Changing a Suprapubic Catheter

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Infection Prevention and Control

Changing a suprapubic catheter

Infection Prevention and Control Changing a suprapubic catheter Purpose To ensure all relevant staff are aware of the principles of changing a suprapubic catheter 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 changing of suprapubic catheters.

Guidance A suprapubic cystostomy or suprapubic catheter is a surgically created connection between the urinary bladder and the skin which is used to drain urine from the bladder in individuals with obstruction of normal urinary flow

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The insertion of the first suprapubic catheter is usually performed in hospital by a urology specialist. In some areas the first change is also performed by the specialist; thereafter the catheter is usually changed by a person who has received specific training in this procedure and is competent to carry it out

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Only trained and competent staff can change a supra pubic catheter using an aseptic non touch technique

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Frequency of change of a supra pubic catheter will depend on the make of the catheter. Follow manufacturer’s recommendations

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Never remove a suprapubic catheter unless it is going to be changed immediately or removed permanently (Rigby, 2009)

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Prior to changing the suprapubic catheter ensure you are aware of how to contact other healthcare professionals should any difficulties arise during the procedure

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The size of catheter used should be no smaller than 16Ch in adults with a 10ml balloon, unless otherwise specified (and documented) by an appropriate specialist. A larger Charriere size may be used if the catheter persistently blocks. Check care plan and service user notes for record of persistent blocking or ongoing problems

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Gain consent from the service user to carry out procedure and document this in service users’ notes

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Client Name Start Date: 00/00/0000 End Date: 11/11/1111 1 of 6 - Changing a suprapubic catheter

Rationale

If not using a pre-connect system, connect a catheter valve or an appropriate drainage bag; once urine starts to flow, ensure this is below the level of the bladder;

To ensure unrestricted flow of urine into a closed system

Affix urinary catheter fixation device; Attach the drainage bag if using a leg bag to the leg, using straps, night bag or a catheter valve.

To prevent catheter “drag” which can result in trauma to suprapubic site and bladder

A small sterile keyhole dressing can be applied around the supra‐pubic opening

To absorb any exudate

Make the service user comfortable and ensure the area is dry

To promote comfort for the service user; if the area is left wet or moist, particularly with bodily fluids, secondary infection and skin irritation may occur

Dispose of used equipment into correct waste stream and clean trolley or tray

To prevent environmental contamination and ensure appropriate disposal

Perform effective hand hygiene by washing hands with soap and water or using hand sanitizer if hands are visibly clean

To reduce the risk of infection

Where required collect and send a urine sample for investigation

To detect presence of bacteria

Explain to the service user the importance of maintaining cleanliness around the suprapubic site by maintaining a clean dressing and avoiding touching or pulling the catheter or dressing

To reduce the risk of infection and trauma

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Action

Client Name Start Date: 00/00/0000 End Date: 11/11/1111 5 of 6 - Changing a suprapubic catheter

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