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Catheter Care Policy

1. Purpose

At {{org_field_name}}, we are committed to delivering safe, effective, and person-centred catheter care to individuals requiring urinary catheterisation. This policy ensures that catheter care is provided in a dignified, hygienic, and clinically safe manner, reducing the risk of infection and promoting comfort and independence.

This policy is in line with CQC regulations, NICE Guidelines (CG139: Infection Prevention and Control of Catheter-Associated Urinary Tract Infections), The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and The Mental Capacity Act 2005.

2. Scope

This policy applies to all staff, including permanent, temporary, agency, and volunteer workers involved in catheter care within our Supported Living service. It covers all aspects of catheter insertion, maintenance, monitoring, infection control, and removal.

3. Related Policies

• SL12 – Safe Care and Treatment Policy
• SL16 – Infection Prevention and Control Policy
• SL07 – Person-Centred Care Policy
• SL08 – Dignity and Respect Policy
• SL34 – Confidentiality and Data Protection (GDPR) Policy
• SL21 – Medication Management and Administration Policy
• SL13 – Safeguarding Adults from Abuse and Improper Treatment Policy

4. Principles of Catheter Care

4.1 Person-Centred Approach

• Individuals must be fully informed about their catheter care and involved in decision-making wherever possible.
• Staff must respect privacy and dignity, ensuring catheter care is provided discreetly and sensitively.
• Support must be tailored to individual needs, promoting independence where possible, such as assisting individuals in self-care.

4.2 Assessment and Catheter Selection

• Catheterisation should only be undertaken when clinically necessary and after alternative solutions have been considered.
• The type and size of catheter (e.g., urethral, suprapubic, intermittent) must be prescribed by a healthcare professional.
• A catheter care plan must be developed in collaboration with healthcare professionals, the individual, and their family (where appropriate).
• The plan must detail:
  • The type and size of catheter
  • The reason for catheterisation
  • Expected duration of use
  • Signs and symptoms requiring medical intervention
  • Individual preferences and comfort measures

4.3 Infection Prevention and Control

• Strict hand hygiene must be followed before and after catheter care.
• Catheter care must be provided using aseptic non-touch techniques (ANTT) to minimise infection risks.
• Catheters must be securely positioned to prevent unnecessary movement, which could lead to trauma or infection.
• Daily monitoring for signs of infection (e.g., cloudy urine, fever, pain, or swelling) must be conducted.
• Catheter-associated urinary tract infections (CAUTIs) must be documented, and individuals must be referred for medical review if required.

4.4 Catheter Maintenance and Monitoring

• Daily Cleaning: The catheter and surrounding skin should be cleaned twice daily with warm water and mild soap. Avoid using antiseptic solutions unless prescribed.
• Fluids and Hydration: Encourage the individual to drink plenty of fluids (unless contraindicated) to maintain adequate urine flow and reduce infection risk.
• Checking for Kinks and Blockages: The catheter tubing should be checked frequently to ensure it is free from kinks, twisting, or pressure from clothing or furniture.
• Positioning and Securing the Catheter:
  • The catheter should be secured to the individual’s thigh or abdomen (for suprapubic catheters) to prevent movement and trauma.
  • Ensure the drainage bag is below bladder level to prevent backflow but does not touch the floor.
• Emptying the Drainage Bag:
  • The leg bag or bedside drainage bag should be emptied every 4-6 hours or when two-thirds full.
  • Use clean disposable gloves and empty the bag into a clean container to reduce contamination risk.
• Changing the Catheter Bag:
  • Leg bags should be changed every 7 days unless visibly soiled or damaged.
  • Night drainage bags should be changed daily.
• Monitoring Urine Output and Colour:
  • Check for cloudy, foul-smelling, or blood-tinged urine, which may indicate infection.
  • Document urine output to ensure adequate hydration and identify potential blockages.
• Checking for Leaks and Discomfort:
  • Observe for leakage around the catheter site, which may indicate a blockage or displacement.
  • If the individual experiences pain, burning, or bladder spasms, report it immediately for medical review.
• Dealing with Blockages:
  • If urine output is significantly reduced or stops, check for kinks, reposition the individual, and encourage fluid intake.
  • If the blockage persists, contact a healthcare professional immediately for catheter irrigation or replacement.
• Catheter Changes:
  • Indwelling catheters should be replaced as per the healthcare provider’s recommendation (typically every 4-12 weeks).
  • Only a trained healthcare professional should change the catheter to avoid complications.

4.5 Recognising and Managing Complications

• Staff must be able to recognise the following complications:
  • Blockages or reduced urine output
  • Signs of infection (e.g., fever, pain, blood in urine)
  • Leakage around the catheter site
  • Discomfort or pain during use
• If complications arise, staff must follow escalation procedures, including contacting the individual’s GP, district nurse, or emergency services if required.

4.6 Catheter Removal and Trial Without Catheter (TWOC)

• Catheters should be removed as soon as no longer clinically necessary.
• The Trial Without Catheter (TWOC) process must be followed under medical guidance, ensuring:
  • The individual is fully informed and supported.
  • Hydration levels are maintained to assess bladder function.
  • Urine output is monitored for 24-48 hours post-removal.
  • Any difficulties with urination are reported immediately for reassessment.

5. Staff Training and Competency

• Staff involved in catheter care must complete mandatory training in:
  • Infection prevention and control
  • Aseptic non-touch technique (ANTT)
  • Identifying and managing catheter-related complications
  • Supporting individuals in maintaining comfort and dignity
• Competency assessments must be conducted annually to ensure best practices are followed.
• Any staff member unsure about catheter care procedures must escalate concerns to senior staff or healthcare professionals.

6. Record-Keeping and Documentation

• All catheter-related interventions must be documented in the individual’s care plan and daily records.
• Records must include:
  • Date of catheter insertion, changes, and removal
  • Size and type of catheter used
  • Signs of infection or complications
  • Hydration levels and fluid intake monitoring

7. Confidentiality and Data Protection

• All catheter care records and medical information must be stored securely and accessed only by authorised personnel.

8. Policy Review

This policy will be reviewed annually or sooner if required due to:

• Changes in legislation or CQC regulations.
• Updates in clinical guidelines.
• Feedback from staff, individuals receiving care, or healthcare professionals.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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