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This Procedure defines the arrangements for the promotion of the safe and hygienic care of service user catheterisation sites:


1. CONSIDERATIONS:


The aim of cleansing is to remove secretions and encrustations and prevent infection. Cleansing with soap and water has been found to be as effective as any other method.


Where possible, and to promote independence and enhance dignity, service users should be taught to manage their own meatal and perineal hygiene, thus reducing the risk of cross infection. Powders and lotions should not be used after cleansing as these trap organisms in the area. Perineal and meatal hygiene should be performed once daily unless there is excessive exudate or encrustations.


2. EQUIPMENT:


  • Disposable gloves

  • Soap

  • Warm water

  • Disposable washcloth

  • Clean towel


3. PROCEDURE:


3.1 Explain the procedure to the service user.


3.2 To ensure privacy close door, screen bed or draw curtains.


3.3 With the service user in a supine position with their knees and hips flexed and slightly apart, to allow easy access to the perineal area.


3.4 Wash and dry your hands, put on gloves and apron.

3.5 Female Service Users:


3.5.1 Wash the vulvar area with soap and water from above downwards using soap and water, to reduce risk of contamination, especially with E-Coli.


3.5.2 Cleanse the catheter by gently wiping in one direction away from the catheter-meatal junction. Ensure the cleansed area is rinsed well and dried.

3.6 Male Service Users:


3.6.1 Retract the foreskin before cleansing.


3.6.2 Cleanse the shaft of the catheter away from the catheter-meatal junction and rinse well.


3.6.3 Dry the area by patting with the towel.


3.6.4 Replace the foreskin on completion of cleansing.


3.6.5 Dispose of waste appropriately.


3.6.6 Remove gloves and apron and then help service user to rearrange clothing.


3.6.7 Wash and dry hands. Report and record any abnormal findings.




4. EMPTYING DRAINAGE BAGS:


It is common practice for night drainage bags to be attached to the outlet of a leg bag for several days before the leg bag is changed. This reduces the risk of introducing infection into the bladder.


4.1 Equipment:

  • Measuring jug and a paper towel to cover it

  • Tissue or alcohol-impregnated swab

  • Disposable Gloves

  • Disposable Apron

4.2 Procedure:


4.2.1 Explain the procedure to the service user, moving the service user to a place of privacy (e.g. a bathroom or their bedroom).


4.2.2 Wash and dry hands, put on gloves and apron.


4.2.3 Take the covered jug and other equipment to the service user.


4.2.4 Hold the bag over the jug making sure that the drainage port does not touch the jug.


4.2.5 Open the drainage port and allow the urine to flow into the jug. Close the drainage port.


4.2.6 Wipe the aperture with the swab or tissue to prevent dripping.


4.2.7 Reposition catheter bag as necessary, ensuring the drainage port is not touching the f floor and the tubing is not kinked.


4.2.8 Cover the jug and take it to the sluice or toilet. Measure the amount of urine and discard.


4.2.9 Clean the urine jug.


4.2.10 Remove gloves and apron, wash and dry hands.


4.2.11 Record amount of urine on a fluid balance chart, if appropriate.

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