Techniques and Procedures for Use - Intermittent Catheters

Techniques & Procedures for Use

Type Technique
 Sterile   
  • Use of sterile gloves, disinfectant wipes or swabs, sterile single-use catheter, sterile drainage tray, or closed collection bag
 Clean, single-use
  • Use of a sterile, disposable catheter and clean hand hygiene
  • Catheter is single-use and is disposed after use
  • Product does not feature a protective sleeve or collection bag. 
 *Clean re-used  
  • Re-use of a sterile, disposable catheter and with good hand hygiene
  • *After use, catheter is washed and rinsed
  • Catheter is then air dried and stored in a ventilated container or ziplock plastic bag
  • Catheter is re-used by the same patient for a limited period of time (usually 1 week) as directed by clinician

 * Manufacturer guidelines state that a catheter designed for intermittent drainage of the bladder is single-use and is to be disposed after its catheterization.  

Medicare Changes Reimbursement Policy to End Re-use of Intermittent Catheters

On April 1st, 2008, Medicare changed its reimbursement policy on intermittent catheterization. The previous policy only allowed reimbursement for one intermittent catheter per week (4 per month), unless the individual user had lab results or medical documentation stating the existence of at least 2 urinary tract infections (UTIs) in the course of one calendar year. This new policy now allows reimbursement for up to 200 intermittent catheters per month per individual.

This change allows for up to 6 catheter changes a day in hopes to stop re-use of FDA labeled "single-use" catheters. The old policy made individuals sterilize and clean their catheters any way they knew how which lets a very high-risk opportunity to have the individual get infected with catheter-associated bacteria to arise.  No longer will catheter users suffer from severely painful UTIs.

Further Related Content:
Watch: Intermittent Catheters - Techniques

Written by: Diane K. Newman, DNP, ANP-BC, FAAN
References: 1. Beauchemin, Lisa, Diane K. Newman, Maureen Le Danseur, Angela Jackson, and Mike Ritmiller. "Best practices for clean intermittent catheterization." Nursing2019 48, no. 9 (2018): 49-54.

2. Goetz, Lance L., Linda Droste, Adam P. Klausner, and Diane K. Newman. "Catheters used for intermittent catheterization." In Clinical Application of Urologic Catheters, Devices and Products, pp. 47-77. Springer, Cham, 2018.

3. Lapides, Jack, Ananias C. Diokno, Sherman J. Silber, and Bette S. Lowe. "Clean, intermittent self-catheterization in the treatment of urinary tract disease." The Journal of urology 107, no. 3 (1972): 458-461.

4. Lindehall, B., K. Abrahamsson, U. Jodal, I. Olsson, and U. Sillén. "Complications of clean intermittent catheterization in young females with myelomeningocele: 10 to 19 years of followup." The Journal of urology 178, no. 3 (2007): 1053-1055.

5. Moore, Katherine N., Jean Burt, and Donald C. Voaklander. "Itermittent catheterization in the rehabilitation setting: a comparison of clean and sterile technique." Clinical rehabilitation 20, no. 6 (2006): 461-468.

6.Moore, Katherine N., Mandy Fader, and Kathryn Getliffe. "Long‐term bladder management by intermittent catheterisation in adults and children." Cochrane Database of Systematic Reviews 4 (2007).