Urinary catheter maintenance

Catheter maintenance

• indwelling catheters should be connected to a sterile closed urinary drainage system or catheter valve
  
  
• healthcare workers should ensure that the connection between the catheter and the urinary drainage system is not broken except for good clinical reasons (for example changing the bag in line with the manufacturer's recommendations)
  
  
• healthcare workers must decontaminate their hands and wear a new pair of clean, non-sterile gloves before manipulating a patient's catheter, and must decontaminate their hands after removing gloves
  
  
• urinary drainage bags should be positioned below the level of the bladder, and should not be in contact with the floor
  
  
• a link system should be used to facilitate overnight drainage, to keep the original system intact
  
  
• urinary drainage bag should be emptied frequently enough to maintain urine flow and prevent reflux, and should be changed when clinically indicated
  
  
• meatus should be washed daily with soap and water
  
  
• to minimise the risk of blockages, encrustations and catheter-associated infections for patients with a long-term indwelling urinary catheter: develop a patient-specific care regimen consider approaches such as reviewing the frequency of planned catheter changes and increasing fluid intake document catheter blockages
  
  
• bladder instillations or washouts must not be used to prevent catheter associated infections
  
  
• antibiotic cover when changing urinary catheter
  • when changing catheters in patients with a long-term indwelling urinary catheter:
    • do not offer antibiotic prophylaxis routinely
    • consider antibiotic prophylaxis for patients who:
      • have a history of symptomatic urinary tract infection after catheter change
      • or experience trauma during catheterisation

Reference:

• 1) NICE (March 2012). Infection - Prevention and control of healthcare-associated infections in primary and community care