catheter two Flashcards
Catheter lengths
■ Standard
■ Female
■ Paediatric
40–44 cm
23–26 cm
30 cm
Standard length is appropriate for
immobile female patients
but should always be used in male patients.
Insertion risks
60% of healthcare-associated infections are related to
catheter insertion
Guidance for catheter insertion
■ Assess the need for catheterisation; avoid if possible and consider alternatives
■ Ensure professionals are trained and competent in procedure
■ Document the reason for insertion, the continuing need and/or date of removal
■ Catheterisation is an aseptic procedure, which includes personal protective
equipment
■ Clean urethral meatus before insertion with appropriate fluid, e.g. sterile normal
saline (check local policy) using correct wiping technique (there is no evidence of an
advantage in using aseptic preparations)
■ Use an appropriate lubricant from a single-use container to minimise urethral
trauma/infection (see local policy)
■ Selection of catheters—smallest gauge that will allow free drainage, material will
depend on patient assessment and duration of catheterisation (Table 1)
■ Select drainage option—sterile closed urinary system or catheter valve
Catheter insertion quick tips
■ Be competent in the skill of insertion
■ Assess the reason for catheterisation
■ Be aware of length of time catheter required and remove as soon as possible
■ Be aware of any allergies, e.g., latex
■ Use smallest appropriate Ch to promote free drainage
■ Use balloon no larger than 10 ml unless for heamostatis in post-urological procedure
(EAUN, 2012)
■ Use standard length for all males and immobile females
■ Document all information relating to catheter selection/insertion
Lifespan of indwelling urinary catheters and recommended Charriere sizes Short term Medium term Long term
left in situ for up to 7 days- Catheter (PVC), specialised catheters
left in situ for up to 28 days - Polytetrafluoroethylene (PTFE), silver alloy, hydrogel, nitrofurazone impregnated
Long term Up to a maximum of
12 weeks
Silicone–elastomer, Hydrogel, All
silicone, All silicone with open tip and
integral balloon, Dover silver catheter
Drainage devices
Choice of device will be based on:
■ Patient choice ■ Required bag capacity ■ Tube length required ■ Tap design ■ Placement and ease of use for individual based on dexterity, mobility and cognitive ability ■ Bladder capacity for catheter valves (
It is imperative that drainage bags are
sterile and kept as a closed
system and the bag is changed in line with the manufacturer’s
recommendations usually every 5–7 days.
Catheter valves
offer patients comfort, independence and a convenient way to manage their catheter
ot suitable for all patients and certain factors should
be considered when advising or selecting a valve. These include
the individual’s cognitive ability to understand bladder function,
manual dexterity to manipulate the valve, bladder sensation to
avoid over distention of the bladder, mobility and bladder capacity.
The same precautions should be taken as when changing a
valve for drainage bags, which is recommended every 5–7 days
Hand hygiene and manipulation
Decontaminate hands and wear a new pair of
clean non-sterile gloves before manipulating
each patient’s catheter. Decontaminate hands
immediately following the removal of gloves.’
Emptying the bag
Drainage bags should always be positioned below the bladder
and should be secured either by retaining straps or a supporting
system.
be emptied when three-quarters full.