Urinary catheterization is the process of draining the bladder by inserting an indwelling flexible catheter into the bladder through the urethra. The catheter allows urine to flow through it into an attached drainage bag. Depending on the type of catheter used and the reason for using it, the catheter may remain temporarily or permanently in the patient.
Urinary catheters are usually inserted by medical professionals such as doctors and nurses in clinics and hospitals. Hence, patients who use urinary catheters permanently will need professional help to remove and replace catheters at least once in every 2 months.
A urinary catheter is used in patients who are unable to urinate naturally. Some common medical conditions include urinary retention and benign prostatic hyperplasia (BPH). Since catheterized patients are at high risk of getting urinary tract infections (UTIs), homecare nurses or caregivers should always be cautious when caring for these patients.
Home caregiver’s role in caring for patient with urinary catheter
Using long-term urinary catheters increases risks of UTIs as well as other possible complications. In order to avoid these, caregivers need to perform daily catheter care. As part of the routine, caregivers should practice good hand hygiene such as washing hands with soap and water before and after caring for the patient.
Cleaning the genitals
The genital areas should first be cleansed with mild soap and water. For men, retract the foreskin of the penis and clean away from the tip of the penis. For women, separate the labia and always clean from front to back. Remember to dry genitals gently using aseptic cloths.
Cleaning the catheter
While cleaning the catheter, hold it firmly at the point it enters the urethra so that it will not get pulled out. Start cleaning the catheter from the same point and move down the tube in the direction that is away from the body. Rinse the catheter with soap and water and dry it with a separate cloth. The catheter is attached to the body using either tape or cath-secure. Replace with new adhesive tape or cath-secure once the old one is removed.
Changing drainage bag
A drainage bag is used to collect the urine. It is an extension of the catheter which can be removed and replaced by the caregiver. When changing the drainage bag, place an aseptic cloth or gauze piece under the connection point of the catheter. Tightly press on the catheter with your fingers and slowly disconnect the drainage bag.
Clean the tip of catheter and connector with separate alcohol pads. Connect the new bag to the catheter and then release your fingers. Dispose the used drainage bag. Make sure that there are no kinks or twists in the catheter and drainage bag.
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
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