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Infection Prevention and Control
Changing a suprapubic catheter
Infection Prevention and Control Changing a suprapubic catheter Purpose To ensure all relevant staff are aware of the principles of changing a suprapubic 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 changing of suprapubic catheters. Guidance A suprapubic cystostomy or suprapubic catheter is a surgically created connection between the urinary bladder and the skin which is used to drain urine from the bladder in individuals with obstruction of normal urinary flow
The insertion of the first suprapubic catheter is usually performed in hospital by a urology specialist. In some areas the first change is also performed by the specialist; thereafter the catheter is usually changed by a person who has received specific training in this procedure and is competent to carry it out
Only trained and competent staff can change a supra pubic catheter using an aseptic non touch technique
Frequency of change of a supra pubic catheter will depend on the make of the catheter. Follow manufacturer’s recommendations
Never remove a suprapubic catheter unless it is going to be changed immediately or removed permanently (Rigby, 2009)
Prior to changing the suprapubic catheter ensure you are aware of how to contact other healthcare professionals should any difficulties arise during the procedure
The size of catheter used should be no smaller than 16Ch in adults with a 10ml balloon, unless otherwise specified (and documented) by an appropriate specialist. A larger Charriere size may be used if the catheter persistently blocks. Check care plan and service user notes for record of persistent blocking or ongoing problems
Gain consent from the service user to carry out procedure and document this in service users’ notes
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Rationale
If not using a pre-connect system, connect a catheter valve or an appropriate drainage bag; once urine starts to flow, ensure this is below the level of the bladder;
To ensure unrestricted flow of urine into a closed system
Affix urinary catheter fixation device; Attach the drainage bag if using a leg bag to the leg, using straps, night bag or a catheter valve.
To prevent catheter “drag” which can result in trauma to suprapubic site and bladder
A small sterile keyhole dressing can be applied around the supra‐pubic opening
To absorb any exudate
Make the service user comfortable and ensure the area is dry
To promote comfort for the service user; if the area is left wet or moist, particularly with bodily fluids, secondary infection and skin irritation may occur
Dispose of used equipment into correct waste stream and clean trolley or tray
To prevent environmental contamination and ensure appropriate disposal
Perform effective hand hygiene by washing hands with soap and water or using hand sanitizer if hands are visibly clean
To reduce the risk of infection
Where required collect and send a urine sample for investigation
To detect presence of bacteria
Explain to the service user the importance of maintaining cleanliness around the suprapubic site by maintaining a clean dressing and avoiding touching or pulling the catheter or dressing
To reduce the risk of infection and trauma
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Action
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