The transition from a large-volume overnight catheter drainage bag to a smaller, more discreet leg bag is a routine procedure for individuals managing an indwelling urinary catheter. This switch allows for greater mobility and discretion during the day, as the leg bag secures to the thigh or calf and can be concealed beneath clothing. The fundamental goal is to maintain a sterile, or “closed,” drainage system to prevent the entry of bacteria into the urinary tract, the primary cause of catheter-associated urinary tract infections (CAUTIs). Performing the change correctly minimizes the risk of contamination at the connection point, allowing the user to safely and confidently resume daily activities.
Gathering Supplies and Preparing the Area
Before beginning the change, all necessary supplies must be gathered and the workspace prepared to ensure a smooth, contamination-free transition. You will need a new or thoroughly cleaned leg bag equipped with its securing straps, clean disposable gloves, and several antiseptic wipes, typically 70% alcohol pads. A clean towel or disposable pad should also be ready to place under the connection point, and a container may be needed for measuring and disposing of the old bag’s contents.
Begin the process by washing your hands thoroughly with soap and water for at least 20 seconds, and then don the clean gloves. Clear a clean, flat surface to work on, ensuring the new leg bag’s connector remains protected from any surface contact. Position the person comfortably, or find a stable place to work if self-caring, ensuring the catheter tubing is easily accessible without being pulled or strained.
Step-by-Step Instructions for Switching the Bag
The first physical step is to interrupt the flow of urine to prevent leakage during the disconnection. Locate the soft catheter tube just above the junction with the overnight bag and pinch it closed firmly between your fingers, or use a catheter clamp if one is available. With the catheter securely pinched, empty any remaining urine from the larger drainage bag into the toilet or a measuring container, taking care not to touch the drain spout to any surface.
Next, grasp the connection point where the catheter meets the drainage tube and use a gentle twisting motion to separate the old bag from the catheter. Immediately place the disconnected overnight bag onto the clean towel to keep its connector tip from touching anything. Maintain the pinch on the catheter tube to keep the system closed while you prepare the new leg bag.
Take one of the antiseptic wipes and clean the external tip of the catheter tube, wiping away from the opening to push any surface bacteria away from the inner channel. The new leg bag comes with a protective cap, which should be removed and saved for later use when switching back to the night bag. Without letting the new tip touch anything, firmly insert it into the cleaned opening of the catheter tube with a gentle twisting motion until the connection is secure.
Once the new bag is connected, release the pinch or remove the clamp from the catheter tube, immediately restoring the urine flow to the leg bag. Finally, secure the leg bag to the thigh or calf using the provided straps, ensuring the straps are snug but not so tight as to restrict circulation.
Preventing Infection and Recognizing Complications
Maintaining a closed system is the most effective way to prevent a catheter-associated urinary tract infection (CAUTI). The leg bag must always be kept positioned below the level of the bladder to prevent urine backflow, and the tubing should be free of kinks or loops that could impede drainage. The leg bag should be emptied regularly, typically when it is about two-thirds full, to prevent tension on the catheter and reduce the chance of reflux.
Ongoing vigilance for signs of infection or mechanical issues is necessary. A fever above 100.4°F (38°C) or the presence of chills may indicate a systemic infection. Other localized warning signs include cloudy urine, urine with a foul or strong odor, or visible blood (hematuria).
Severe lower abdominal or flank pain (pain in the back just under the ribs), or the sudden onset of bladder spasms are serious symptoms that require prompt medical evaluation. Any persistent leakage around the catheter insertion site or an inability to resolve a blockage in the tubing warrants immediate contact with a healthcare provider.