Page 56 - policy and procedure infection control

Policies and Procedures on Infection Control

6. Irrigation
Irrigation should be avoided unless obstruction is anticipated, as might occur with
bleeding with prostatic or bladder surgery, closed continuous irrigation may be use
to prevent obstruction. To relieve obstruction due to clots, mucous or other causes,
an intermittent method of flushing may be use. Continuous irrigation of the bladder
with antimicrobials has not proven to be useful and should not be perform as a
routine infection prevention measures. The catheter tubing junction should be
disinfected before disconnection.
A large volume and a sterile syringe and sterile irrigant should be used and then
discarded. The person performing irrigation should use aseptic technique.
If the catheter becomes obstructed and can be kept open only by frequent irrigation,
the catheter should be changed since it is likely that the catheter itself is contributing
to the obstruction.
7. Specimen collection
If small volumes of fresh urine are needed for examination, the distal end of the
catheter, or preferably the sampling port if present, should be cleansed with a
disinfectant, and urine then aspirated with a sterile needle and syringe. Larger volume
of urine for special analyses should be obtained aseptically from the drainage bag.
8. Urinary flow
Unobstructed flow should be maintained. Occasionally, it is necessary to temporarily
obstruct the catheter for specimen collection or other medical purposes.

To achieve free flow of urine;
• The catheter and collecting tube should be kept from kinking.
• The collecting bag should be emptied regularly using a separate clean collecting
container for each patient. (Change glove for each patient).
• Poorly functioning or obstructed catheters should be irrigated or if necessary,
replaced.
• Collecting bag should always be kept below the level of the bladder. Always hang
drainage bag at beside below groin level to allow gravity drainage and maintain
unobstructed urine flow. Do not allow urine to flow from bag or tube back into
bladder as the flow of urine may be contaminated and can cause urinary tract
infection.
9. Meatal care
Catheter care should consist of good personal hygiene around the meatal area carried
out a regular basis. Wiping after bowel cleaning should be carried out from front to
back to avoid infection.
10. Catheter change interval
Do not change catheters at arbitrary fixed intervals. However to prevent encrustation,
non silicone catheter may need to be change 2 or 3 weeks. Change only when
necessary, such as when tube is obstructed, discolored etc.

Ministry of Health Malaysia 45