As a nurse, nursing assistant, or another healthcare professional or personal caretaker, there is a good chance that you will take care of patients who have an indwelling urinary catheter (IUC). The goal when caring for an IUC is keeping the patient safe and healthy. While IUCs are convenient for healthcare staff and help accurately monitor output, there is a great concern with preventing catheter-associated urinary tract infection (CAUTI). Join us today as we review some things to consider when caring for your patient’s catheter.

Secure tubing and drainage bag.

IUC tubing should always be secured to the patient’s leg with a commercial strap that is included with the catheter set. The purpose of securing the tubing is to help prevent tugging on the catheter, which can cause the bladder balloon to pull into the urethra, causing significant damage. Drainage bags should also always be secured, whether your patient is using a leg bag or a larger bag. The bag should be hung from the patient’s bed, wheelchair, or chair so that it moves with the patient without pulling. The drainage bag should never be placed on the floor, nor in the chair or bed next to the patient. The drainage system depends on gravity to shunt the urine away from the patient and setting the bag on the bed or next to them in the chair will cause the urine to backflow into the bladder.

Empty and clean the drainage bag regularly.

Drainage bags should be emptied regularly to prevent overfill causing backflow and stagnant urine from developing bacteria. Drainage bags and tubing should be cleaned regularly. To clean the outside of the tubing, you can wipe with alcohol wipes and wipe down the outside of the drainage bag with Sani-wipes or whatever wipes your facility protocol dictates. For the insertion site, peri-care should be performed regularly using warm water and soap. This should be done once per shift, at a minimum. Additionally, anytime there is fecal contamination or leaking urine, the area should be thoroughly cleaned and assessed for tissue breakdown.

To clean the inside of the tubing and the drainage bag, use the port to flush the line with sterile water or normal saline. Be sure to kink the tubing unless you are also flushing the bladder out. When swapping a leg bag for an overnight large collection bag, fill the drainage bag with a vinegar-water mix and allow it to rest until it is ready to be used again. Rinse out the vinegar mixture before reattaching the bag to the tubing for use.

Prevent obstruction or kinks in the tubing.

Kinks or obstructions can easily happen in catheter tubing so it is important to be mindful about placement and assess regularly. Ensure that the patient’s leg is not on top of the tubing and that the tubing does not become twisted during movement. If the drainage system does not seem to be collecting much urine, first check the line to ensure it is not kinked or blocked.

Maintain a closed drainage system.

A closed drainage system is important for both hygiene and infection control. If you must disconnect tubing, ensure that you kink the line beforehand so that urine does not leak out and the tubing does not have the opportunity to be exposed to unnecessary bacteria. When emptying the drainage bag, empty it into a new, clean container and immediately close it off.
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