The retention catheter and drainage system may be continued for days, weeks, or indefinitely.
As a general rule, the retention catheter is changed in accordance with the infection control standard operating procedure (SOP).
Daily, continuing care of the patient and the equipment includes the following essentials:
a. Maintain an accurate intake and output record. Unless otherwise ordered, encourage the patient to drink at least 3000 ml of fluids daily to provide an effective “internal irrigation” system for the bladder, catheter, and drainage tubing.
b. Observe the tubing and catheter connections frequently for kinks. Make sure the patient is not lying on the tubing since this both obstructs drainage and causes undue pressure on the skin.
c. Maintain cleanliness and protect the urethral meatus. This requires direct observation and specific hygiene measures. Wash the perineal area carefully, from front to back. Remove secretions of mucus and other discharge gently but thoroughly to help reduce irritation and possible infection. Follow infection control SOP for guidance on frequency of catheter care and choice of antiseptic/antimicrobial cleansers to be used.
d. Measure and record the collected output in accordance with (IAW) local SOP. Never permit the drainage bag to become more than three-fourths full in order to prevent any possibility of the tubing outlet becoming immersed in the draining urine.
e. Do not disconnect tubing from drainage bag.
f. Keep the collecting bag below the level of the bladder, but never allow it to touch the floor.
g. Provide continued gravity drainage for the ambulating patient. Check to see that the tubing is not excessively long or looped below the level of the bag when he is standing upright.
h. DO NOT separate connecting tube and catheter. Obtain a urine specimen without disrupting the closed system. A needle and syringe is used to aspirate urine from a special port on the collecting tubing.
i. Change the catheter as ordered or IAW local infection control policy. The order may be to remove the catheter and then to replace it following several hours interval to relieve pressure on the urethra. Remember:
(1) Always deflate the balloon of a self-retaining catheter before removal.
(2) Use aseptic techniques for any procedure involving the urethra and bladder. Each catheterization is a potential source of injury and infection if not performed properly.