Urinary Catheter Types and Care for Residents With Catheters

AHRQ Safety Program for Long-Term Care: CAUTI

Slide 1: Urinary Catheter Types and Care for Residents With Catheters

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Slide 2: Learning Objectives

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Upon completion of this module, clinicians and staff who care for residents with catheters will be able to—

  • Explain the similarities and differences between the four different types of catheters.
  • Explain ways to prevent catheter-associated urinary tract infections; and
  • Identify some common errors when caring for catheters.

Slide 3: Indwelling Urinary Catheter Entry Pathways for Microbes1

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Bladder

  • Entry during insertion.
  • Bacteria movement up the catheter.

Urethra
(Urinary tract entrance)

  • Breaks in the catheter tubing or collection bag.
  • Contamination of the catheter tubing or collection bag.

Image source: Maki DG, Tambyah PA. Engineering out the risk of infection with urinary catheters. Emerg Infect Dis. 2001 Mar-Apr;7(2):342-7.
CMS, State Operations Manual, 2014.

1. Maki DG, Tambyah PA. Engineering out the Risk for Infection with Urinary Catheters. Emerg Infect Dis. 2001;7(2):342-7.

Slide 4: Alternatives to Indwelling Urinary Catheter Types

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  • Suprapubic catheters.
  • Straight catheters.
  • External "condom" catheters.

Slide 5: Hygiene and Standard Precautions Assisting the Nurse With Catheter Insertion2

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  • Wash your hands!
  • Don gloves and gown.
  • Help the resident to get comfortable in a supine position and assist the nurse as needed.
  • Catheter insertion is done as a sterile technique. Do not touch the sterile field.
  • Assist to place and secure the catheter drainage bag below the level of the bladder and off the floor.
  • Remove gown and gloves and wash hands!

2. Willson M, Wilde M, Webb M, et al. Nursing interventions to reduce the risk of catheter‐associated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009;36(2):137-54.

Slide 6: Drainage Bag2

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  • Only trained staff should empty the urine collection bag and rinse/store containers.
  • Follow manufacturer instructions on use.
  • Empty drainage bags regularly (at least once per shift).
  • Stabilize the catheter and drainage bag.
  • Keep drainage bag below level of bladder at all times OFF floor.
  • Consider where to place the drainage bag during resident's daily activity
    • Wheelchair
    • Walker (clamp or hook)
    • Bed
    • Dining/activity area
    • Lounge/reading chair (peg on side)

2. Willson M, Wilde M, Webb M, et al. Nursing interventions to reduce the risk of catheter‐associated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009;36(2):137-54.

Slide 7: Maintenance Avoiding Common Mistakes3

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  • Wash hands BEFORE and AFTER any contact with urinary catheter, tubing, or bag.
  • Keep bag below bladder at all times without kinking.
  • When emptying bag, do not let outlet port touch ANYTHING
    • Drain into a container used only for ONE resident.
  • Sampling port must be DISINFECTED before any use
    • Only STERILE needle/syringe can be used to aspirate urine.

Slide 8: Maintenance Care of Indwelling Urinary Catheter3

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  • Use standard precautions before contact with catheter, tubing, or bag.
  • When performing peri-care use only soap and water
    • Periurethral area should NOT be cleaned vigorously or with antiseptic solutions.
  • Keep the catheter and all tubing from kinking/obstruction.
  • Indwelling urinary catheter and suprapubic catheter systems must be kept CLOSED
    • If any disconnection of tubing or bag leakage, replace it.
  • Make sure you don't contaminate catheter outlet valve when emptying the collection bag.
  • Certified nursing assistants are daily hands on the "front line" between residents and families, and potential infection-causing microbes.

3. Lo E, Nicolle LE, Coffin SE, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(S2):S32-S47.

Slide 9: Teaching Family and Residents About Catheters4,5

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Image: FAQ CAUTI - A snapshot from Catheterout.org's FAQ page about CAUTIs and catheter care.

Resources for educating residents and families can be found on the following Web sites:
Centers for Disease Control and Prevention
National Consumer Voice

4. Catheter-Associated Urinary Tract Infections. October 2015. Centers for Disease Control and Prevention.
5. Infection Prevention: Catheter-Associated Urinary Tract Infection. 2016. The National Consumer Voice for Quality Long-Term Care.

Slide 10: References

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  1. Maki DG, Tambyah PA. Engineering out the Risk for Infection with Urinary Catheters. Emerg Infect Dis. 2001;7(2):342-7.
  2. Willson M, Wilde M, Webb M, et al. Nursing interventions to reduce the risk of catheter‐associated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009;36(2):137-54.
  3. Lo E, Nicolle LE, Coffin SE, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(S2):S32-S47.
  4. Catheter-Associated Urinary Tract Infections. October 2015. Centers for Disease Control and Prevention.
  5. Infection Prevention: Catheter-Associated Urinary Tract Infection. 2016. The National Consumer Voice for Quality Long-Term Care.
Page last reviewed March 2017
Page originally created March 2017
Internet Citation: Urinary Catheter Types and Care for Residents With Catheters. Content last reviewed March 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementaion/education-bundles/indwelling-urinary-catheteruse/catheter-insertion/unlicensed-staff/unlicensed-catheter-slides.html