Care of Catheters and Accessories
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Disclaimer: The following statements represent the result of clinical trials and actual experience of the authors, Joy K. Hewitt, RN,BSN,CCCN and Judy A. Wells, MN,RN,GNP. The repeated use of a the single-use catheter as described below has not been approved by the FDA. NAFC does not endorse either the position of the FDA or the opinions rendered below but has provided the information below for education purposes only. Use of the single-use catheters should be discussed with a medical professional, and all final decisions as to the use of same should be that of the patient in reliance upon his physician.
Care of Catheters
Reusable catheters are used by many adults and children to completely empty their bladder of urine. Most of these people use a “clean” technique rather than a sterile technique for catheterizing; hence the procedure “clean intermittent self-catheterization.” This procedure requires clean hands and fingernails with the nails smoothly trimmed, a clean urethral opening (meatus), and clean catheters.
Reusable catheters can easily be cleaned using a plain liquid soap without deodorant or perfume. After catheterizing, the catheter is washed well with the plain liquid soap and is rinsed thoroughly until all soap residue is gone. The excess water should be shaken out of the catheter. The catheter can then be placed on a clean paper towel that has not been used for anything else. The catheter should be allowed to completely dry. Clean reusable catheters can also be soaked in a home made vinegar solution: One part white vinegar and three parts water (room temperature).
After soaking in the vinegar solution for thirty minutes, the catheters are rinsed thoroughly with water. The excess water is then shaken out of the catheters and they are allowed to completely dry. All reusable catheters can be stored in a clean zip lock storage bag (with a tiny slit for air flow), tampon case, tooth brush holder, or small camera case. Any storage case is only used for clean catheters. A basin used for soaking and cleaning catheters must be used only for that purpose and cleaned well after each use. If a catheter cannot be cleaned immediately, it should be put in a separate bag or case and cleaned as soon as possible. Using a “bag in a bag” with clean catheters in the inner bag and used catheters in the outer bag is an inexpensive way to keep the catheters separate.
Catheters must be discarded when the catheter becomes hard, brittle, cracked, or if the color of the catheter changes.
If you use self-catheterization, always talk with your health care professional to clarify any questions you may have.
Care of Leg Bags and Night Drainage Systems
Some men, women, and children manage their bladders by using a catheter which stays in the bladder (indwelling catheter). Some men manage their bladder by using a condom or external catheter which is worn on the penis. All of these individuals must also use special tubing and collection bags or containers for storing urine between bathroom trips.
The tubing may be attached to a leg bag or a bedside drainage bag. Leg bags are easier to use at school, work, or at home during waking hours. The leg bag or bedside drainage bag is attached to the catheter by tubing and an adapter. The leg bag is worn around the upper or lower leg with velcro or elastic straps.
Bedside bags are used for nighttime or by people who cannot get out of bed. There are two types of bedside drainage systems. One type makes use of bags that hang from the bed frame. The second uses jugs or containers that sit on the floor. Both are attached to the catheter by an extension tube and an adapter.
Each system has good and bad points. Leg bags are easily hidden under skirts, dresses, or pants. They are available in different sizes and styles. Leg bags provide the greatest amount of movement and freedom to the user but they need to be emptied as necessary. The bedside bag, jug, or container holds a larger volume than leg bags. This allows the user to sleep well or not to have to make frequent trips to the bathroom to empty the urine. The jugs or containers are easy to clean and take care of, but they usually cost more than leg bags.
Many health care providers do not think a system with an indwelling catheter should be taken apart at all because of the chance of infection. Many people who use these types of catheters become expert managers of the catheters and drainage systems. They find a routine of care and cleaning that meets their needs and also lowers the chances of germ growth which causes infection and illness.
When Drainage System Is Not Changed Daily
- Make sure that the tube is attached to the bed or clothing to prevent pulling on the catheter in the bladder.
- Make sure the tube is straight without kinks which may stop the flow of urine.
- Make sure the drainage system is below the person so the urine will drain easily.
- Clean the opening where the catheter goes into the body (meatus) with soap and water daily or after soiling. Rinse thoroughly. Dry thoroughly.
When Drainage System is Changed Frequently
There are products which can be bought from medical suppliers or from pharmacies. If one of these is used for cleaning, follow the directions which come with the cleaner disinfectant. The vinegar and water mixture mentioned previously is an inexpensive, homemade disinfectant.
You will need either a turkey baster or a catheter tip syringe and alcohol pads. Choose a basin or bucket only for cleaning the drainage system. Do not use the basin or bucket for other things. Always clean it thoroughly first. If using the white vinegar solution, mix it after making sure the bucket is clean. An example of the solution would be 1 quart white vinegar mixed with three quarts water = one gallon of solution.
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Make sure the clean drainage system you are going to use is attached together (tubing, adapter, bag).
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Empty all urine from the system that is to be cleaned.
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Wash hands with soap and water.
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Hold catheter, indwelling or external with hand.
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Disconnect old system and place it where it cannot be soiled.
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Connect the clean or new system.
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Using the turkey baster or syringe or by holding tubing under the sink faucet, flush the used tubing and drainage system with water.
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Drain water and close the drainage spout. Fill the bag one half full with vinegar solution through the tubing with the baster or syringe.
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Close tubing cap. Soak for 30 minutes.
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Release air from bag or put in more solution to make sure that the inside surfaces that touch urine are cleansed by the solution.
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Pour out vinegar solution. Rinse the entire system with tap water and drain.
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Hang system to dry with all caps and end open.
Instructions for care and cleaning of reusable drainage systems used with external or condom catheters are the same for reusable drainage systems that attach to indwelling catheters.
