Question about clean catheterization

[supernova004]

Maybe someone can help me here.

I don't understand what is the difference between sterile and clean cathing.

Obviously you use sterile technique vs. clean in one versus the other and I understand that fully, but the device goes in the same place(s).

If pts. getting UTIs from steril cathing that wasn't quite as sterile as desired is problem in hospitals, how come anyone would ever clean cath themselves?

Is it because clean cath is not usually indwelling and sterile is usually indwelling?

Thanks

[Future_Nurse_Natalie]

From what I have learned cathing is never done clean. Pts who cath themselves should be taught to do it sterile.

[NRSKarenRN, BSN, RN]

Clean technigue done at home all the time as pt's body use to regular own environment bacteria. Still need to use good technique with cleaning and storing equipment.

Great info here: Reusing Catheters in Home Care? No Way!

[EricJRN, MSN, RN]

Is it because clean cath is not usually indwelling and sterile is usually indwelling?

I think you've hit on a big factor there. Home/clean cathing is usually in and out as opposed to indwelling. Also, think about this: Do you think you're safer cathing in the confines of your own home, or being cathed by the nurse who has been exposed to the cooties of eight other patients that shift?

Besides the fact that infections are usually not a major problem for home clean cath pts, another big factor (highlighted in the previous thread that Karen points us to) is cost. It's just not practical for a pt who caths Q4H to pull a new one out of the package every time.

The standard for home catheter care used to involve washing with soap and betadine after every cath, periodic soaking in Betadine, and boiling. Now many providers are recommending just washing the catheters with good ol' soap and water.

[Daytonite, BSN, RN]

i have been trying to post this for you since about 9pm on saturday evening. i'm glad the website is finally up and running again! here is the information i was trying to post for you:

self catheterization is done on folks with a neurogenic bladder such as those who are paraplegic from a spinal injury, or for those who suffer from urinary incontinence or urinary retention. the concept of clean intermittent catheterization (cic) was developed by urologist, jack lapides, m.d., and is considered to be one of the greatest contributions to the field of urology of our times. you can read a little about it here: http://www.auanet.org/museum/content/milestones/catheterization/p4.cfm - this web document entitled milestones in urology talks about the development of cic by physician jack lapides, m.d. his research showed that a person was more likely to get an infection from a full bladder than an unwashed catheter. i'm having difficulty finding his actual research on this, but i am finding references to his work throughout urology papers.

you can read the instructions for the cleaning and use of an intermittent catheter for male and female self-catheterization at this site http://www.urologychannel.com/education/ . what an eye-opener! i cringed at the part where they tell you what to do if you drop the catheter on the floor and don't have the opportunity to wash it before using it. yuck! it seems like it goes against all the principles of sterility that we have learned, but lapides' research proved otherwise. i am also finding nursing reference that indicates that in patients who need to perform cic in themselves, the bacteria that may colonize their urine does not constitute a clinically significant uti. there has also been some nursing research that was done on cic that indicated that there were no serious complications resulting from cic.

here is another site with the procedure: http://www.umm.edu/ency/article/003972.htm - clean intermittent catheterization procedure

[supernova004]

Thank you for the responses. I'm going to carefully reveiw all the research suggested. I love this site!