Catheter Care – Problem Solving Presented by Cheryl Hammond Clinical Nurse Specialist

Objective To maintain urinary drainage and reduce the risk of trauma and infection.

Educate the patient  Discuss catheter care - hygiene - securing catheter - supporting drainage bag - catheter not kinked or twisted - drainage bag emptied regularly - advise on fluid intake and prevention of constipation - importance of a closed system

Catheter by-passing  Check tubing is not twisted or kinked  Catheter secured  Check patient not constipated  Check size of catheter is correct  Check balloon inflated correctly

 Check if bag needs emptying  Check for infection  Check catheter not blocked  Consider possibility of bladder spasm or irritation

Catheter blocked  Check catheter in correct position  Check drainage bag, below bladder level and empty if full  Check tubing not kinked or blocked

Catheter by-passing due to bladder spasm  Decrease known bladder irritants i.e. caffeine and alcohol.  Decrease size of catheter  Check balloon size  Check bag is secured and empty bag.

Possible infection  Maintain closed system  Follow hand hygiene guidelines  Position bag below bladder level  Drainage bag should be off the floor  Catheter secured correctly

Risk factors  Patient been in hospital last 12 months  Patient taken antibiotics in last 6 months  Over 65 years of age  Diabetes  Chemotherapy  Taking steroids  Chronic wounds

Possible encrustation  Inspect for encrustation in the catheter lumen and on outer surfaces of the tip and the balloon.  Monitor PH of urine, urine is normally acidic.  Monitor time of catheter life and when blockage

Unable to deflate the balloon  Check for kinked tubing  Relieve in constipation  Try a different syringe and leave in place.  Try and dislodge debris blocking the deflation channel by milking the catheter along its length.  Never cut the catheter or inflation valve  Never attempt to burst the balloon by over inflating it..

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