Placement of the urinary catheter:
A catheter is inserted into the bladder via the urethra and remains in situ to drain urine. There are two types: short-term urinary catheter and long-term urinary catheter.
 
Indwelling urinary catheter:
Indwelling urinary catheters often lead to urinary tract infections. Therefore, it is important to routinely clean urinary catheters to prevent infections. It should be removed as soon as possible if the patient is not indicated for its further use.
 
Follow the tips mentioned below on how to take care of your urinary catheter:
  1. How to clean around the urinary catheter
    1. Wash your hands before and after handling the drainage device.
    2. Tape the catheter to your body. It can avoid urethral injury and bleeding caused by urinary catheters while being pulled out, reduces the patient’s complaint of discomfort, and lowers the risk of pressure injury that may develop surrounding urethra’s skin.
    3. Secure female patients’ urinary catheter to the thigh and male patients’ to the lower abdomen.
    4. Regularly check if the tubing is not kinked or leaking before and after placing the patient's position.
    5. Clean the urethral meatus once per day with water. Keep the area around the urethra dry to prevent infection.
  2. How to take care of urine bags
    1. Wash your hands before and after cleaning urine bags.
    2. Empty the urine bag when it is 1/2~2/3 full or at least every 8 hours.
    3. Do not let the drain tubes touch anything. When the bag is empty, close the clamp to prevent infection.
    4. Maintain a close and sterile drainage system to prevent infection: both the connection tube and the urine bag must be tightly connected. Make sure that there should be no urine leakage caused due to loosening of connectors.
    5. Keep the urine bag below the level of your bladder and off the floor at all times. If your urine bag is fixed to the calf, it should be suitably tied to the calf.
    6. Patient with a long term use of indwelling urinary catheter does not have to change catheter regularly unless the following situation happens: the urinary catheter slips out, blocks, ruptures or crystallizes, deposits, leaks, or stinks. The urine bag needs to be replaced every two weeks.
    7. Dietary instruction: Patients should be encouraged to have a good fluid intake of at least 2 liters per day. Some acidic foods such as cranberries, vitamin C, etc. are also recommended. It could help to acidify the urine and thus, avoid the obstruction caused by adhesions.
 
Reference
  1. Kuo, N.Y., Huang, Y. H., Ye, H. L., & Cheng, Y.T. (2017). Project for Reducing the Incidence of Catheter Associated Urinary Tract Infections in a Medical ICU. Cheng Ching Medical Journal, 13(4), 63-72.
  2. Liu, Y., Xiao, D., & Shi, X.H. (2018). Urinary tract infection control in intensive care patients. Medicine, 97(38), e12195. doi:10.1097/MD.0000000000012195
  3. Menegueti, M.G., Ciol, M.A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G.G., Canini, S.R.M.D.S., … 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 atheters: A quasi-experimental study. Medicine, 98(8), e14417. doi:10.1097/MD.0000000000014417
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