Urinary Catheter Change

Urinary Catheter Change Policy 

Purpose 

To ensure the proper management and timely change of urinary catheters and drainage bags to prevent infections and maintain a closed drainage system, following current CMS guidelines and State Operations Manual (SOM) requirements for long-term care facilities. 

Policy 

Urinary catheters are changed only as needed unless otherwise ordered by the physician. Urinary catheters should be changed when a urinary tract infection is suspected or if contamination is suspected. A urine sample for culture and sensitivity should be obtained from the new catheter once it is inserted. 

Urinary drainage bags will be changed when the urinary catheter is changed or as needed due to accumulation of sediment, discoloration of the bag, odor, or leakage. When the bag is replaced, care should be taken to prevent contamination of the closed system. Leg bags will be disposed of daily. 

Every effort will be made to minimize unnecessary opening of the closed system. When it is necessary to disconnect tubing, it will be done carefully to prevent contamination. 

Procedure 

I. Indications for Catheter Change: 

• Change the urinary catheter as needed based on clinical indications, such as: 

• Suspected urinary tract infection (UTI) 

• Suspected contamination of the catheter 

II. Preparation: 

• Explain the procedure to the resident and provide privacy. 

• Assemble necessary equipment: 

• Sterile catheter insertion set 

• Appropriate size sterile indwelling catheter 

• Sterile water for balloon inflation 

• Sterile gloves 

• Sterile drainage bag (if needed) 

III. Changing the Catheter: 

1. Hand Hygiene and PPE: 

• Perform hand hygiene. 

• Don sterile gloves. 

2. Removal of Old Catheter: 

• Deflate the balloon of the old catheter and gently remove it. 

• Dispose of the old catheter in an appropriate biohazard container. 

3. Insertion of New Catheter: 

• Clean the periurethral area with antiseptic solution. 

• Lubricate and insert the new catheter using sterile technique. 

• Inflate the balloon with the appropriate amount of sterile water. 

• Attach the new drainage bag to the catheter, ensuring a closed system. 

4. Sample Collection: 

• Obtain a urine sample for culture and sensitivity from the newly inserted catheter if required. 

5. Securing the Catheter: 

• Secure the catheter to the resident’s body to prevent traction and trauma. 

6. Documentation: 

• Document the catheter change, including: 

• Date and time of the procedure 

• Reason for catheter change 

• Catheter size and type 

• Resident's response to the procedure 

• Condition of the urine and any other relevant observations 

IV. Drainage Bag Management: 

7. Change Drainage Bags: 

• Change the urinary drainage bag when the catheter is changed or as needed due to sediment, discoloration, odor, or leakage. 

8. Prevent Contamination: 

• Use aseptic technique to prevent contamination when disconnecting and reconnecting tubing. 

9. Leg Bags: 

• Dispose of leg bags daily. 

V. Infection Control: 

• Maintain a closed urinary drainage system whenever possible. 

• Minimize unnecessary openings of the system. 

• Use sterile technique when disconnecting and reconnecting tubing. 

Documentation 

• Record all catheter changes in the resident's medical record, including: 

• Date and time 

• Reason for change 

• Catheter size and type 

• Resident's response 

• Condition of urine and any other relevant observations 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.