[JellyBean1]

I was always taught that maintaining a sterile environment and a closed drainage system is crucial in catheter care. If a resident switches between a leg bag and reg. drainage bag in the day it is routine at our facility that the larger drainage bag is washed and rinsed with vinegar or......any other cleanser available in the service room. This goes against everything I've ever been taught. The bag is taken to a service room and stays there through the day to drain. What about the sterility of the system, back flow of unrinsed cleansers? It's not sterile anymore. You'd think with the stronger bacteria around these days that this would be frowned upon. Maybe I"m old fashioned but to me this is something best not tampered with. Can anyone offer thoughts on this?

[joprasklpn]

We did this at all the LTC places I worked. We cleaned the ends with alcohol preps and rinsed the bags and left them to air dry usually in the patients bathroom. Maybe it is because the caths were in long term and had more risk of infection just from being in for long periods of time with the possibility of germs getting in that way. We never used cleansers beside soap and water so I don't know about back flow. We did not seem to have alot of infection related to this practice, but it does seem germy.

[siggie13]

Ahhh, cath care. In my 40 years of nursing, I have seen changes in the procedure and the thinking concerning catheter insertion and catheter care. Our body does a marvelous job of keeping bacteria away from the kidneys and the main cause of kidney infections when it comes to catheters is urine backflow. As long as the urine keeps moving out of the catheter then you are okay. The current thinking about cath care is that it is a CLEAN procedure and handling of the drainage bag need only be clean, not sterile. Even placing the catheter in the bladder is now considered a clean as possible procedure, done with sterile equipment. I teach people to self cath with catheters that are only washed with soap and water after use. When you stop and think about it, how many of our sterile procedures are really sterile? Our bodies are very efficient factories that can maintain a balance between good and bad bacteria. Remember, washing hands is still the best way to stop the spread of infection.

[Valerie Salva]

The distal end of the cath is sterile. At least it is when the cath is first placed. The connecting ends of both the leg bag and night bag are also sterile, when first opened.

Theoretically, "sterile on sterile = sterile." So, as long as the distal end of the catheter and the connecting ends of the bag never touch anything besides each other, and sterile catheter bag caps, the system remains sterile.

Urine in the bladder is considered sterile. If it flows through a steril tube into a sterile bag and backflows into the steril bladder, it supposedly remains sterile.

This is the theory, anyway.

[evilnightwitch]

Catheter placement IS A STERILE procedure, even if your patient is 500 pounds and has mobility issues the initial prcedure can and should always be done as a sterile procedure. Cleaning and rinsing bags is very important when switching between leg bag and large drainage bags beleive it or not as long as the integrity of the system is kept clean between catheter changes your patient still maintains the similiar environment as if they did not require a catheter. Cleaning the vagina and the penis very well with very mild soap and good clean rinses will prevent infection from long term catheter placement, again emptyinh the bag frequently and keeping the tubing draining well maintains the system.