Minimizing bacteria at entry points

Policies and Procedures on Infection Control Ministry of Health Malaysia 44 The urinary tract is one of the most common site of infection. Most urinary tract infection is following instrumentation of urinary tract, mainly urinary catheterization. One of the most impor- tant infection control measures is to limit the use of urinary catheterization to carefully selected patients. However, if there is a need to perform urinary catheterization, sterile procedure must be observed. Urinary catheters may be use as a short term measure or long term as in indwelling catheter. The following are general principle of urinary catheter insertion to reduce the infection of urinary tract.

4.2.1 General principles of urinary catheter insertion 1.

Personnel Only personnel trained on the correct technique of insertion can perform aseptic catheter insertion. Hospital personnel and others who take care of catheters should be given periodic in-service training stressing the correct technique of insertion, care and potential complications of urinary catheterization.

2. Catheter use

Urinary catheter should be inserted only when necessary and left in place only when as long as necessary. For selected patients other method of urinary drainage such as condom catheter drainage, suprapubic catheterization and intermittent urethral catheterization, can be useful alternatives to indwelling urethral catheterization.

3. Hand hygiene

Hand hygiene should be practice before and after any manipulation of the catheter site or apparatus.

4. Catheter insertion

Catheter should be inserted using aseptic technique and sterile equipments glove, drape, sponges, an appropriate antiseptic solution for peri-urethral cleaning, a single used packet of lubricant jelly should be use for insertion. Non-touch technique should be practice. Use as small a catheter as possible, consistent with good drainage should be use to minimized urethral trauma. Indwelling catheter should be properly secured after insertion to prevent movement and urethral traction. Use of silicone type catheter may be considered in long term indwelling catheter. After insertion the date of insertion should be documented.

5. Close sterile drainage

A sterile continuously closed drainage system should be maintained. The catheter and drainage tube should not be disconnected unless the catheter must be irrigated. If breaks occur in aseptic technique, disconnection, of leakage occur, the collecting system should be replaced using aseptic technique after disinfecting the catheter tubing junction.

4.2 Urinary Catheter Care