Introduction Show
Aim Definition of Terms Indications Preparation Catheter size Procedure for insertion of urinary catheter Special precautions Documentation Ongoing nursing management Troubleshooting Removal of urinary catheter Complications Discharge information Companion documents References IntroductionInsertion of an indwelling urethral catheter (IDC) is an invasive procedure that should only be carried out using aseptic technique, Insertion of an indwelling urethral catheter (IDC) is an invasive procedure that should only be carried using aseptic technique, either by a nurse, or doctor if complications or difficulties with insertion are anticipated. Catheterisation of the urinary tract should only be done when there is a specific and adequate clinical indication, as it carries a risk of infection. AimTo ensure the insertion and care of the urinary catheter is carried out in a safe manner that minimises trauma and infection risks. Definition of terms
Indications
PreparationPreparation of the child and family
Preparation of Environment and EquipmentEnsure the patient’s privacy is maintained throughout the procedure and that they are kept warm. Ensure there is adequate light to perform the procedure. Prepare the following equipment:
Catheter sizeUse an appropriate size catheter
depending on the age of the child. Catheters that are too big or small are at risk of urethral trauma or leakage. The rational for IDC insertion should also be considered when selecting catheter, for example a patient requiring an IDC post kidney trauma may require a larger size to provide adequate drainage of potential blood clots. Consider silicone catheter if for long term use.
Procedure for insertion of urinary catheterThe need for an IDC should be discussed with the patients’ medical team prior to insertion. Medical approval for IDC insertion should be ordered and/or documented. The following should be completed in line with the RCH Aseptic Technique Procedure. Female child
Male child
If unable to pass the catheter seek assistance from treating medical team or Urology registrar. DO NOT use force as you may damage the urethra.
Special precautionsRapid drainage of large volumes of urine from the bladder may result in hypotension and/or haemorrhage. If concerned clamp catheter if the volume seems excessive. Release clamp after 20 minutes to allow more urine to drain. A medical review of the child should be requested. For post obstructive diuresis IV replacement of fluid and electrolytes may be required. This should be discussed with the treating medical team. DocumentationInsertion of the IDC should be documented in the LDA activity.
Ongoing nursing management
Drainage systemAdherence to a sterile continuously closed method of urinary drainage has been shown to markedly reduce the risk of acquiring a catheter associated infection. Therefore breaches to the closed system should be avoided. Consider changing the catheter tube and/or bag based on clinical indicators including infection,
contamination, obstruction or if system disconnects. If the equipment is damaged or leaks, replace system and/or catheter using aseptic technique and sterile equipment. Hygiene
Infection surveillance
Specimen collection
Troubleshooting
The following
techniques to check for patency and/or flush a catheter should be completed following the Aseptic Technique Procedure.
Catheter leaking
Removal of urinary catheterEquipment required for removal:
Procedure:
Complications
Discharge information
Companion documentsOther RCH IDC resources available:
References
Evidence tableIndwelling urinary catheter insertion and management evidence table Please remember to read the disclaimer. The development of this nursing guideline was coordinated by Liam Cunningham, RN, Day Medical Unit, and approved by the Nursing Clinical Effectiveness Committee. Updated September 2020.
Which action would a nurse take to prevent infection from a urinary retention catheter?Clean the skin around the catheter daily using soap and water. Dry with a clean towel afterward. You can shower with your catheter and drainage bag in place unless your doctor told you not to. When you clean around the catheter, check the surrounding skin for signs of infection.
What is the best nursing intervention to prevent infection in a client with an indwelling urinary catheter?Best practices for UTI prevention
Maintain good hand hygiene and use gloves before manipulating the catheter. Dispose of gloves and promptly wash hands after contact with the patient and catheter. Maintain a closed drainage system; any opening creates an entry route for bacteria, which can lead to infection.
What is nursing responsibilities in urinary catheterization?Caring for the Patient with an Indwelling Catheter
Be sure to wash hands before and after caring for a patient with an indwelling catheter. Clean the perineal area thoroughly, especially around the meatus, twice a day and after each bowel movement. This helps prevent organisms for entering the bladder.
How might the nurse best prevent infection in a patient with an indwelling urinary catheter quizlet?Rationale: This is the correct answer. To reduce the risk of CAUTI in a patient with an indwelling urinary catheter, the nurse would use the smallest-size catheter possible. To reduce the risk of CAUTI, the nurse would wear sterile, not simply clean, gloves to insert the indwelling urinary catheter.
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