AHRQ Safety Program for Long-term Care: HAIs/CAUTI

Catheter Types and Care for

Residents with Catheters

National Content Series for All LTC

Staff

June 2015Click icon to add picture

Learning Objectives

Upon completion of this webinar, clinicians and staff 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 CAUTI; and

• identify some common errors when caring for catheters.

2

Indwelling Urinary CatheterEntry Pathways for Microbes

Bladder

Urine Collection Bag

Urethra(Urinary tract entrance)

• Entry during insertion• Bacteria movement

up the catheter

• Breaks in the catheter tubing or collection bag

• Contamination of the catheter tubing or collection bag

Figure Source: Dennis G. Maki and Paul A. Tambyah. Engineering Out the Risk of Infection with Urinary Catheters. Emerg Infect Dis, Vol. 7, No. 2, March-April 2001. http://www.cdc.gov/ncidod/eid/vol7no2/makiG1.htm; CMS, State Operations Manual, 2014.

3

Alternatives to Indwelling Urinary Catheter Types

• Suprapubic catheters

• Straight catheters

• External “condom” catheters

4

Hygiene and Standard PrecautionsAssisting the Nurse with Catheter Insertion

• 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!5

Drainage Bag• 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)6

MaintenanceAvoiding Common Mistakes

• 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

urine7

Maintenance Care of Indwelling Urinary Catheter

• 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, must be replaced

• Make sure you don’t contaminate catheter outlet valve when emptying the collection bag

• CNAs are the daily hands on “front-line” between residents and families and potential infection causing microbes

8

Teaching Family and Residents About Catheters

9

These resources for educating residents and families can be found at: http://www.catheterout.org/?q=patient-family-ed

1. AHRQ Safety Program for Long-term Care: HAIs/CAUTI Project WebsiteLogin information

Username: ltcsafetyPassword: ltcsafety

2. TeamSTEPPS® for Long-term Care

Stay Updated with Useful Resources

AHRQ Safety Program for Long-term Care: HAIs/CAUTI Project Website

Login information

Username: ltcsafety

Password: ltcsafety

TeamSTEPPS® for Long-term Care

3. www.catheterout.org

10