CONTENT

TOPIC: CATHETER CARE

SUBMITTED TO: SUBMITTED BY:

MADAM K. MANDAL JAYITA GAYEN
SENIOR LECTURER M.SC. NURSING 1ST YEAR
GOVT COLLEGE OF NURSING GOVT COLLEGE OF NURSING
ID&BG HOSPITAL CAMPUS
ID&BG HOSPITAL CAMPUS
KOLKATA10
KOLKATA10
 Definition:
Perineal care and the cleaning of the first 2 inches of the catheter are called catheter care.

 Purposes:
 To promote patient comfort, cleaning the secretion at catheter insertion site.
 To reduce chances of infection
 To prevent obstructed flow
 To promote healing
 To promote comfort

 Indication
 Patient who are unable to do self-care
 Patients with excessive vaginal discharge
 Patients recovering from chronic illness and surgery
 Patient bedridden for prolonged time
 For investigations
 Patient who are immune compromised
 Patients with indwelling catheter

 Preliminary assessment:
 Assess the condition of the perineal skin, any itching, irritation, ulcers, oedema, drainage etc.
 Assess the need and frequency of catheter care
 Assess whether catheter care should be done under aseptic technique or clean technique
(when there is a wound the catheter care should be done under aseptic technique)
 Check physian’s order for any specific instruction
 Assess the patient’s self-ability for care
 Assess the patient’s mental ability to follow instruction
 Check the articles available in the patient’s unit

 Preparation of Equipments:
Ensure the patient’s privacy is maintained throughout the procedure. Ensure there is adequate
light to perform the procedure.

Articles Purposes

A sterile tray containing

a. Artery forceps  To hold the swab

b. Dissecting forceps  Do

Articles Purposes
 c. Cotton balls  To clean the perineum

d. Bowl for antiseptic lotion and  To clean the perineum with anti-septic
sterile water solution

A clean tray containing

a. Two clean wash cloth or towel To protect the bed

b. Warm water To clean the perineum

c. Antiseptic lotion

d. Mackintosh and draw sheet To protect the bed

e. Antibiotic ointment To prevent further growth of micro -organism

f. Clean gloves To prevent cross infection

g. Sterile gloves
To keep up aseptic technique

h. Drapes To maintain patients’ privacy

i. Kidney tray and paper bag To collect specimen and dispose the used
product

j. Adhesive tape and scissor To fix the catheter tubing from kinking

 Preparation of the patient and the unit:

 Explain the procedure to the patient.

 Provide privacy by a screen and drapes.
 Remove all articles that may interfere with the procedure.
 Give extra pillow to raise the head.
 Prepare the unit to avoid draught.
 Adjust the bed to a working height.
 place a mackintosh under the buttocks over the draw sheet.
 Offer the bedpan. leave the patient for some time so that she or he may pass stool, if
necessary. Get the toilet wash down tray.
 Arrange the articles conveniently on the bedside table.
 Procedure:

Steps
Assess the bowel incontinence of patient to discomfort Accumulation oof secretions or faeces
causes or protocol for routine care
Explain the procedure to the patient
Close door or bedside curtain
Perform hand hygiene
Position of patient
Female: dorsal recumbent position with leg flexed
Male: supine position
Place mackintosh and draw sheet under patient
Drape the legs and only expose perineal area
Put clean gloves
Rationale
causes irritation and media for bacterial
growth
Reduces anxiety and promotes co
operation
Maintain privacy
Reduce transmission of infection
Ensure easy access to perineal area
Protect bed linen from soiling
Prevent unnecessary exposure of body
part
Protect hand from soiling

Assess urethral meatus and surrounding tissue for Determine presence of local infection
inflammation, swelling and discharge or any burning and hygiene status
sensation or discomfort. note amount, colour, odour,
and consistency of discharge
Cleanse the perineal area
Female: cleaning from pubis towards anus, clean labia
majora. spread labia majora with thumb and index
finger to clean labia minora, clitoris, and vaginal
orifice using separate cotton swab with non-dominant
hand. clean around meatus. prevent transfer of
microorganism using one swab at a time from least
contamination area to most contamination
Male: clean around catheter first while spreading
urethral meatus then wipe in circular motion around
meatus and glans
Remove clean gloves and wash hands To prevent cross infection
Put sterile gloves To maintain sterile field
Clean the catheter from meatus outwards for Antiseptic lotion act as irritant to skin
approximately 3-4cm using cotton swab soaked in
sterile water
Apply antiseptic ointment (if prescribed) at urethral Reduce further growth of micro-
meatus and along 2.5 cm of catheter insertion site organisms
Re anchor catheter tubing
Place patient in safe and comfortable position Promote comfort
Dispose contaminated supplies, remove gloves Prevent spread of infection
 Steps Rationale
Wash hands
Report and record of characteristics of drainage,
condition of perineal tissue and any discomfort
reported by patient

 After care of the client and articles:

 Wash and dry the perineum to remove any urine left on the skin
 Remove the drapes, replace the garments and bedcover
 Position the patient for correct body alignment
 Make the client comfortable
 Take the bedpan to sanitary annex. Remove the cotton swab, if any and empty the content into
the toilet.
 Clean all the articles. boil /autoclave the forceps and replace the articles
 Remove the screen and tidy up the unit
 Send the urine specimen, if any, to the lab
 Wash hands
 The insertion site and securement should be assessed at least once a shift, to ensure the
catheter is not pulling on the genitals and not twisted. 
 The drainage bags should be emptied once a shift at a minimum. 
 Position drainage bag to prevent backflow of urine or contact with the floor. Gravity is
important for drainage and prevention of urine backflow. Ensure the drainage bag is below the
level of the bladder, is not kinked or twisted and is secured.
 Record the procedure with date, time and the observation made. If anything, unusual report to
the doctor

 Don’ts of urinary catheter care:

 Don't change catheters or drainage bags at routine, fixed intervals
 Don't administer routine antimicrobial prophylaxis
 Don't use antiseptics to cleanse the periurethral area while a catheter is in place
 Don't clean the periurethral area vigorously
 Don't irrigate the bladder with antimicrobials
 Don't instil antiseptic or antimicrobial solutions into drainage bags
 Don't routinely screen for asymptomatic bacteriuria
 Don't contaminate the catheter outlet valve during collection bag emptying

 Precautions for care of catheter:

 Always wash your hands before and after caring for the patient and catheter
 Make sure that there are no blockages or leakages in the tube
 Keep the drainage bag below the bladder level without touching the floor
 Maintain genital hygiene for the patient
 Patient should be kept well hydrated
 Keep a record of water intake and urine output so urine can be drained as frequently as
needed

 When to call for medical help:

 When the catheter comes out
 When you notice blood, or any blood clots in urine
 When patient complains of abdominal pain
 When urine smells bad or changes colour
 When there is a reduction of urine output
 When there is a rise in patient’s body temperature (>37.5°C)
 When you notice redness or swelling in patient’s genital area
 When there is a large amount of urine leakage

 Special point for remember:

o If urethral discharge present:

 Increase frequency of catheter care
 Notify health care provider
 Apply topical antibiotic ointment according to prescription

o If accidental catheter dislodgement:

 Notify healthcare provider
 Assess for urethral trauma
 Monitor urine output
References:

1. Kundu Arup; Bedside Clinics in Medicine; 5th Edition; Bangalore; KSP Publishers;2020; Page No:
134-138.
2. The Trained Nurse Association of India; Fundamental of Nursing A Procedure Manual; 1 st Edition;
New Delhi; Published by Secretary General; 2011; Page No: 574-582.
3. Tylor Carol, Lillie Carol, Lynn Pamela; Fundamental of Nursing: The Art and Science of Person-
Centred Nursing Care; 8th Edition; New Delhi; Published by Wolters Kluwer Pvt Ltd; Page No:
324-337.
4. West Bengal Nursing Council; Nursing Theories and Practices; 4th Edition; Kolkata; Nursing
Publication; 2019; Page No: 241-245.