Nephrostomy Tube Care Policy

Nephrostomy Tube Care Policy 

Purpose: 

• To maintain an unobstructed flow of urine. 

• To prevent and detect early complications. 

• To maintain skin integrity. 

Policy: 

• A physician's order is required for the nephrostomy tube and its care. 

• The licensed nurse is responsible for the overall care of the nephrostomy tube. 

Definition: A nephrostomy tube is a temporary or permanent catheter placed directly into the renal pelvis to decompress the renal system. This procedure is performed by a physician. 

Procedure: 

I. Monitoring: 

• Every Shift: 

• Check the tubing for kinks. 

• Ensure the collection bag is kept below the kidney level. 

• Label the drainage bag with the date it was changed. 

• Record the characteristics and amount of drainage, including the description of the urine. 

• Notify the Physician if any of the Following Occur: 

• Bright red drainage. 

• Scanty discharge. 

• Foul-smelling urine, fever, chills, or flank pain. 

• If the tube becomes dislodged. 

• Ensure the tubing is anchored to the skin with tape to avoid strain at the insertion site. 

• The drainage bag should be emptied every shift (unless otherwise ordered by the physician), and the output recorded if the resident is on intake and output (I&O). 

II. Dressing Change: 

• Perform dressing changes as per the physician’s order. 

III. Documentation: 

• Record dressing changes, I&O, and any adverse findings. 

• Update the resident’s care plan as indicated. 

References: 

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

• State Operations Manual (SOM), CMS.