Urinary Catheter Care in the Home

CPDTime.
4m

Published: 17 June 2021

This article will provide a refresher on how to monitor, empty and change drainage bags for a client with a urinary catheter in-situ.

For information related to the catheterisation procedure, read: Caring For a Urinary Catheter.

Catheter Monitoring and Routine Care

As part of routine care, you should ensure that:

  • There are no kinks or loops in the drainage bag tubing and the urine is being continuously drained
  • Both the catheter and draining device are connected securely
  • The drainage bag is being supported by a stand or hook so that the outlet and tubing are kept off the floor
  • The drainage bag is below bladder level at all times, including during transportation and ambulating
  • The catheter is attached to the client with a securing device
  • The drainage device is closed unless it is being emptied.

(NSW Health 2015; Ausmed 2020)

How to Empty the Catheter Drainage Bag

Drainage bags should be emptied when ¾ full and before any client transportation (NSW Health 2015).

  1. Document the amount of urine that is in the bag
  2. Perform hand hygiene
  3. Don apron or gown and eye protection
  4. Don non-sterile gloves
  5. Put the drainage bag over the device in which the draining will occur (clean receptacle or toilet)
  6. Open the port at the bottom of the drainage bag
  7. Empty the bag into the toilet or clean receptacle (do not allow the drainage port to touch the toilet rim or receptacle)
  8. After the drainage bag has been emptied, dry the drainage port with a clean tissue or toilet paper
  9. Close the drainage port and clean it with an alcohol wipe
  10. If using a receptacle, wash and dry it thoroughly
  11. Perform hand hygiene.

(NSW Health 2015; NHS Borders 2016)

When to Change the Catheter Drainage Bag

The drainage bag should only be changed:

  • At least every seven days as a general rule (note that changing the drainage bag too frequently can increase the risk of infection)
  • In accordance with the manufacturer’s instructions
  • If the drainage bag becomes disconnected from the catheter
  • If the drainage bag tube is blocked due to a build-up of sediment
  • If the drainage bag fails.

(NSW Health 2015)

catheter care home urine drainage bag
The drainage bag should be changed at least every seven days as a general rule.

How to Change the Catheter Drainage Bag

Remember to always use aseptic technique when changing a drainage bag (NSW Health 2015).

  1. Explain the procedure to the client and obtain their consent
  2. Ensure the client’s privacy is protected
  3. Perform hand hygiene
  4. Gather and assemble the new drainage bag and alcohol wipes
  5. Don an apron or gown and eye protection
  6. Perform hand hygiene
  7. Don non-sterile gloves
  8. Put a protective sheet under the area where the catheter connects to the drainage bag
  9. Clamp the catheter with an appropriate device that is safe for catheter tubing in order to prevent urine from leaking out
  10. Thoroughly clean the area where the catheter lumen and drainage bag connect using an alcohol wipe
  11. Allow this to dry before disconnecting
  12. Gently disconnect the catheter from the securing device
  13. Remove the used drainage bag. Place it into a clean receptacle
  14. Remove the plastic cover from the tip of the new drainage bag
  15. Immediately secure the new drainage bag to the drainage port on the catheter
  16. Do not touch the part of the drainage bag that is being inserted into the catheter. (Note: you should always bring the bag to the catheter. Never bring the catheter to the bag)
  17. Secure the new drainage bag to the patient’s leg
  18. Measure the amount of urine in the old drainage bag prior to emptying
  19. Empty the urine from the old drainage bag into the toilet
  20. Place the old drainage bag into a plastic bag and secure it
  21. Place the old drainage bag into the appropriate bin for bodily fluids (follow your organisation's policies and procedures)
  22. Remove non-sterile gloves and perform hand hygiene
  23. Remove other PPE and perform hand hygiene
  24. Document the drainage bag change and volume of urine that was in the old drainage bag.

(NSW Health 2015; Healthy WA 2014; Sunshine Coast University Hospital 2017)

When to Escalate Care

The following signs and symptoms may indicate a deterioration in the client’s health or a problem with the catheter and require immediate escalation of care to an appropriately qualified medical practitioner:

  • Bladder cramps
  • Cloudy, bloody, discoloured or unpleasant-smelling urine
  • Fever, chills, shaking or generally feeling unwell
  • Nausea or vomiting
  • Pain in the bladder, pelvis, lower back or flank
  • Irritation, swelling, redness or tenderness around the insertion site
  • Lack of drainage from the catheter
  • Leaking around the catheter
  • Dislodgement of the catheter.

(Sunshine Coast University Hospital 2017; B&B 2016)

Catheter Troubleshooting

If there is no drainage from the catheter:

  • Check whether the catheter tubing is bent or kinked
  • Ensure the drainage bag is below the client’s bladder level
  • Check whether there is any sediment blocking the tubing
  • Check whether the client has been drinking enough
  • Ask the client to try moving around to see if it dislodges the blockage
  • Contact an appropriately qualified medical practitioner if no urine has been passed after four hours.

(Sunshine Coast University Hospital 2017)

catheter care home tubing
Check whether the catheter tubing is bent or kinked.

Infection Control

It is crucial to ensure proper infection control when attending to a urinary catheter:

  • In order to uphold aseptic technique principles:
    • Make sure the client’s body is clean
    • Use sterile equipment
  • Always perform hand hygiene before and after attending to a catheter or performing catheter care
  • Never lay a drainage bag on the floor while in use, as this increases the risk of infection
  • Use separate receptacles for different clients
  • The drainage port should never make contact with the receptacle or the toilet
  • Ensure you change the drainage bag if it is discoloured, smells unpleasant, contains sediment or is damaged. Notify the medical team of these observations prior to changing the bag
  • Note that changing the drainage bag too frequently will break the sterile system and increase the risk of infection
  • Ensure drainage bags are changed at least every seven days
  • Never reuse, wash or reconnect drainage bags
  • Never add antiseptic or antimicrobial solutions to drainage bags
  • Ask for help if needed.

(RCN 2019; Sunshine Coast University Hospital 2017)

Waste Management

Always dispose of waste, including used drainage bags, according to local policies and procedures (NSW Health 2015).

Note: This article is intended as a guide only for non-clinical staff providing catheter care to home care clients and should not replace best-practice care. Always refer first to your organisation's policies and procedures on urinary catheter care, monitoring and drainage bag changes.


References

Test Your Knowledge

(Subscribers Only)

Question 1 of 3

At what volume should urine drainage bags be emptied?

Start an Ausmed Subscription to unlock this feature!

Author