Best Practices for Management - Indwelling Catheters

  • Document in the patient’s medical record all procedures involving the catheter or drainage system.
  • Remove catheter as soon as possible to reduce the risk of CAUTIs. Insert the catheter using an aseptic technique.
  • Use the smallest size catheter possible.
  • Cleanse the catheter insertion site daily with soap and water or with a perineal cleanser.
  • Use of an antiseptic is unnecessary.
  • Empty the urine in the drainage bag at least every 4-6 hours to avoid migration of bacteria up the internal and external lumen of the catheter and undue tension on the catheter.
  • Adequately secure and anchor the catheter to prevent urethral and bladder-neck tension.
  • Ensure that urine drainage is unobstructed. Health-care workers and clinicians in institutions should observe their facility’s protocols for care of catheters and drainage bags.
  • Avoid routine or arbitrary catheter changing schedules in the absence of infection.
  • Maintain a uniform and adequate daily fluid intake to continuously flush the urinary drainage system.
  • Maintain a closed urinary drainage system to prevent introduction of bacteria into the urinary tract.
  • Clamping the catheter prior to removal is unnecessary.
  • Routine catheter and bladder irrigations and/or instillations are not recommended.
  • Avoid routine urine cultures in the absence of infection.
  • Avoid inappropriate use of antibiotics and antimicrobials.
  • Maintain the acidification of urine.
  • Patients and caregivers should be educated about their role in preventing CAUTIs.
  • Acute and long-term care staff should be educated through quality improvement programs about the selection, insertion, and management of indwelling catheters to reduce UTI incidence.
  • Patients with indwelling urinary catheters should be reevaluated periodically to determine whether an alternative method of bladder drainage can be used instead.
  • Patients should undergo bladder training after catheter removal to successfully regain bladder function.

References:

Newman DK.  Wein, AJ. Mananging and Treating Urinary incontinence. 2009 Health Professional Pres, Inc. Baltimore, MD. 

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