Component Task: Care of an Indwelling Urinary Catheter

 

It is the act of cleaning the catheter insertion point and its periphery with an antiseptic lotion and changing of the urine bag to prevent the introduction of microorganisms into the urinary tract. This is done as often as it is necessary or as stated in the ward’s protocol.

Aims

·         Prevent infection

·         Keep the catheter clean

Requirements

A trolley contaminating the following:

a.      Top shelf (a sterile field with the following)

·         Two sterile gallipot

·         Kidney dish

·         Sterile Cotton swab

·         Sterile drapes

b.      Bottom shelf

·         Antiseptic solution

·         Receiver for soiled items

·         Mackintosh and dressing towel

·         Disposable gloves

·         Sterile gloves

·         Urinal

·         Measuring jug

·         Urine bag if necessary

·         Antibiotic ointment

Steps

1.        Establish rapport with patient (Refer to steps)

2.      Explain procedure to patient (Refer to steps)

3.      Assemble necessary items

4.      Ensure privacy

5.      Perform hand hygiene, prepare trolley and send to bedside

6.      Put patient in the supine position

7.       Place mackintosh and dressing towel under patient

8.      Cover patient up so that only genital area is exposed

9.      Remove anchor device to free catheter tubing

10.    Perform hand hygiene and wear sterile gloves

11.      If it is a male, retract foreskin if present to expose urethral meatus, clean around catheter first, and then wipe in a circular motion around meatus and glans

12.    If it is a female, clean vulva using cotton wool swab and antiseptic solution towards anus, clean urethral meatus, moving down the catheter

13.    Inspect urethral meatus for discharge

14.    Use sterile cotton swab soaked in antiseptic lotion, wipe in a circular motion along the length of catheter

15.    Anchor catheter back

16.    Apply antibiotic ointment at urethral meatus and along 2.5cm of catheter

17.    Empty the urine and change the bag if necessary

18.    Record urine output

19.    Remove drape, mackintosh and dressing towel

20.  Remove gloves and perform hand hygiene

21.    Put patient into a desirable position

22.  Dispose off used items and decontaminate instruments and trolley

23.  Perform hand hygiene

24.  Document in nurses’ notes, intake and output chart (manual or electronic)

25.  Report findings to appropriate officer