What is your catheter change policy?

[Stace NYRN]

Hi everyone,

The LTC facility I work for is readdressing their catheter change policy. Currently they change resident catheter bags daily; the leg bag is attached in the am and the overnight bag is put on at night. The CNA's generally do this.

The facility is currently having an increase in ESBL UTI's and is trying to look at possible causes for this starting with catheter and bladder scan competency testing as well as looking into how the catheter bags are stored over night.

They currently remove the bag in the BR and hang it in there with an alcohol swab used as a cap. They are left out overnight or throughout the day in the BR, without being rinsed/cleaned out.

They alcohol swab the ports with each change.

For all you in LTC,

1. What is your policy/procedure regarding this issue?

2. I feel by not rinsing the bags that allows bacteria to travel up the tube and regardless of swabbing the ports can be a risk for infection. Administration looked at me funny when I suggested this. What are your thoughts?

3. What would be a good way to store the bags in a sanitary manner? Some say bottom of closet, some say emesis basin, some say in their drawer. Any ideas?

4. Also, I'm concerned that CNA's may not care as much as nurses when changing bags and that they could be unsanitary when completing the procedure and when taking care of the unused bags. Any thoughts?

Thank you all!!

StaceNYRN

[Tenebrae, BSN, RN]

What we do

1. Night bags are changed daily. We put on a new night bag every night

2. As for CNA's changing bags, if they are reusing a bag that has been sitting around unchanged and unrinsed from the previous night, skill is not an issue, those bags are a breeding ground for bacteria

3. we have very few infections in our patients with long term catheters

[JKL33]

4. Also, I'm concerned that CNA's may not care as much as nurses when changing bags and that they could be unsanitary when completing the procedure and when taking care of the unused bags. Any thoughts?

If something to do with the CNAs is a factor I certainly wouldn't introduce it in this manner. There is a high likelihood that the facility's own policies, the instruction of the CNAs, and the patient care load all come into play at least as much as how much the CNAs "care."

[Stace NYRN]

Thank you! No my concern with CNAs is my personal experience with aides that are trying to do their job too quickly and may skip steps without in depth background infection control education. I don't think this is a concern of the facilities' ( and so far they are excellent at educating staff, I've only been here 2 full wks). I just couldn't believe that they are not required to rinse bags and was wondering how other facilities handle this. I guess if infection is decreased then it would be more cost effective to dispose of the catheter bags daily. Thank you for your input!