intermittent straight catheterization

APBT mom, LPN, RN · Jan 20, 2008

I knew a woman who had the nerve to her bladder cut during her hysto and she did the same thing with her caths. Her insurance company would only give her 10 for the month so she would use one for a couple of days. She did the same thing rinsed with water soaked it in a ziplock bag full of alcohol for a hour. She only got fresh ones when she was in the hospital and most of the time they would put a foley in to save her from having to do it so frequently.

Noryn · Jan 20, 2008

I dont know that the catheters should be rinsed in alcohol as it may damage them. I think most people just use soap and water and rinse really well then allow them to dry. Some have soaked in hydrogen peroxide and others have boiled them but I dont believe anyway has shown to be more effective than just soap and water.

Most insurance companies will only pay for a few a month. Sometimes if you are having frequent infections they will pay for sterile catheters for each cath but usually they wont.

Intermittent catheterization is a much better option than a Foley as it decreases infections and the risk of bladder stones and bladder cancer.

Daytonite, BSN, RN · Jan 20, 2008

it is not uncommon for this to be done in a home situation. the theory is that the patient is accustomed to the bacteria in their home environment. i know it sounds shocking, but it goes on all the time. similar is done with dressing changes.

however, if the patient is now in the hospital, single use sterile catheters should be used for each catheterization due to the high nosocomial infection rates in hospitals. i would point out to the mother that the hospital is rampant with bacteria and it's not a good thing to tempt fate if she is insisting on continuing her home practice in the hospital.

elkpark · Jan 20, 2008

People doing their own intermittent caths at home/wherever use different protocol than staff in hospitals -- "clean" technique rather than sterile technique. This involves cleaning the catheters well and re-using them. The reason this is okay is because they are accustomed to their own standard flora and the risk of infection is not as great as when they are being catheterized by a stranger in a hospital environment. What I have seen over the years is that sterile technique is used in the hospital, even though people are used to using only clean technique at home, because of the increased range of unfamiliar "bugs" in the hospital environment.

DutchgirlRN, ASN, RN · Jan 20, 2008

The patients I've encountered wash the catheters with soap and water and soak in a water and vinegar solution for several hours, rinse and let dry on paper towels.

I don't understand any advantage of intermittent caths? An indwelling foley surely would be less likely to cause a UTI than cathing oneself every 6 hours, especially for a female.

Noryn · Jan 20, 2008

The patients I've encountered wash the catheters with soap and water and soak in a water and vinegar solution for several hours, rinse and let dry on paper towels.
I don't understand any advantage of intermittent caths? An indwelling foley surely would be less likely to cause a UTI than cathing oneself every 6 hours, especially for a female.

Studies have shown the exact opposite, plus long term indwelling is associated with increased risk of bladder cancer.

I used to think the same thing as you did but in my mind I came up with something like "a door that is always open lets in more cold air than one that is only opened every 6 hours."

But yeah hospitals should be sterile use, home clean.

caliotter3 · Jan 20, 2008

For our peds patient that used intermittent catheterization, we washed the caths with hot soapy water, rinsed well, and hung them on a coat hanger to air dry. Didn't use the soaking in vinegar solution, although I would have recommended it. Another client was provided with sterile caths. A new one was used each time. Wondered how his got paid for yet the peds patient's was not. As far as I knew, the same payor was involved in both cases. An example of how different cases get different services.

elkpark · Jan 20, 2008

Studies have shown the exact opposite, plus long term indwelling is associated with increased risk of bladder cancer.
I used to think the same thing as you did but in my mind I came up with something like "a door that is always open lets in more cold air than one that is only opened every 6 hours."
But yeah hospitals should be sterile use, home clean.

In addition to both the above reasons, intermittent caths are a more "normal" lifestyle than walking around all day with a catheter sticking out of you!

Because of the simpler "clean" technique (as opposed to the big production of doing a sterile cath in the hospital setting), once people get familiar & comfortable with doing it, doing the intermittent caths is no more complicated or time-consuming than anyone else using the bathroom.