Catheter Care – Problem
Solving
Presented by Cheryl Hammond
Clinical Nurse Specialist
Objective
To maintain urinary drainage and reduce the
risk of trauma and infection.
Educate the patient
Discuss catheter care
- hygiene
- securing catheter
- supporting drainage bag
- catheter not kinked or twisted
- drainage bag emptied regularly
- advise on fluid intake and prevention of constipation
- importance of a closed system
Catheter by-passing
Check tubing is not twisted or kinked
Catheter secured
Check patient not constipated
Check size of catheter is correct
Check balloon inflated correctly
Check if bag needs emptying Check for infection
Check catheter not blocked
Consider possibility of bladder spasm or irritation
Catheter blocked
Check catheter in correct position
Check drainage bag, below bladder level and empty if full
Check tubing not kinked or blocked
Catheter by-passing due to bladder spasm Decrease known bladder irritants i.e. caffeine and
alcohol.
Decrease size of catheter
Check balloon size
Check bag is secured and empty bag.
Possible infection Maintain closed system
Follow hand hygiene guidelines
Position bag below bladder level
Drainage bag should be off the floor
Catheter secured correctly
Risk factors
Patient been in hospital last 12 months Patient taken antibiotics in last 6 months Over 65 years of age Diabetes Chemotherapy Taking steroids Chronic wounds
Possible encrustation
Inspect for encrustation in the catheter lumen and on outer surfaces of the tip and the balloon.
Monitor PH of urine, urine is normally acidic.
Monitor time of catheter life and when blockage
Unable to deflate the balloon
Check for kinked tubing Relieve in constipation Try a different syringe and leave in place. Try and dislodge debris blocking the deflation
channel by milking the catheter along its length. Never cut the catheter or inflation valve Never attempt to burst the balloon by over inflating
it.
.
References Bond P and Harris C (2005) Best practice in urinary catheterisation and catheter care, Nursing Times, 101 (8) 54-58.
Freeman C (2009) Why more attention must be given to catheter fixation , Nursing Times, 105 (29)
Fraczyk L Godfrey H (2004) Current practice of antibiotic prophyalaxis for catheter procedures, British Journal of Nursing , 13 (10) 610-617.
Getliffe K and Dolman M (2007) Catheters and containment products, 10, 259- 307; Promoting Continence A Clinical and Research Resource.
Holtam B (2004) Blocked indwelling urethral catheters ; Evaluating the evidence, Journal of Community Nursing, 18, 3.
Howell AB, Foxman B (2002) Cranberry juice and adherence of antibiotic resistant uropathogens, Journal of the American Medical Association, 287, 3082-3
Madeo M and Roohouse AJ (2001) Reducing the risks associated with urinary catheters, Nursing Standard , Supplement, 3-13.
Promfret I (2007) Urinary catheter problems 2, Journal of Community Nursing, 21, (7) 23-25.
Robinson J (2006) Selecting a urinary catheter and drainage system, British Journal of Nursing, 15 (19), 1045-1050.
Royal College of Nursing (2012) Catheter Care, RCN guidance for nurses.
Turner B and Dickens N (2011) Long term urethral catheterisation, Nursing Standard, 25 (24) 49-56
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