Infection control manual - NHS Lothian

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Author(s): Carol Rae, Audrey Pringle, Mary Brown Version: 1 Page 4 of 11 NHS LOTHIAN INFECTION CONTROL MANUAL Insertion and Maintenance of Indwelling Urinary Catheters In Adults 1. Aim To minimise the risk of urinary tract infection as a result of urinary catheterisation. 2. Statement Catheter Associated Urinary Tract Infection (CAUTI) is the most common nosocomial infection. Catheterisation places patients in significant danger of acquiring a urinary tract infection (EPIC 2 2007). Urinary catheters are the second leading cause of blood stream infections (Health Protection Scotland 2008). Only use an indwelling urinary catheter after considering alternative options. Document the need for catheter insertion in the patient‘s notes. Follow Urinary Catheter Insertion bundle developed by Health Protection Scotland. Follow the Urinary Catheter Maintenance Bundle developed by Health Protection Scotland. Regularly review the patient’s clinical need for continuing urinary catheterisation and remove the catheter as soon as possible.
3. Requirements Healthcare Professional (HCP) who have been given formal training and are competent in the procedure. Author(s): Carol Rae, Audrey Pringle, Mary Brown Version: 1 Page 5 of 11 Sterile Dressing or Catheterisation pack. A non-sterile procedure pad to protect bedding Appropriately sized sterile catheter to facilitate urine drainage. Type of catheter will depend on anticipated duration of catheterisation, existing latex allergy, length required (standard or female) and patient choice. Please note that a standard length catheter must always be used to catheterize a male patient per urethra. Catheter balloon size should not exceed 10ml. Urological patients may require a 30ml balloon catheter following surgery. Patient allergies e.g. latex, lignocaine or silver. (Please note patients with Spina Bifida should be considered as a potential “high risk” for a latex allergy). Sterile single use antiseptic lubricant if not contra-indicated. Sterile single use plain lubricating jelly if antiseptic lubricant is contraindicated or if this is the lubricant of patient’s choice. Two pairs of Sterile Nitrile gloves. Normal saline sachet for skin cleansing. Cooled boiled water is acceptable cleansing solution in the community setting. Appropriate legbag and night bag according to the patients clinical need, mesh sleeve may be used instead of straps depending on the patients preference. Catheter retaining device to prevent traction. Catheter valve if this option to be used in cognitively intact patients. Night bag stand for bed bound patients. A light source may be required. Alcohol gel. Informed consent should be obtained prior to procedure. The HCP must document how consent was obtained. In a clinical emergency e.g. acute setting, a doctor will authorise and document in the patients medical notes. They should inform nurses that the patient now has an indwelling catheter and needs appropriate support and advice. Consider need for chaperone (NHS Lothian 2007). 4. Location At the bedside, theatre or clinical environment. Due care must be taken to ensure patient’s modesty and privacy.
Page 1 and 2: INSERTION AND MAINTENANCE OF INDWEL
Page 3: 6. Correct disposal of all equipmen
Page 7 and 8: CATHETERISATION PROCEDURE Author(s)
Page 9 and 10: 8. Obtaining a Urine Specimen Patie
Page 11: REFERENCES EPIC 2 (2007) National e

Infection control manual - NHS Lothian

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