Definition
Performing catheter care is essential for preventing catheter-associated urinary tract infections (CAUTIs) and maintaining patient comfort and dignity
Purposes
- To promote patient comfort.
- To reduce chances of developing urinary tract infection.
Articles
A sterile “catheter care kit” containing:
- Thumb forceps
- Cotton balls/swabs.
- Bowls for antiseptic lotion and sterile water.
A clean tray containing:
- Clean washcloth or towel (2 nos.).
- Warm water and soap.
- Antiseptic lotion.
- Normal saline.
- Mackintosh/waterproof pads and draw sheets.
- Antibiotic ointment.
- Clean gloves.
- Sterile gloves.
- Drapes.
- Adhesive tape and scissors.
- Kidney tray.
Procedure
| NURSING ACTIONS | RATIONALE | |
| 1. | Before procedure Prepare necessary equipment and supplies. | Ensures efficiency and smooth functioning. |
| 2. | Explain procedure to patient, offer opportunity for self-care if possible. | Reduces anxiety and promotes cooperation. |
| 3. | Provide privacy. | Maintains patient’s self-esteem. |
| 4. | During procedure Wash hands. | Reduces transmission of microorganisms. |
| 5. | Position of patient: Female: Dorsal recumbent position with legs flexed. Male: Supine position. | Ensures easy access to perineal area. |
| 6. | Place waterproof pad/mackintosh and draw sheet under patient. | Protects bed linen from soiling. |
| 7. | Drape sheet over patient exposing only perineal area. | Prevents unnecessary exposure of body parts. |
| 8. | Don clean gloves. | |
| 9. | Remove anchor tapes to free catheter tubing. | |
| 10. | Expose the urethral meatus (with nondominant hand). Female: Gently retract labia to fully expose urethral meatus and catheter insertion site. Maintain position of hand throughout procedure. Male: Retract foreskin if patient is not circumcised and hold penis at shaft just below glans. Maintaining position of hand throughout procedure. | Provides full visualization of urethral meatus. Retraction prevents foreskin contaminating the meatus, during cleansing. Accidentally letting go of penis requires that process be repeated. |
| 11. | Assess urethral meatus and surrounding tissue for inflammation, swelling, and discharge. Note amount, colour, odour, and consistency of discharge. Ask patient if burning or discomfort is felt. | Determines presence of local infection and hygiene status. |
| 12. | Cleanse the perineal area. Female: Wash labia majora, with soap and water, use nondominant hand to gently retract labia from thigh, with dominant hand, wash in skinfolds and wipe in direction from perineum to anus. Repeat on opposite side, using separate section of wash cloth. Separate labia majora with nondominant hand to expose urethral meatus and vaginal orifice. With dominant hand, cleanse thoroughly around labia minora, clitoris, and vaginal orifice using separate section of cloth. Male: Gently grasp the shaft of penis, if client is uncircumcised, retract foreskin. If client has an erection, defer procedure until later. Wash the tip of penis at urethral meatus first. Using circular motion, cleanse from meatus outward and down the shaft discard wash cloth and repeat with clean cloth until penis is clean. Return foreskin to its natural position. Wash shaft of penis with special attention to underlying surface of penis. | Cleansing reduces number of microorganisms. Use of clean cloth prevents transfer of microorganisms. Moving from the cleanest area decreases risk of recontamination. |
| 13. | After procedure Remove clean gloves and wash hands. | |
| 14. | Don sterile gloves. | |
| 15. | Clean the catheter from meatus outwards for approximately 3-5 cm using saline swabs. | |
| 16. | Repeat step (15) using cotton swabs soaked in sterile water/ normal saline. | Antiseptic solution may act as an irritant to skin. |
| 17. | Apply antiseptic ointment (if prescribed) at urethral meatus and along 2.5 cm (1 inch) of catheter and anchor catheter. | Reduces further growth of microorganisms at insertion site. |
| 18. | Place the patient in a safe and comfortable position. | Promotes comfort. |
| 19. | Remove gloves, dispose off contaminated supplies, and wash hands. | Prevents the spread of infection. |
| 20. | Record and report condition of perineal tissue, the time procedure was performed, patient’s response and abnormalities noted. | Provides data to document procedure and informs concerned others of patient’s condition. |
Special Consideration
- Catheter has to be changed periodically as per Hospital policy.
- Use soap and water—avoid antiseptics unless prescribed
- Do not routinely change catheters or drainage bags unless clinically indicated
- Keep the drainage bag off the floor and below bladder level at all times
- Educate patients and caregivers on hand hygiene and signs of infection
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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