Short Term Indwelling Urinary Catheters

Introduction

There is consistent evidence that a significant number of healthcare associated infections (HCAIs) in hospital are related to urinary catheterisation.

Urinary tract infections (UTIs) account for 17.2% of HCAIs with 43% to 56% of UTIs associated with a urethral catheter.

These infections are due to trauma of the urethra and the catheter produces a pathway for bacteria and other organisms to enter the bladder.

Consequently around 50% of hospitalised patients catheterised longer than 7-10 days contract bacteriuria.

A third of IV antibiotics prescribed are inappropriately aimed at treatment of asymptomatic UTIs.

Purpose

Indwelling urinary catheters should only be inserted if there is no available alternative, and then kept in place for as short a time as possible.

The longer a catheter is in place, the greater the risk of infection and risk of developing bacteriuria is approximately increased by 5% for each day of catheterisation.

General Principles

• Hands should be washed with soap and water followed by hand sanitiser immediately before and after catheter insertion. Hands must be decontaminated before and after manipulation of the catheter or drainage system.
• Protective clothing of non-sterile gloves and apron should be used in accordance with the guideline on standard precautions.
• Insertion, manipulation, sampling and removal of urinary catheters must be undertaken only by trained and competent staff using strict Aseptic Non Touch Technique.(ANTT)
• The date of insertion and removal of the device must be documented in the clinical and nursing records along with the clinical reason for the urethral catheter being inserted.
• Catheter care must be documented on each shift using the urinary catheter assessment monitoring form in accordance with the urethral catheter core care plan.
• Pre-connected urinary catheterisation packs to be used where possible. This is not appropriate for some urology procedures.

Policy Details

See also:

• Aseptic Non Touch Technique Policy
• Standard Precautions Policy
• Clinical skills.net
• Royal Marsden Manual