Page 55 - policy and procedure infection control

Policies and Procedures on Infection Control

4.2 Urinary Catheter Care

The urinary tract is one of the most common site of infection. Most urinary tract infection is
following instrumentation of urinary tract, mainly urinary catheterization. One of the most impor-
tant infection control measures is to limit the use of urinary catheterization to carefully selected
patients. However, if there is a need to perform urinary catheterization, sterile procedure must be
observed.
Urinary catheters may be use as a short term measure or long term as in indwelling catheter. The
following are general principle of urinary catheter insertion to reduce the infection of urinary tract.

4.2.1 General principles of urinary catheter insertion

1. Personnel
Only personnel trained on the correct technique of insertion can perform aseptic
catheter insertion. Hospital personnel and others who take care of catheters should
be given periodic in-service training stressing the correct technique of insertion, care
and potential complications of urinary catheterization.
2. Catheter use
Urinary catheter should be inserted only when necessary and left in place only when
as long as necessary. For selected patients other method of urinary drainage such
as condom catheter drainage, suprapubic catheterization and intermittent urethral
catheterization, can be useful alternatives to indwelling urethral catheterization.
3. Hand hygiene
Hand hygiene should be practice before and after any manipulation of the catheter
site or apparatus.

4. Catheter insertion
Catheter should be inserted using aseptic technique and sterile equipments glove,
drape, sponges, an appropriate antiseptic solution for peri-urethral cleaning, a single
used packet of lubricant jelly should be use for insertion. Non-touch technique should
be practice.
Use as small a catheter as possible, consistent with good drainage should be use to
minimized urethral trauma. Indwelling catheter should be properly secured after
insertion to prevent movement and urethral traction. Use of silicone type catheter
may be considered in long term indwelling catheter. After insertion the date of insertion
should be documented.
5. Close sterile drainage
A sterile continuously closed drainage system should be maintained. The catheter and
drainage tube should not be disconnected unless the catheter must be irrigated. If
breaks occur in aseptic technique, disconnection, of leakage occur, the collecting system
should be replaced using aseptic technique after disinfecting the catheter tubing junction.

44 Ministry of Health Malaysia