【Major points】

1. The indwelling catheter needs to choose an appropriate place to fix the catheter, so as to avoid accidentally pulling the urinary catheter during activities.

2. Avoid twisting or pressing the urinary catheter under the body when moving or changing position.

3. Empty the urine collection bag every 8 hours or immediately when the urine volume exceeds 1/2 of the bag.

4. Keep the urine collection bag below your bladder to prevent urine from flowing back into your bladder, which could cause an infection.

 

What is an indwelling urinary catheter?
The indwelling urinary catheter is a hollow rubber/silicone tube that is inserted through the urethra into the bladder to drain urine. There is a balloon at the front end that can fix the tube in the bladder. The end of the tube will be connected to a closed urine collection bag.
 

Who needs an indwelling urinary catheter?

An indwelling urinary catheter is usually used when patients have urinary diseases (e.g. difficulty urinating, after urinary tract or adjacent tissue surgery…etc.) or in needs of urinary disease treatment (e.g. needs of measuring urine output, receiving full or half-body surgery anesthesia, long-term bedridden patients…etc.)

 

What items are necessary needed and prepared for patients who have indwelling urinary catheter?

Cleaning gloves, non-alcoholic wet wipes, warm water or neutral cleaning solution, breathable paper tape or catheter fixation tape and waterproof nursing pads.

 

Principles of taking care of patients who have an indwelling urinary catheter?

  1. An indwelling urinary catheter can easily lead to urinary tract infection. To keep  the catheter smooth and prevent infection, it should be removed when it’s not necessary.
  2. Caring tips for patients who have an indwelling urinary catheter.
    1. Wash your hands before and after cleaning the catheter. You may put on the clean gloves. Hand hygiene should be performed after removing gloves.
    2. Choose an appropriate place to fix the catheter, avoiding accidentally pulling during activities that may cause urethral injury, bleeding and reduce any discomfort as well as causing any damage of the tube on the mucous membrane in the urethra.
    3. The urinary catheter should be fixed on the inner thigh for female patients, and it can be fixed on the lower abdomen for male patients.
    4. Keep the catheter smoothly during activities or changing positions to avoid the catheter being twisted or pressed under the body.
    5. To avoid urethra and bladder infections, clean the urethral orifice two times a day. Use warm water ,non-alcoholic wet wipes or neutral solution to clean the urethral orifice after pooping, make sure to keep it clean and dry.
    6. Patients who need long-term catheter placement, the catheter and urine bag do not need to be replaced frequently. Replacement should be considered unless catheter slippery, blockage, broken, leakage or crystals and sediments, odors occurred.
  3. Caring tips of urine collection bag:
    1. Wash hands before and after touching the urine collection bag.
    2. Empty the urine collection bag every 8 hours or immediately when the urine volume exceeds 1/2 of the bag.
    3. Be sure to not touch the tip when you let the urine flow out of the urine bag into the container. When the bag is empty, always close the clamp to prevent infection.
    4. Make sure the connector on the urine bag is pushed in as far as possible to ensure a secure connection.
    5. Keep the urine bag below your bladder to prevent urine from flowing back into your bladder, which could cause an infection. If a leg bag is used, place the leg bag on your calf. Not too tight  or  too loose.
  4. Dietary advice:
    1. It is recommended to drink more than 2000ml of water daily.
    2. Eating more acidic foods such as cranberries, vitamin C …etc to make the urine acidic and reduce sediment or crystallization caused by alkaline urine, which can cause urinary catheter blockage.
 
Reference
  1. Chen, C. F., Chen, H. L., Chen. P. W., & Hsu, C. H. (2019). Introducing Bundle Care to Reduce Catheter Associated Urinary Tract Infection in the Medical Intensive Care Unit. Journal of Medicine and Health, 8(2), 85-98.
  2. Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., Canini,Silvia Rita Marin da Silva, Basile-Filho, A., & Laus, A. M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patients through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheters: A quasi-experimental study. Medicine, 98(8),e14417. https://doi.org/10.1097/MD.0000000000014417
  3. Tremayne, P. (2020). Managing complications associated with the use of indwelling urinary catheters. Nursing Standard (Royal College of Nursing (Gre -at Britain) : 1987, 35(11), 37-42. https://doi.org/10.7748/ns.2020.e11599
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