The Attendant’s Responsibilities for Care

Although we have not had to deal with indwelling urinary catheters for quite some time in our hospital, our population is changing and we are getting more medically-compromised patients, particularly on 422B.

Although the management of urinary catheters is primarily a responsibility of licensed nurses, attendants must also be aware of the care and precautions needed to prevent complications for patients with indwelling urinary catheters.

Indwelling Urinary Catheter

The indwelling urinary catheter is a hollow, flexible tube that can be inserted into the bladder and then a balloon is inflated at the proximal end, which prevents the catheter from slipping out. This allows continuous drainage of urine into a collection bag.

The number one risk for a patient who has an indwelling urinary catheter in place is a urinary tract infection.

Maintenance of a sterile, closed drainage system is an essential component of the prevention of catheter-related urinary tract infections.

All indwelling urinary catheters MUST be secured according to the manufacturer’s recommendations for the device used.

For a female patient, secure the catheter to inner thigh when using a leg strap.

For a male patient, secure catheter to lower, anterior abdominal wall or high on either inner thigh to avoid traction on the catheter during activities.

The drainage bag should be in a dependent position below the level of the bladder, with tubing free of kinks and kept above the level of the drainage bag. If tubing and bag must be elevated for an extended period of time, care should be taken to prevent backflow of urine from the bag.

Drainage bag should not be allowed to rest on the floor.

Keep skin around the catheter and tubing clean.

Make sure that if patient defecates that the perineal area is thoroughly cleaned, using soap and water.

Complete perineal routine care (with soap and water) daily.

Blockage ◦ Partial or complete obstruction of urine flow is a

common and difficult-to-manage problem for catheter users. Biofilms are a primary cause of encrustation and blockage, although blockage can also be caused by

Kinked tubing

Occlusion by clothing

Collection bag is not below the level of the bladder

Constipation

Enlarged prostate

Prevention of Blockage ◦ Caregivers must be aware of position of catheter at

all times, especially during and after transfers.

◦ Inconsistent fluid intake may contribute to increased precipitation of sediment and subsequent encrustation/blockage. Maintain adequate fluid intake.

Report to the nurse any of the following signs/symptoms of urinary tract infection:

Fever Unusual complaints of not feeling well Unusual mental confusion or decrease in

alertness Urge to urinate (even though urine is draining

freely from the catheter) Foul-smelling urine or dark-colored urine Lower abdominal or pelvic pain Back Pain

If the catheter is pulled out or falls out of the bladder

If urine is leaking around the catheter

If there is no urine in the bag within one hour after the bag is emptied

Urine color/odor changes

If the tubing comes apart.

If the drainage bag is more than ½ full

You have now completed the inservice

“Indwelling Urinary Catheters: Attendant’s Responsibilities for Care”

Name (printed): __________________________

Signature: _______________________________

Date: ________________

Print, sign and date this slide and send to Terry Slayback in the Nursing

Administration Office.