Hospital Infections control – Practical Insertion and Maintenance of Urinary Catheters

Hospital Infections control – Practical
Insertion and Maintenance of Urinary Catheters
Hand hygiene before and after placement
Aseptic technique and use of sterile equipment
Use sterile gloves, drape, an antiseptic solution for periurethral cleaning, and a single packet of lubricant for insertion.
non-traumatic urethral insertion using an appropriate lubricant
Maintain Sterile Technique
Placement of Urinary Catheter
Use smallest catheter size effective for patient (14 or 16F)
Catheters should be properly secured to prevent movement and urethral traction
Maintenance of Urinary Catheters
If there is a break in sterile technique, or leak from the closed system, replace the urinary catheter and the drainage system
Make sure the urinary flow is not obstructed
No kinks of catheter
The urinary bag should always be lower than the bladder
Regular emptying of urinary bag
Maintenance of Urinary Catheters
Do not change urinary systems routinely
Consider changing urinary system if:
Infection
Obstruction
Break or leak of the closed system
Potential Site for Contamination
Potential Site for Contamination
Potential Site for Contamination
Maintenance of Urinary Catheter: Irrigation
Avoid irrigation unless necessary (obstruction of catheter)
Catheter tubing junction should be disinfected before irrigation
Use the sampling port to relieve the obstruction
Do not disconnect the closed system unless you cannot use sampling port
Periurethral or Meatal Care
Washing meatus with povidone-iodine or soap is not associated with lower infection risk.
Aggressive cleaning may be associated with increased infection!
Routine hygiene during bathing is appropriate.
What Needs to be Done
Both nurses and physicians should evaluate the indications for urinary catheter utilization.
Physicians should promptly discontinue catheters that are no longer needed.
Nurses evaluating catheters and finding no indication should contact physician to promptly discontinue catheter.
Urinary Catheter Use
Place Only When Necessary
Promptly Remove When Not Necessary