Care of an indwelling urinary catheter in nursing
A urinary catheter is a hollow tube that is inserted into the bladder to drain urine. They can be used intermittently, short term or long term. However, insertion of a urinary catheter should only ever be performed if sound justification can be advanced, as the risk of infection both during and following insertion is very high and can lead to prolonged hospitalization and even death in susceptible individuals.
Given the inherent risk of developing a urinary tract infection following catheterization it is vital that a health care professional explain to the client how to care for their catheter. If the client is unable to care for the catheter then the nurse or carer should be able to competently carry out the following procedures in keeping with local policy.
Emptying a catheter bag
If a catheter is left in the bladder to drain urine continuously, the urine will pass through a closed circuit and be stored in a sterile drainage bag until the client or nurse empties it.
Equipment
Gloves
Apron
Clean measuring jug
Chlorhexidine or other wipes (see local policy)
Paper towel
Each time a catheter bag is emptied the closed system is disrupted. The more times this is done, the greater the risk of infection. The bag should therefore only be emptied when necessary, to reduce this risk. However, if the catheter bags are allowed to fill to capacity they can become very heavy and increase the drag factor for the client – that is, the pressure on the bladder neck should the bag inadvertently be dropped or allowed to pull. The interval between emptying a catheter bag therefore needs to be assessed on an individual basis.
Cleaning the catheter and surrounding area
To reduce the risk of infection, the area of the client’s body around the catheter should be washed with soap and water at least twice a day and following a bowel action. Clients with an indwelling catheter should be encouraged to perform this activity as part of their normal hygiene routine.
Removing a urinary catheter
To restore client comfort and promote normal functioning.
Equipment
Apron
Gloves
Receiver
Syringe
Disposal receptacle
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