:  6 Holker Street, Newington 2128 (cnr. Avenue of Africa)
Phone No: 1300 88 66 01
Hours:    8 :30am - 4 :30pm
          Monday - Friday

Paraquad has a store trading as BrightSky
Phone number as above.
Webstore
www.brightsky.com.au
Email : order@brightsky.com.au



                            DEPARTMENT OF VETERANS’ AFFAIRS (DVA)


The Commonwealth Department of Veterans’ Affairs (DVA) provides a range of incontinence
products to eligible veterans and ward widow (er) s via the Rehabilitation Appliances Program (RAP).
Eligible applicants need to:

    •   hold a Gold Card ; ( eligible for treatment of all conditions whether or not they are related to
        war service) ;
    •   hold a White Card and the incontinence is a result of a specific accepted disability;
    •   have been assessed by a health professional as requiring products for incontinence; or
    •   products are provided as part of the overall health care management

Gold and White Card holders are not eligible if they are residents receding high level aged care

A form requesting the incontinence products is filled out by the assessing doctor or health
professional. It is then sent to an authorised product supplier on behalf of the client.

For all enquiries in regards to continence products and supply arrangements, contact the South
Australian State Office:



Adapted by GMCT Sept 2008                         17
National Continence Contract Team
Department of Veterans’ Affairs
GPO Box 1652
(199 Grenfell St)
Adelaide SA 5001
Phone: 1300 131 945

Or NSW Dept of Health – Primary Health & Community Partnerships: (02) 9391 9515
   Continence Promotion Centre: (02) 8741 5699




                                         MAJOR CHEMIST

You may like to discuss with your chemist about getting your supply and negotiate the price.




             Adapted by GMCT Sept 2008           18

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:94
posted:12/28/2011
language:English
pages:18