Clean Intermittent Catheterization

Disclaimer: This toolkit is intended to provide resources for school nursing practice as it relates to the care of students in Oregon schools. This is not medical nor nurse practice advice and is not prescriptive as it relates to individual students or individual nursing practice. These resources do not override individual assessment, and clinical judgement. Nurses are responsible for their own assessment and practice.

Clean intermittent catheterization (CIC) is a way to drain urine from the bladder.  This is done by putting a catheter (which looks like a small straw) into the bladder to drain the urine.  The catheter is removed when the bladder is empty. CIC allows patients more control over their bladder emptying, and avoid inconveniences of indwelling urethral catheter (Seth et al, 2014; Lamin & Newman, 2016).

CIC is used to empty the bladder or take pressure off the bladder when an individual has difficulty  with emptying the bladder or emptying the bladder completely.  This may occur because the individual is unable to sense that they have a full bladder, they are unable to initiate a urine stream,  or because they are unable to empty the bladder. This results in residual urine which places them at risk for urinary tract infections (UTIs).  The bladder should be emptied at regular intervals to reduce the risk of overfilling or prevent leakage (Haider & Annamaraju, 2023; HCO, 2019).

Students who require the use of a CIC at school may require ongoing education and support for successful CIC care.  Some students may need help planning their schedule, overcoming stigma associated with CIC, physical challenges and/or pain, supply and financial issues, and/or feelings of anxiety, fear, and nervousness (Hasan et al, 2022).   Typical bladder and catheterization problems that may occur while the student is in school include; difficulty emptying the bladder, difficulty passing the catheter into the bladder, UTI’s and other infections, wetness/leaking (Selekman, 2019, p.731-732).

Evidence Based Practice

Basic Information

Legal Practice Standards

At the forefront of nurse case management for school nurses, is the understanding of scope of practice as it relates to case management and delegation of  nursing tasks in a community setting:

Public Access Practice Resources

The professional nurse in the school setting should understand and access existing resources and framework for care of students who have a condition which may require clean intermittent catheterization .

Note: the following are national or regional resources that serve as a reference, they may or may not be consistent with Oregon law and do not supersede Oregon Nurse Practice or clinical judgment.

Centers for Disease Control and Prevention(CDC)

The Cleveland Clinic

The Royal Children’s Hospital Melbourne

UCSF Benioff Children’s Hospital

Professional Development

Nurses must ensure that they have proficiency in areas of practice in which the delegate. The following include Free Continuing Education resources for Nursing related to clean intermittent catheterization:

Centers for Disease Control and Prevention

Wild Iris CEU

Appletree CEU


The following templates are modifiable for use by school nurses as it relates to their practice and should be used consistently with Oregon State Board of Nursing, Delegation Laws and local school policy.

Individualized Health Plans

An individualized health plan (IHP) is the totality of the plan that includes all applicable procedures for students with chronic disease. Because these are intended to be individualized, the attached is an example of a compiled IHP:


Procedures also greatly vary by student health status, needs, level of care and type of regimen. The following are sample templates for specific procedures. A complete student  assessment should be made to determine appropriate procedures:

Teacher Notification

Teacher notifications, sometimes referred to as health status notifications or health information pages, can be used or combined with emergency action plans to ensure that all staff working with a student with CIC are informed of conditions and actions when necessary. These are abbreviated documents to provide critical information, but less comprehensive information than a complete IHP. This is a modifiable form for teacher notification:


Documentation is a necessary element of delegated care. Whenever feasible using electronic and portable delegated care logs is preferred.


Because CIC is a clinical procedure rather than a medication,  an authorization identifying the procedures should be signed by parent/guardian before the procedure occurs at school.


Self Management inventory is a critical element in determining a student's level of autonomy and ability with CIC.

  • CIC Self-Management Checklist

Prescriber Order Template

Obtaining orders for CIC in the school setting is a necessary step in development of student care plans.



Jerilyn Wernet
Lisa McEntire

Peer Reviewer/SME: Jan Olson

Editorial Reviewer: Ann Occhi


American Academy of Pediatrics, (2015, November 21). Clean Intermittent Catheterization.

Cleveland Clinic. (2020, October 23). Self-Catheterization (Clean Intermittent Catheterization).

Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, (2009) Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009 [Internet]. Atlanta (GA): Centers for Disease Control and Prevention;

Haider MZ, Annamaraju P. Bladder Catheterization. [Updated 2022 Dec 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

Hasan SA, Neal-Herman L, Norman HS, Zhao JZ, Carlson A. (2022) . Patient Support Program and Healthcare Resource Utilization in Patients Using Clean Intermittent Catheterization for Bladder Management. J Wound Ostomy Continence Nurs.01;49(5):470-480. doi: 10.1097/WON.0000000000000901. PMID: 36108231; PMCID: PMC9481293 (2015). Clean intermittent catheterization.

Health Quality Ontario.(2019) Intermittent Catheters for Chronic Urinary Retention: A Health Technology Assessment. Ont Health Technol Assess Ser. 2019 Feb 19;19(1):1-153. PMID: 30847008; PMCID: PMC6395058.

Kanaheswari, Y., Kavitha, R., & Rizal, A. (2015). Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters. Spinal cord, 53(3), 209–212.

Lamin E, Newman DK. (2016) Clean intermittent catheterization revisited. Int Urol Nephrol. 48(6):931–9.

Mitchell, B. G., Prael, G., Curryer, C., Russo, P. L., Fasugba, O., Lowthian, J., Cheng, A. C., Archibold, J., Robertson, M., & Kiernan, M. (2021). The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. American journal of infection control, 49(8), 1058–1065.

Newman DK, Willson MM. (2011). Review of intermittent catheterization and current best practices. Urol Nurs. 31(1):12-28, 48; quiz 29. PMID: 21542441

Prieto JA, Murphy CL, Stewart F, Fader M. Intermittent catheter techniques, strategies and designs for managing long-term bladder conditions. Cochrane Database Syst Rev. 2021 Oct 26;10(10):CD006008. doi: 10.1002/14651858.CD006008.pub5. PMID: 34699062; PMCID: PMC8547544.

The Royal Children’s Hospital Melbourne. (2023, February). Teaching and supporting Clean Intermittent Catheterisation for parents and children.

Selekman, J., Shannon, R. A., & Yonkaitis, C. F. (2019). School nursing: A comprehensive text (third). F.A. Davis Company.

University of California San Francisco. (2023). Patient Education A to Z: Clean Intermittent Catheterization.

Wilde, M. H., Brasch, J., & Zhang, Y. (2011). A qualitative descriptive study of self-management issues in people with long-term intermittent urinary catheters. Journal of advanced nursing, 67(6), 1254–1263.