Preventing Infection in Indwelling Urinary Catheters

Preventing Infection in Indwelling Urinary Catheters of 15 Version 1.1 March 2019

Infection Prevention and Control Assurance - Standard Operating Procedure 17 (IPC SOP 17)

Preventing Infection in Indwelling Urinary Catheters

Why we have a procedure?

To ensure employees of the Black Country Partnership NHS Foundation Trust have a standard procedure to follow when caring for patients with indwelling urinary catheters.

The Health and Social Care Act 2008: Code of Practice for the NHS for the Prevention and Control of Healthcare Associated Infections (revised January 2015) stipulates that NHS bodies must, in relation to preventing and controlling the risk of Health Care Associated Infections (HCAI), have in place appropriate core policies/procedures. Implementation of this procedure will contribute to the achievement and compliance with the Act, the NICE and EPIC quality guidelines in relation to the prevention of Catheter Associated Urinary Tract Infections (CAUTI).

What overarching policy the procedure links to?

This procedure is supported by the Infection Prevention and Control Assurance Policy

Which services of the trust does this apply to? Where is it in operation?

Group Inpatients Community Locations

Mental Health Services all

Learning Disabilities Services all

Children and Young People Services all

Who does the procedure apply to?

This document applies to all clinical staff employed by or working on behalf of the Black Country Partnership NHS Foundation Trust caring for patients as part of their role and job description.

When should the procedure be applied?

Effective prevention and control of healthcare associated infection (HCAI) must be embedded

into everyday practice and applied consistently. Crucial to this are the identification of risk and

the adoption of measures to remove or control such risks for patients who require urinary

catheter devices.

Additional Information/ Associated Documents

Infection Prevention and Control Assurance Policy

Hand Hygiene Policy

IPC SOP 1: Standard Infection Control Precautions

IPC SOP 3: Surveillance of Infection and Data Collection

IPC SOP 10: Aseptic Procedures


Epic 3: National evidence based guidelines for preventing healthcare associated infections in NHS hospitals in England (2014) (section UC1 – UC24)

NICE Quality Standard QS61: Infection Prevention and Control (April 2014)

The Royal Marsden Manual of Clinical Nursing Procedures 9th Edition (Section 5.7 – 5.12 and 10.25)

Aims People who need a urinary catheter device will have their risk of infection minimised by the completion of these specified procedures necessary for the safe insertion and maintenance of the catheter and its removal as soon as it is no longer needed.

Definitions

Aseptic technique A method developed to ensure that only uncontaminated objects/fluids make contact with sterile/susceptible sites. It should be used during any procedure that by-passes the body’s natural defences

Catheterisation A procedure used to insert a urinary catheter into the bladder to drain and collect the urine

CAUTI Catheter associated urinary tract infection

Foley catheter All indwelling urinary catheters are Foley catheters; this simply means that the catheter has a balloon

French/Charrier size Catheter diameter is measured in French (Fr) or Charrier (Ch) units ranging from 6 Fr for children to a 22 Fr for adults

Healthcare Acquired Infection (HCAI)

Healthcare associated infection (HCAI) refers to infections that occur as a result of contact with the healthcare system in its widest sense – from care provided in the patient’s own home, to general practice, hospital and nursing home care

Insitu A Latin phrase meaning in place or in position

IPCT Infection Prevention and Control Team

Risk Assessment A process used to identify and potential hazards and analyse what could happen and to identify steps to be taken to reduce or minimise the risk

Urinary Catheter A tube which is inserted into the urethra and into the bladder and remains in place until it is no longer needed

UTI A urinary tract infection

Long-term urinary catheter

A urinary catheter designed to stay in the bladder for up to 90 days

Medium-term urinary catheters

A urinary catheter designed to stay in the bladder for less than 28 days


Short-term urinary catheter

A urinary catheter designed to stay in the bladder for up to 7 days

TWOC Trial without catheter to assess if the patient can pass urine without the need for a catheter

STATLOCK®

Simpla® Strap

Consent must be obtained from the individual prior to the procedure of catheterisation, the nurse must have working knowledge` of how to obtain valid consent and how to confirm that sufficient information has been provided on which to base this judgment. Six distinct interventions need to be considered to reduce the risk of infection for patients with an indwelling urethral catheter insitu: Intervention 1 Assessing the need for catheterisation - catheterisation should only be used after considering alternative methods of management. The patient’s clinical need for catheterisation should be reviewed regularly by the multidisciplinary team (at least weekly) and the urinary catheter removed as soon as possible. Where necessary the ongoing assessment for the need of the catheter may require input from a specialist urologist. The need/reason for catheterisation, as well as details about the insertion, changes and ongoing care/management must be documented using the standard documentation seen in Appendix 1. There is strong association between the duration of catheterisation and the risk of infection – the longer the catheter is in place the higher the incidence of Catheter Associated Urinary Tract Infection (CAUTI) and the risk increases 5% for each day of catheterisation.

Only use a short-term indwelling urethral Foley catheter in patients for whom it is clinically indicated, following assessment of alternative methods and discussion with the patient

Document the clinical indication(s) for catheterisation, date of insertion, expected duration, type of catheter and drainage system and planned date of removal

Assess and record reasons for catheterisation every day

Remove the catheter when no longer clinically indicated and record date/time and reason for removal (catheter removal procedure see the Royal Marsden Manual of Clinical Nursing Procedures)

A stabilization device used for securing a urinary catheter to enhance patient comfort

A stabilization device used for securing a urinary catheter to enhance patient comfort

Key Principles for Preventing Infections Associated with the use of Urethral Catheters


N.B. for patients admitted to an in-patient unit with a urinary catheter already insitu the assessing nurse must establish the reason the catheter was inserted, when it was inserted and when it is due to be removed or replaced. This must be documented in the patients care records using the standard documentation in Appendix 1. Intervention 2 Selection of catheter type and system - Smaller gauge catheters with a 10ml balloon minimise urethral trauma, mucosal irritation and residual urine in the bladder – all factors which predispose to CAUTI. Note there is also a risk of urethral trauma associated with using a female length catheter in a male patient – this is a never event (see the alert*).

Assess patients’ needs prior to catheterisation in terms of latex allergy, length of catheter and the French/Charrier size. Short length catheters are generally used for ambulatory female patients (unless obese or wheelchair bound), which allows for a leg bag to be worn

A short length catheter must never be used in male patients as this can cause severe trauma to the prostatic urethra

Select the type of sterile drainage bag and sampling port e.g. urometer, 2L bag, leg bag etc.

Ensure the patients comfort and dignity is not compromised

Select a catheter that minimises urethral trauma, irritation and patient discomfort and is appropriate for the anticipated duration of catheterisation e.g. short, medium or long-term

Choose the smallest French/Charrier size catheter that with a 10ml retention balloon in adults that will drain adequately for its intended use ), e.g. Female 12/14 Fr/Ch, Male 12/14/16 Fr/Ch. (Follow manufacturer’s instructions for paediatric catheters usually 5ml balloon)

Catheter Size Catheter Length Balloon Size

Female 12/14 Fr/Ch Short 23-26cm 10ml

Male 12/14/16 Fr/Ch Standard 40-44cm 10ml

Paediatric 6/8/10/12 Fr/Ch 30cm 5ml

Intervention 3 Catheter insertion – urinary catheters must be inserted using sterile equipment and the aseptic technique.

Catheterisation should only be undertaken by healthcare workers trained and competent in the procedure – it is usually performed by nurses and doctors following the Royal Marsden Manual of Clinical Nursing Procedures – Urinary Catheterisation.

The urethral meatus should be cleaned with sterile normal saline prior to insertion of the catheter.

An approved lubricant from a sterile single use container must be used to minimise urethral discomfort, trauma and the risk of infection and should be inserted/retained for 5 minutes before catheter insertion.

Only sterile water to be used to inflate the balloon.

The catheter must be secured comfortably to reduce risk of further trauma using a STATLOCK® device or Simpla® Strap. Staff must record on the catheter documentation the date/time of insertion and types of catheter, procedure used and date due for review/removal (Appendix 1).


Intervention 4 Catheter maintenance – maintaining a sterile, continuously closed urinary drainage system is central to the prevention of CAUTI. The risk reduces from 97% with an open system to 8-15% when a sterile closed system is used. Breaches in closed system such as unnecessary emptying, changing of the urinary drainage bag or taking a urine sample, will increase the risk of CAUTI.

Connect the catheter to a sterile closed urinary drainage bag system with a sampling port

Do not break the connection between the catheter and the urinary drainage bag system unless clinically indicated

Hands must be decontaminated and clean non-sterile gloves must be worn before manipulation of the catheter or closed system, including drainage taps. Decontaminate hands immediately following the removal of gloves

Drainage bags should be changed when necessary according to the manufacturer’s instructions or the patient’s clinical need

Position the urinary drainage bag below the level of the bladder to prevent back-flow (i.e. positioned below the level of the bladder)

Drainage bags should be hung on a catheter stand to prevent contact with the floor

Use the sampling port and the aseptic technique to obtain a catheter specimen of urine

Do not allow the urinary drainage bag to fill beyond three-quarters full

Use a separate, clean disposable container for each patient and avoid contact between the urinary drainage tap and the container when emptying the drainage bag

Do not add antiseptic or antimicrobial solutions to urinary drainage bags or use bladder maintenance solutions to prevent CAUTIs

Daily routine personal genital hygiene is all that is required for meatal cleansing

Intervention 5 Education of patients, relatives and healthcare workers – it is important that patients, their relatives and healthcare workers responsible for catheter insertion and management are educated about infection prevention, signs and symptoms of UTI and how to access expert help when difficulties arise.

Healthcare workers must be trained and competent in the appropriate use, selection, insertion, maintenance and removal of indwelling urethral catheters


Ensure patients, relatives and carers are given information regarding the reason for the catheter and the plan for review and removal

If discharged with a catheter the patient should be given written information and shown how to:

- Manage the catheter and drainage system - Minimise the risk of CAUTI - Obtain additional supplies suitable for the individuals needs - Be referred to GP/community services as required for review and follow up

ideally with a catheter passport which provides all the essential information (see Appendix 2)

Intervention 6 System interventions for reducing the risk of infection – Catheterised patients should be encouraged to have a good fluid intake of at least 2 litres per day to discourage infection. For surveillance, monitoring and audit purposes, all patients with an indwelling urinary catheter insitu should be notified to the Infection Prevention and Control Team. This will enable the team to monitor and advice on individual patient management in order to reduce the risks of CAUTI and ensure:

Audit and feedback of compliance with practice guidelines

Audit and feedback of compliance with catheter insertion and maintenance documentation

Continuing professional education Removal/Changing

All indwelling urinary catheters must have the balloon deflated prior to removal. The water is removed from the balloon using a syringe fitted into the catheter valve. Care needs to be taken to avoid violent suction, which will collapse the inflation channel making deflation of the balloon difficult. (See the Royal Marsden Manual of Clinical Nursing Procedures section 5.12)

The catheter must be removed slowly to minimise trauma

Catheters should only be changed when clinically necessary, not exceeding the manufacturers recommendations

No patient should be discharged or transferred to/from any in-patient unit with a catheter insitu without a management plan and catheter passport/documentation (see Appendix 1 and 2)

Choice of Drainage Systems The choice of drainage system must be dictated by the intended duration, patient mobility and dexterity and patient choice.

Closed System Drainage In order to prevent infection, the connection between the catheter and urinary drainage system is not broken except for good clinical reasons e.g. changing the bag in line with the manufacturer’s recommendations. Changing the drainage bag is usually recommended every 7 days according to the manufacturer’s instructions or sooner if clinically indicated. When a leg bag is not suitable for use e.g. end of life care, a large drainable bag should be used to create a continual circuit and increase collection capacity.

Other Considerations


Leg Bags Together, the catheter, leg bag and night bags form a continuous circuit known as a total ‘closed link’ drainage system. This not only facilitates overnight drainage but also keeps the original system in tact thereby preventing bacteria getting into the system. The night drainage bag should always be positioned below the level of the bladder and be attached to a supporting stand to avoid contact with the floor.

Ambulant patients will probably prefer leg bags. These are available in 350, 500 and

750ml volumes with short, medium or long tubing.

Leg bags are usually worn by women on the thigh and by men on the calf so selecting the correct type of equipment is essential.

Choose a length that will prevent kinking or dragging of the catheter and tubing.

Attachment of leg bags may be either with straps or a leg bag sleeve. The bags should have a drainage tap (lever type) to facilitate emptying.

At night a night bag will be required, when in hospital a single use disposable night bag must be used. The leg bag is not disconnected from the catheter unless it is due for change (usually every 7days in accordance with the manufacturer’s instruction).

It is important that the night bag is attached using the ‘closed system’ technique e.g. attached to the leg bag and the valve on the leg bag opened to allow free drainage.

The night bag is removed and discarded in the morning ensuring the leg bag valve is closed.

See Appendix 3 for details of the procedure. Discharge of Patients with an Indwelling Urinary Catheter

No patient should be discharged or transferred with an indwelling urethral catheter without a plan documenting their:

- Reason for a catheter - Clinical reasons for continuing catheterisation - Date of removal or review by an appropriate professional overseeing their

care See Appendix 2


Obtaining a Catheter Specimen of Urine (CSU) Patients with an indwelling urinary catheter insitu have an increased risk of developing a urinary tract infection. The process of obtaining a sample of urine from a patient with an indwelling urinary catheter must be obtained from a sampling port. The sampling port is usually situated in the drainage tubing proximal to the collection bag which ensures the freshest sample possible. The use of drainage systems without a sampling port should be avoided. The procedure for obtaining a CSU can be found in the Royal Marsden Manual of Clinical Nursing Procedures section 10.25.

Where do I go for further advice or information?

Infection Prevention and Control Team

Physical Health Matron Your Service Manager, Matron, General Manager, Head of Nursing, Group Director Your Group Governance Staff Training Staff may receive training in relation to this procedure, where it is identified in their appraisal as part of the specific development needs for their role and responsibilities. Please refer to the Trust’s Mandatory and Risk Management Training Needs Analysis for further details on training requirements, target audiences and update frequencies. Monitoring / Review of this Procedure In the event of planned change in the process(es) described within this document or an incident involving the described process(es) within the review cycle, this SOP will be reviewed and revised as necessary to maintain its accuracy and effectiveness.

Equality Impact Assessment Please refer to overarching policy

Data Protection Act and Freedom of Information Act Please refer to overarching policy.


Urinary Catheter Care Pathway (3 pages)

To be completed for all patients/clients with a urinary catheter insitu and retained in the patients records. Short-term catheters = up to 7 days Medium-term catheters = up to 28 days Long-term catheters = up to 90 days

Patient details: affix documentation identification

label Name: Address: NHS Number: DOB:

1. Admitted with a catheter YES/NO

2. Insertion Date:

Reason for catheterisation: (please circle below):

Retention of urine

Fluid monitoring

Pressure sore management

Urologists decision

Other reason please specify: Latex or other allergy (detail below): (if latex suggest silicone catheter)

Residual urine in mls: Dipstick test:

3. CATHETER CHOICE (please detail below):

Brand: e.g. Bard Type: e.g. latex,

silicone, silver etc.

Size: e.g. 14Fg Male/Female/ Paed:

Catalogue No:

Other:

4. INSERTION TECHNIQUE (please detail each of the 9 steps below box): NB all 9 steps recommended

Procedure Yes No Procedure Yes No Catheter Sticker (Found on packaging)

1. Hand Hygiene 1. Sterile gloves

2. Explain procedure to patient 2. Urethral meatus clean (use 0.9% normal saline)

3. Facial protection (only if risk of

splash injury) 3. Instillagel used

Batch No:

4. Disposable apron 4. Aseptic technique followed

5. Sterile field

5. Number of mls of sterile water used to inflate balloon ……………….. Batch No:

Signed: Print Name:

Who inserted catheter? (circle one) RGN/RMN/HO/SHO/Registrar/Consultant/Student Nurse/Med Student/other:

5. CATHETER DUE DATE CHANGE/REMOVAL (this will depend on type of catheter used see manufacturer guide):

Give details:

6. PATIENT EDUCATION RE: CATHETER CARE

YES NO 1. Hand Hygiene – how and the importance prior to handling catheter/equipment 2. Daily catheter hygiene - how and the importance 3. Correct position for catheter bag drainage and avoiding kinks to tubing (below hip/bladder) 4. How to attach a leg bag and secure to leg to prevent pulling (STATLOCK® or Simpla® strap)

Female Catheter Male Catheter

5. How to attach a catheter drainage bag 6. How to clean the spout before and after emptying 7. How to empty without contaminating the drainage spout 8. Signs of infection what to look for (offensive smell and/or cloudy urine, pain, temperature,

increasing confusion)

9. How much to drink – importance of fluid intake 10. How and when – the frequency for changing the drainage bag and when the catheter is

due for review – using the catheter passport

Patient Sign:

Nurse sign/print

Appendix 1


7. Give details of catheter equipment in use e.g. name/make and order codes o Catheter type

o Leg bag

o Closed circuit drainage bag

o Catheter stand

o Leg straps (STATLOCK® or Simpla® strap)

o Other (specify)

8. CATHETER SPECIMEN OF URINE (CSU) send CSU on insertion if leucocytes present Generally CSU’s are ONLY to be taken if there are signs of infection – use red top universal container Date UTI

suspected If YES please state

symptoms Sample taken

aseptically from catheter sample

port

Lab Results Treatment

Yes No Yes No

9. URINARY CATHETER CARE PATHWAY – enter Y for Yes, N for No or NA or V for Variance – for any N or

V please record in section 10 and actions taken to reduce risks Day/Date

DD/MM/YY

Mon Tue Wed Thur Fri Sat Sun

1. Is the catheter still needed?

2. Single use gloves have been worn for all catheter interventions preceded and followed by hand hygiene.

3. Urethral meatal hygiene has been included as part of daily genitalia hygiene care

4. Catheter circuit remains unbroken (except for good

clinical reason)

5. If the patient is mobile a leg bag is used

6. When a leg bag is in use at night a closed circuit bag is attached and the leg bag valve is opened and the overnight bag is discarded after each use (in-

patients discard after each use, community patients can be used up to 7 days as per the manufacturer’s instructions)

7. Leg bags when in use are secured to the patient to reduce trauma.

8. All leg bags and continuous drainage bags are dated and changed every 7 days (night bags discarded

after each use)

9. Urine drainage bags are emptied at regular intervals to prevent backflow (at least 4x daily) and recorded on fluid balance chart

10. The patient is encouraged to drink at least 2L fluid every 24hrs and input/output recorded of fluid balance chart

11. Catheter drainage bags are attached to a hanger and placed 30cms below the bladder and the drainage bag is off the floor

12. Colour of urine is observed and appropriate action taken as required e.g. if urine concentrated, cloudy,

offensive, haematuria etc.

13. The patient is involved in caring for their catheter

Initials of Nurse assessing patients care:

N.B. this document is in addition to the individual’s care plan


Continuation sheet use as required – Urinary Catheter Care Pathway Date due for removal/change:

Day/Date DD/MM/YY



1. Is the catheter still needed?

2. Single use gloves have been worn for all catheter interventions preceded and followed by hand hygiene.

3. Urethral meatal hygiene has been included as part of daily genitalia hygiene care

4. Catheter circuit remains unbroken (except for good

clinical reason)

5. If the patient is mobile a leg bag is used

6. When a leg bag is in use at night a closed circuit bag is attached and the leg bag valve is opened and the overnight bag is discarded after each use (in-

patients discard after each use, community patients can be used up to 7 days as per the manufacturer’s instructions)

7. Leg bags when in use are secured to the patient to reduce trauma.

8. All leg bags and continuous drainage bags are dated and changed every 7 days (night bags discarded

after each use)

9. Urine drainage bags are emptied at regular intervals to prevent backflow (at least 4x daily) and recorded on fluid balance chart

10. The patient is encourage to drink at least 2L fluid every 24hrs and input recorded of fluid balance chart

11. Catheter drainage bags are attached to a hanger and placed 30cms below the bladder and the drainage bag is off the floor

12. Colour of urine is observed and appropriate action taken as required e.g. if urine concentrated, cloudy,

offensive, haematuria etc.

13. The patient is involved in caring for their catheter

Initials of Nurse assessing patients care:


Please send 2 copies with the patient (1 for the patient and 1 for the GP/District Nurse) - 2 pages

Transfer/Discharge Plan - Urinary Catheter Care Pathway

Patient details: affix documentation identification

label Name: Address: NHS Number: DOB:

Admitted with a catheter insitu: YES/NO

Catheter Insertion Date:

Reason for catheterisation:

Type/size catheter insitu:

Date catheter due for removal/TWOC:

1. Copy of page 1 of Urinary Catheter Care Pathway included (detailing full insertion records)

Yes/No

2. Give details of catheter equipment in use e.g. name/make and order codes

o Catheter type

o Leg bag

o Closed circuit drainage bag

o Catheter stand

o Leg straps (STATLOCK® or Simpla® strap)

o Lubricating insertion gel

o Other (specify)

A one week supply of all catheter equipment has been provided circle below:

Catheter Y N NA

Leg Bag Y N NA

Leg bag straps

Y N NA

2L drainage bag

Y N NA

Catheter stand

Y N NA

Additional information:

3. Contact Details

GP notified patient has a catheter insitu (give details date/time/name of contact):

District Nurse notified (give details date/time/name of contact):

Contact Number:

Date of 1st visit:

Other please specify:

Appendix 2


4. Patient/carer are aware how to care for catheter:

Patient Carer (Name):

Yes No Yes No

Hand hygiene Hand hygiene

Daily genital hygiene care Daily genital hygiene care

How to attach leg bag and secure to leg to prevent pulling

How to attach leg bag and secure to leg to prevent pulling

Correct position for catheter bag drainage (below bladder)

Correct position for catheter bag drainage (below bladder)

Preventing kinks to catheter and tubing

Preventing kinks to catheter and tubing

How to empty leg and overnight drainage bags without contaminating the spout

How to empty leg and overnight drainage bags without contaminating the spout

How to clean the spout before/after emptying the bags

How to clean the spout before/after emptying the bags

How to dispose of equipment How to dispose of equipment

How to attach drainage bag to the catheter stand

How to attach drainage bag to the catheter stand

How and when to replace the drainage bag

How and when to replace the drainage bag

How much to drink How much to drink

Signs of infection (offensive cloudy urine,

pain, high temperature, confusion) Signs of infection (offensive cloudy urine,

pain, high temperature, confusion)

Who to call for help and contact numbers

Who to call for help and contact numbers

5. Do’s and Don’ts

DO….. DON’T…….

Remember to drink plenty of fluids unless informed fluids are restricted for medical reasons – ideally drink 2 litres/day

Always wash your hands with soap and water before touching/emptying your catheter.

Clean the area around the catheter daily with unperfumed soap/water. Men should be sure to wash under their foreskin.

Night urine drainage bags should be positioned below the level of the bladder and not be in contact with the floor. A catheter stand should be used to support this.

Catheter tubing should be fixed to the leg to avoid kinking of the tubing and pulling of the bladder neck.

Take regular exercise but avoid anything too vigorous, ensure your catheter is well supported before any exercise.

Don’t disconnect the leg bag unnecessarily or touch the end of the connector or this can lead to infection.

Don’t use oil based creams or talcum powder around the catheter area.

6. Call a healthcare professional if:

No urine or very little urine is flowing into the collection bag and you feel your bladder is full

You have new pain in your abdomen, pelvis, legs or back

Your urine has changed colour, is very cloudy, looks bloody or has large blood clots in it

The insertion site becomes very irritated, swollen, red or tender

Your urine has a foul odour (smell)

Urine is leaking from the insertion site

You have a fever

You develop nausea, vomiting or feel unwell.


Attaching and Disconnecting the Night Drainage System Attaching the Night Drainage Bag 1. Wash your hands thoroughly noting the areas frequently missed and put on gloves. (See

hand hygiene policy). Note: Patients managing their own catheters, and their carers, must be educated about the need for hand decontamination before and after manipulation of the catheter and drainage bag

2. Remove protective cap from the disposable, single use, non-drainable/drainable 2 litre night bag

3. Insert night bag connector firmly into the outlet drainage tube of the leg bag 4. Remove leg bag fixation straps or leg bag support sleeve to allow free drainage of urine. 5. Open leg bag tap or valve tap to allow urine to flow into the 2 litre non-drainable/drainable

collection bag 6. Secure the 2 litre non-drainable/drainable night bag on to a supporting stand and ensure that

it is positioned lower than the bladder to assist free drainage and prevent backflow of urine, see diagram below

7. Ensure that the catheter is never pulled by any drainage bag 8. Remove gloves and wash hands

Disconnecting the Night Drainage Bag 1. Wash your hands thoroughly and put on gloves. Note: Patients managing their own catheters,

and their carers, must be educated about the need for hand decontamination before and after manipulation of the catheter and drainage bag.

2. Close the tap on the leg bag or on the catheter valve. 3. Disconnect the non-drainable/drainable urine collection bag from the leg bag or catheter

valve. 4. Empty the urine from the bag and discard as clinical waste. 5. Secure the leg bag on to the thigh or calf using fixation straps or a leg bag support sleeve. 6. Remove gloves and wash hands

Appendix 3


Standard Operating Procedure Details

Review and Amendment History

Version Date Description of Change

1.1 Mar 2019 Procedure reviewed as required. No changes necessary. All references checked & updated.

1.0 Apr 2016 New Procedure established to supplement Infection Control Assurance Policy

Unique Identifier for this SOP is BCPFT-COI-POL-05-17

State if SOP is New or Revised Revised

Policy Category Control of Infection

Executive Director whose portfolio this SOP comes under

Executive Director of Nursing, AHPs and Governance

Policy Lead/Author Job titles only

Infection Prevention and Control Team

Committee/Group Responsible for Approval of this SOP

Infection Prevention and Control Committee

Month/year consultation process completed

April 2019

Month/year SOP was approved April 2019

Next review due April 2022

Disclosure Status ‘B’ can be disclosed to patients and the public

Preventing Infection in Indwelling Urinary Catheters

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