Catheter extension tubing is a specialized, flexible tube used to increase the distance between an indwelling urinary catheter and its collection bag. The tubing’s primary purpose is to enhance patient mobility, allowing greater freedom of movement during the day when connected to a leg bag. It also facilitates the connection to a larger, bedside drainage bag for overnight use, ensuring the collection system remains effective while sleeping. Using extension tubing correctly helps maintain a closed, sterile drainage system, which is paramount for minimizing the risk of infection.
Gathering Supplies and Hygiene Protocols
The process of changing catheter extension tubing begins with careful preparation to ensure a sterile environment. Before touching any part of the catheter system, gather all necessary items, including the new, sterile extension tubing, clean gloves, and antiseptic wipes or a 70% alcohol swab. Confirm that the new extension tubing is compatible with the existing catheter and drainage bag connectors to prevent leaks or blockages. Always inspect the new tubing for any visible defects or compromised packaging before opening.
Thorough hand hygiene is the foundational step in preventing contamination. Wash hands completely with soap and water for a minimum of 20 seconds, taking care to clean between the fingers and under the fingernails. This action significantly reduces the transfer of microorganisms. Don clean, non-sterile gloves after handwashing, and establish a clean, well-lit workspace free from clutter.
Connecting the Extension Tubing
Once the workspace is prepared, drain any remaining urine from the existing catheter tubing and collection bag to prevent spillage during the change. To temporarily stop the flow of urine, gently pinch or clamp the catheter tubing just above the existing connection point. This prevents urine from leaking back onto the connection site, which would compromise the cleanliness of the area.
Next, use an alcohol swab to clean the connection point where the catheter meets the current drainage tube, wiping from the catheter tip downward toward the bag. While maintaining the pinch on the catheter, use a twisting motion to gently disconnect the old drainage bag or tubing. It is important not to touch the exposed open ends of either the catheter or the new extension tubing, as this introduces the risk of bacterial contamination.
Carefully remove the protective cap from the new extension tubing, ensuring the tip remains untouched. Insert the tip of the new extension tubing into the catheter port using a gentle, firm twisting motion until the connection is secure and leak-proof. A tight fit is necessary to maintain a closed system and avoid accidental dislodgement. Once the connection is confirmed, release the pinch on the catheter tubing and check for immediate drainage into the new extension tube and bag.
Maintaining Flow and Preventing Complications
After the new tubing is connected, maintaining a clear and continuous flow of urine is necessary for effective drainage and patient health. The collection bag must always be positioned below the level of the bladder, whether the patient is sitting, standing, or lying down. This principle relies on gravity to ensure urine flows out of the bladder and prevents backflow, which could introduce bacteria into the urinary tract.
Regularly check the entire length of the extension tubing for any kinks, twists, or sharp bends that could obstruct the flow. Blockages can lead to a buildup of urine, causing discomfort or potentially contributing to infection. If drainage stops, gently move the tubing or reposition the patient to straighten any concealed kinks.
The tubing must be secured to the body, typically with a specialized securement device or tape, to prevent tension and accidental pulling on the catheter. Securement devices should allow a slight amount of slack between the catheter insertion site and the point of attachment, minimizing stress on the urethra. Secure placement prevents the catheter from being unintentionally dislodged, which is painful and requires immediate medical attention.
Monitor the drainage system and the patient for any signs of complications, which often manifest as changes in urine color, a strong odor, or sediment accumulation in the tube. Lack of drainage, even with adequate fluid intake, may suggest a blockage from debris or blood clots within the system. Patient symptoms such as localized pain, fever, or swelling around the catheter insertion site require prompt consultation with a healthcare provider, as these can indicate a developing infection.
Removing the Tubing and Cleaning
When the extension tubing is no longer needed, or when it is time for scheduled replacement, the removal process must be performed with the same attention to hygiene. Extension tubing is typically designed for single use and should be replaced every five to seven days, though healthcare provider instruction should always be followed. Begin by performing thorough hand hygiene and donning clean gloves, and pinch the catheter tubing above the connection point again.
Disconnect the extension tubing from the catheter using a smooth, twisting motion, taking care to avoid pulling on the catheter itself. Immediately clean the exposed catheter port with an alcohol swab to sanitize the connection point. If the drainage system is being reconnected to a different bag, attach the new bag’s tubing immediately and securely.
If the primary drainage bag is reusable, it should be thoroughly cleaned following the manufacturer’s instructions, often involving a solution of water and white vinegar to reduce bacterial load. Reusable bags must be emptied, rinsed with cold water, and allowed to air-dry completely before re-use. Dispose of the used extension tubing, gloves, and any soiled materials in a designated waste receptacle, followed by a final round of handwashing.