Background: In the past, nurses and providers believed the best way to reduce urinary tract infections (UTIs) was to avoid using an indwelling urinary catheter. Instead providers chose to write orders for temporary (or straight) urinary catheters and ask nursing staff to change them on a near daily basis. After years of research, we know that practice actually increases the risk of UTIs and introduces more bacteria into the urinary system. This would be categorized as a hospital acquired infection (HAI). Infections that are caused by hospital care result in lower rates of reimbursement, poor patient care experiences and additional stress on nursing staff and providers.
Your Role. As a nursing assistant or NAC, your role is to keep indwelling urinary catheters free from bacteria by frequent washing of the visible indwelling catheter. You will only clean a patient’s urinary catheter if ordered by a health care provider, at the frequency they determine. Not every patient with a catheter needs it cleaned.
Important Notes. Secure urinary catheters at the urinary meatus. Do this by pinching and holding the tubing at the most distal end of the catheter, which will avoid tugging or pulling out the urinary catheter. The length of catheter inside the urinary system is considered sterile and does not require cleaning. Catheters (both indwelling and straight) are inserted into the urinary meatus. The terminal point of a catheter is the external genitalia of a patient, the same for both both male and female.
Step by Step Guide. Here are the steps you need to follow when cleaning a catheter on a female mannequin for the Nursing Assistant (NAC, CNA) skills exam. Please consult your hospital or school policy before performing care skills on real patients.
- Explain what you will be doing, and provide privacy with a curtain or door.
- Put on gloves.
- Check the temperature of the water and ask the patient to verify the water is a safe temperature.
- Position the patient on his or her side (a testing evaluator will help you roll the mannequin onto it’s side on exam day) and place bed protector linen.
- Ensure “maximum privacy” by only lifting the gown up to the patient’s hips, and lower the bed sheet no lower than the patient’s knees.
- Clean the catheter by applying soap to a wet wash cloth and moving in one direction only from the patient’s body to the catheter tubing attached to the bag. Use a new wash cloth for rinsing off the soap, and another for drying the catheter tubing. One stroke ONLY is needed; avoid going back and forth over the catheter with multiple strokes.
- Cover the patient and position on his or her side to remove bed protector linen.
- Dispose of all linens in dirty laundry hamper, including unused linens.
- Empty, rinse and dry the basin or tub used for water.
- Take off your gloves and wash your hands.
- Make sure the patient understands where the call light is and position the bed at a safe height for the patient when you leave.
FYI. This skill teaches you to clean 4 inches of urinary catheter tubing from where it exits the body while providing maximum privacy for your patient. While cleaning at least 4 inches is ideal, cleaning beyond 4 inches of the visible catheter is even better. Just make sure to rinse and dry the entire length that you have cleaned!
Usually this skill is done at the same time as peri-care in the clinical setting, however on state nursing assistant skills test peri-care and catheter care are separate skills.
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