Catheters are flexible tubes inserted into the body to drain and collect fluids; the most common type used in home care is the indwelling urinary catheter, often called a Foley. This device drains urine from the bladder into an external drainage bag. Because the catheter creates a direct pathway into the body’s sterile urinary tract, proper hygiene is paramount. Maintaining a strict cleaning routine is the primary method of preventing a Catheter-Associated Urinary Tract Infection (CAUTI).
Daily Care of the Catheter Insertion Site
The immediate area where the catheter enters the body, known as the meatus, requires meticulous daily attention. This prevents bacteria from migrating up the tube and into the bladder. Routine care requires a clean washcloth, mild soap, and clean water. Cleaning should be performed at least once daily, and more frequently if the area becomes soiled, such as after a bowel movement.
Begin by washing your hands thoroughly with soap and water before touching the catheter system. Apply a small amount of mild soap to the washcloth and gently clean the skin around the insertion site. For women, separate the labia; for uncircumcised men, retract the foreskin. The cleaning motion should always be directed away from the body, moving down the tube for a few inches to push microbes away from the urethra.
After cleaning the meatus and the initial section of the tube, rinse the area well with clean water to remove all soap residue. Pat the skin and catheter dry with a separate, clean towel. Do not apply powders, lotions, or creams directly to the insertion site, as these can trap moisture and encourage bacterial growth. Finally, the catheter must be secured to the body, typically the thigh, using tape or a specialized securement device.
Securing the catheter prevents accidental pulling or tension on the tube, which can cause trauma to the urethra or bladder neck. Ensure there is enough slack in the tubing to allow for normal movement without tugging on the insertion site. This minimizes movement-related irritation and helps maintain the integrity of the closed drainage system.
Step-by-Step Procedure for Cleaning the Tubing
Cleaning the length of the catheter tubing is a separate and important step in the daily hygiene routine. This procedure focuses on the tube running from the insertion point down to the connection with the drainage bag. The process begins with a careful hand wash using soap and warm water.
Prepare a basin of warm water mixed with a mild, non-irritating soap. Hold the catheter tube steady where it exits the body to avoid painful tugging or movement. Using a clean, soapy washcloth, begin wiping the tube immediately below the insertion site.
The wiping motion must be consistent, moving in one direction away from the body and toward the drainage bag connector. This directional cleaning physically moves bacteria and debris away from the urethral opening. Clean approximately three to four inches of the tubing’s length.
After cleaning with the soapy washcloth, use a new, clean washcloth dampened with plain water to rinse the soap completely from the tubing. Air-dry the tube or gently pat it dry with a clean towel. Avoid routinely disconnecting the catheter from the drainage bag, as this introduces a break in the closed system and significantly increases the chance of microbial entry.
Cleaning and Disinfecting the Drainage Bag
The drainage bag requires regular cleaning and disinfection to prevent the buildup of bacteria and biofilm, which can back-migrate up the tubing. The bag is typically emptied when it is two-thirds full or every eight hours. Thorough cleaning and disinfection should be performed on a rotating schedule, such as when switching between a leg bag and a night bag, or about once or twice a week.
First, empty the bag completely into a toilet or measuring container. Take care to prevent the drain spout from touching anything, including the floor or the container rim. After emptying, wash your hands and rinse the inside of the bag with cool water to flush out any remaining urine. Avoid hot water, as it can damage the plastic material of the bag.
To disinfect the bag, use a common and effective solution: a mixture of white vinegar and water (one part vinegar to two parts water). Alternatively, use a mild bleach solution (one tablespoon of bleach per quart of water). Pour enough of the chosen solution into the bag to fill it about halfway. Swish the solution around to ensure the entire inner surface and connector tubing are coated.
Allow the disinfection solution to sit inside the bag for 15 to 30 minutes before draining it completely. A thorough rinse with cool, clean water is necessary to remove all traces of the disinfectant, as residual cleaning agents can irritate the urinary tract. Hang the bag to air dry with the drainage spout open and pointing down. Ensure the bag is completely dry before its next use to prevent the growth of mold or mildew.
Signs That Require Medical Attention
While diligent hygiene helps mitigate risk, it is important to recognize signs that indicate a complication, such as a Catheter-Associated Urinary Tract Infection. This requires prompt medical evaluation. A sudden increase in body temperature, specifically a fever of 100.4°F (38°C) or higher, or the onset of chills, are significant indicators of a systemic infection.
Observe the urine itself for changes in clarity, color, or odor. Urine that appears cloudy, contains blood, or has an unusually strong, foul smell suggests a possible infection requiring clinical assessment. Other localized symptoms include pain or tenderness in the lower abdomen or bladder area. Bladder spasms, which are involuntary and often painful contractions, also require attention.
Look for signs of irritation or infection at the insertion site, such as new or worsening redness, swelling, or localized pain. Leakage of urine around the catheter, rather than through the tube, may indicate a blockage or bladder spasm. If the catheter stops draining urine completely, or if the catheter tube accidentally falls out, seek professional medical help immediately.