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urin cath guidlines

Guidelines for Preventing Infection in the Catheterized Patient:

  • Use scrupulous aseptic technique during insertion of the catheter. Use a preassembled, sterile, closed urinary drainage system.

  • To prevent contamination of the closed system, never disconnect
    the tubing. The drainage bag must never touch the floor. The bag
    and collecting tubing are changed if contamination occurs, if
    urine flow becomes obstructed, or if tubing junctions start to leak
    at the connections.

  • If the collection bag must be raised above the level of the
    patient’s bladder, clamp the drainage tube. This prevents backflow of contaminated urine into the patient’s bladder from
    the bag.
  • Ensure a free flow of urine to prevent infection. Improper
    drainage occurs when the tubing is kinked or twisted, allowing
    pools of urine to collect in the tubing loops.

  • To reduce the risk of bacterial proliferation, empty the collection
    bag at least every 8 hours through the drainage spout—more
    frequently if there is a large volume of urine.

  • Avoid contamination of the drainage spout. A receptacle in which
    to empty the bag is provided for each patient.
  • Never irrigate the catheter routinely. If the patient is prone to
    obstruction from clots or large amounts of sediment, use a threeway system with continuous irrigation.
  • Never disconnect the tubing to obtain urine samples, to irrigate
    the catheter, or to ambulate or transport the patient.
  • Never leave the catheter in place longer than is necessary.

  • Avoid routine catheter changes. The catheter is changed only to
    correct problems such as leakage, blockage, or encrustations.
  • Avoid unnecessary handling or manipulation of the catheter by
    the patient or staff.
  • Carry out hand hygiene before and after handling the catheter,
    tubing, or drainage bag.

  • Wash the perineal area with soap and water at least twice a day;
    avoid a to-and-fro motion of the catheter. Dry the area well, but
    avoid applying powder because it may irritate the perineum.

  • Monitor the patient’s voiding when the catheter is removed. The
    patient must void within 8 hours; if unable to void, the patient
    may require catheterization with a straight catheter.
  • Obtain a urine specimen for culture at the first sign of infection.