11 maintenance solutions final

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Infection Prevention and Control

Procedure for the administra1on of catheter maintenance solu1ons

1 of 6 - Infection Prevention and Control Procedure for the administration of catheter maintenance solutions

Infection Prevention and Control Procedure for the administra1on of catheter maintenance solu1ons Purpose To ensure all relevant staff are aware of the principles of administration of catheter maintenance solutions 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 administration of catheter maintenance solutions.

Guidance • • •

• •

Routine use of catheter maintenance solutions should be avoided due to the risk of damage to the epithelial lining of the bladder and risk of infection from disrupting the closed drainage system Catheter maintenance solutions are sterile fluids which are introduced in to the bladder and can be left there for variable periods of time in order to dissolve encrustations, alter bladder pH or suppress bacterial growth There is a difference between bladder irrigation and bladder instillation. Bladder irrigation is carried out within a hospital setting and is a continual flushing of the urinary bladder which normally follows urological surgery; whilst bladder instillation is the instilling of a solution into the bladder and enabling it to either immediately drain or leaving it in the bladder for a period of time Catheter maintenance solutions must be prescribed and discontinued if not successful All catheter maintenance solutions should be given aseptically NOTE: Epic 3 Guidance (2013) recommend that bladder maintenance systems are not used to prevent catheter associated infections

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2 of 6 - Infection Prevention and Control Procedure for the administration of catheter maintenance solutions

Infection Prevention and Control Procedure for the administra1on of catheter maintenance solu1ons Types of solu1ons Solution

Product Licence

Practice Notes/Cautions

Citric acid 3.23% Solution G (pH 4)

To prevent or dissolve crystals which form on the catheter tip under alkaline conditions (pH 7.5-9.5)

Charting of urinary pH over time will allow development of an individual catheter care plan

Citric acid 6% Solution R (pH 2)

Stronger citric acid solution for more persistent crystallisation

Strongly acidic – potential mucosal irritation

Sodium chloride 0.9%

For the washing of debris (blood, mucus, pus) from the catheter

Will not dissolve crystal formation

Equipment • • • • •

disposable plastic apron new drainage bag prescribed maintenance solution single use non sterile disposable gloves sterile dressing pack containing sterile gloves

Procedure Method

Rationale

Explain and discuss the procedure with the service user verbally and obtain their informed consent

To ensure that the service user understands the procedure • Check service users identity • Check any known allergies • Check valid consent

Ensure privacy within the environment where care is being delivered

To maintain service users dignity and privacy

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3 of 6 - Infection Prevention and Control Procedure for the administration of catheter maintenance solutions

Infection Prevention and Control Procedure for the administra1on of catheter maintenance solu1ons Make the service user comfortable in To aid comfort and accessibility a semi prone position Perform effective hand hygiene by washing hands with soap and water or using hand sanitizer if hands are visibly clean prior to putting on a single use plastic apron and nonsterile gloves

To reduce the risk of infection

Empty drainage bag; remove leg bag To aid accessibility to the catheter and straps and position leg bag beside drainage system service user Remove gloves and apron; Decontaminate hands as above

Reduce the risk of transfer of transient organisms

Check catheter solution has been maintained at room temperature

To prevent the bladder going into spasm if the solution is too cold

Prepare maintenance solution as per Manufacturer’s guidance, check expiry date and cross check against prescription chart to ensure the correct solution is administered

To reduce risk of medication error

Open dressing pack, decontaminate hands and put on a single use plastic Maintain aseptic non touch technique for apron and sterile single use gloves procedure from dressing pack; Place sterile sheet under junction of catheter and drainage bag Disconnect the drainage bag (or valve), attach catheter maintenance solution and instil in accordance with the manufacturer’s instruction;

Correct instillation of solution

Do not force solution into bladder Allow gravity to aide instillation

Prevention of trauma to bladder

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4 of 6 - Infection Prevention and Control Procedure for the administration of catheter maintenance solutions

Infection Prevention and Control Procedure for the administra1on of catheter maintenance solu1ons If the fluid is to be retained for a period of time, close the clip, and place the bag on the bed; ensure that the service user is warm and comfortable for the required time When the solution is to be removed, ensure the bag is below the level of the bladder, open the clip and allow the solution to drain back into bag

Disconnect the solution bag and connect a new sterile urinary drainage bag/valve

Ensure comfort Promote service users dignity

Allow gravity to aid drainage

To maintain closed circuit system and reduce risk of infection

Dispose of waste as per local waste To prevent environmental contamination, policy; remove gloves and apron and and cross contamination risk decontaminate hands Make the service user comfortable

To maintain dignity and comfort

Record all information including any untoward events or complications, To maintain accurate records and the catheter maintenance solution accountability name, amount, solution strength, expiry date, batch / lot number

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5 of 6 - Infection Prevention and Control Procedure for the administration of catheter maintenance solutions

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Infection Prevention and Control Gordon House, Station Road
 Mill Hill, London NW2 2JU

6 of 6 - Infection Prevention and Control Procedure for the

Telephone 020 8906 2777 Fax: 020 8906 2233
 administration of catheter maintenance solutions www.infectionpreventionsolutions.co.uk