From the Guidelines
The recommended plan for managing a patient's catheter includes daily assessment of the continued need for catheterization with prompt removal when no longer necessary, as supported by the most recent and highest quality study 1.
Key Components of Catheter Management
- Daily inspection of the catheter insertion site for signs of infection such as redness, swelling, or discharge
- Proper hand hygiene before and after handling the catheter, along with maintaining a closed drainage system
- The collection bag should be kept below bladder level to prevent backflow of urine, and emptied when two-thirds full
- Routine catheter care includes cleaning the perineal area with soap and water daily, securing the catheter to prevent movement and urethral trauma, and ensuring adequate hydration to maintain urine flow
Documentation and Assessment
- Documentation should include insertion date, indication, assessments, and any complications
- Antimicrobial catheters may be considered for high-risk patients, but routine antibiotic prophylaxis is not recommended, as stated in 1 and 1
- These practices help reduce catheter-associated urinary tract infections (CAUTIs), which are among the most common healthcare-associated infections, by minimizing bacterial colonization and biofilm formation on catheter surfaces
Additional Considerations
- The use of indwelling urethral catheters should be avoided due to the risk of urinary tract infections, as recommended in 1
- If used, indwelling catheters should be assessed daily and removed as soon as possible, as stated in 1
- Excellent pericare and infection prevention strategies should be implemented to minimize the risk of infections, as recommended in 1 and 1
From the Research
Catheter Review Plan
To document a plan for catheter review, the following steps can be taken:
- Identify the indications for catheter use and ensure that the catheter is still necessary for the patient 2
- Review the type of catheter being used and consider alternatives if necessary 2
- Develop a plan for catheter maintenance, including regular cleaning and monitoring for signs of infection or other complications 2
- Establish a schedule for reviewing the catheter and assessing the need for continued use 3
Catheter-Associated Complications
Catheter-associated complications, such as urinary tract infections (UTIs), can be minimized by:
- Using best practices for catheter insertion and removal 2
- Implementing strategies to reduce the risk of CAUTIs, such as using antimicrobial-coated catheters 4, 5
- Monitoring patients for signs of infection and taking prompt action if an infection is suspected 3
Antibiotic Prophylaxis
The use of antibiotic prophylaxis for urinary catheter removal is not recommended, as it has not been shown to reduce the risk of UTI in surgical patients 6
Antimicrobial Strategies
Antimicrobial strategies, such as antimicrobial-coated catheters, can be effective in reducing the incidence of CAUTIs 4, 5
- These strategies can be used in conjunction with other infection control measures to minimize the risk of catheter-associated complications 5