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Infection Prevention and Control
Insertion of a Female Urethral Catheter
Infection Prevention and Control Insertion of a Female Urethral Catheter Purpose To ensure all relevant staff are aware of the principles of insertion of a female urethral catheter and understand the rationale that informs the principle, to prevent cross infection between service users, staff and visitors and prevent Health Care Associated Infections.
Target Group This procedure is relevant to healthcare or care staff that have received specific training in the insertion of female urethral catheters.
Introduction
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Urinary tract infection (UTI) is the most common infection acquired as a result of health care, accounting for 19% of Health Care Associated Infections, with between 43% and 56% of UTI’s associated with a urethral catheter.
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This guidance has been formulated to give healthcare and care staff a step by step approach to the insertion of a urethral catheter with a rationale for each stage, based on the current national research and guidance. This guidance should be used in conjunction with other associated infection prevention and control policies and procedures such as Hand Hygiene, Waste Management, Use of Personal Protective Equipment (PPE) and Aseptic Non-Touch Technique (ANTT) Only appropriately trained and competent healthcare or care staff should carry out female urethral catheterisation using an aseptic non touch technique
Equipment:
2 pairs of sterile single use gloves Hand sanitiser Disposable plastic apron Alcohol wipes or hard surface disinfectant wipes 10mls sterile water for catheter balloon Sterile syringe and needle or sterile filler Sterile dressing/catheterisation pack containing sterile receiver Sodium Chloride 0.9% Single use sterile lubricant/anaesthetic gel Catheter of appropriate size/length and type of material Appropriate drainage bag Leg bag straps or means of holding catheter Universal specimen container for specimen if required Clinical waste bag
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service user’s thighs; Using non-dominant hand and gauze swab separate the labia minora so that the urethral meatus is visible; clean using downwards strokes with a sterile piece of gauze moistened with 0.9% saline for each single downward stroke
To reduce the risk of cross-infection and the introduction of skin and meatal flora into the urethra and bladder
Insert the sterile nozzle of the anaesthetic lubrication gel into the urethra; squeeze 6ml into the urethra, remove the nozzle and discard the tube; wait 5 minutes for it to take effect
Adequate lubrication helps to prevent urethral trauma
Inadequate preparation of the urethral orifice is a major cause of infection following catheterisation
Use of a local anaesthetic minimizes the service user’s discomfort
Remove used gloves; perform hand hygiene To reduce contamination following skin and and put on a 2nd pair of sterile gloves meatal contact with 1st pair of gloves To provide a temporary container to maintain sterility prior to insertion and to catch urine as it drains
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Place the sterile urinary catheter, in the sterile receiver, between the service user’s legs
Advancing the urinary catheter prevents the balloon from being trapped in the urethra when inflation occurs
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Gently introduce the tip of the catheter into the urethral orifice directing the catheter tip upward and backwards; Advance the catheter 5-6cm or until urine starts to flow, then advance it a further 68cm
Inflate the balloon according to the manufacturer’s instructions, having ensured that the catheter is draining adequately
Inadvertent inflation of the balloon within the urethra is painful and causes urethral trauma
Withdraw the catheter slightly until the balloon is sitting at the bladder neck, and connect it to the drainage system
Maintain service user comfort and prevent urethral trauma
Support the catheter; ensure it does not pull or become taut as the service user mobilises
To maintain service users comfort and to reduce potential trauma to urethra and bladder neck
Make the service user comfortable and ensure the area is dry
If the area is left wet or moist, particularly with bodily fluids, secondary infection and skin irritation may occur
Observe and measure how much residual urine drains and document after procedure
To ensure volume of urine in bladder at time of catheterisation is recorded especially when service user has presented with urinary retention or impaired renal function (During routine re–catheterisation there should be a minimal amount of urine in the bladder)
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