2014 Intermittent Clean Self-Catheterization Nova Scotia Rehabilitation Centre
Why do I need to do this? Intermittent Clean Self-Catheterization Your bladder may not empty completely when you go to the bathroom, or it may not empty at all. It will keep you dry, prevents infection, and keep your bladder and kidneys healthy. What is intermittent catheterization? A catheter (small, hollow tube) is passed through the urethra (passage that carries the urine (pee) to the outside of your body) and into the bladder to drain the urine. What are the steps? Step 1: Collect all your supplies: Catheter (size # ) Container to collect the urine such as: Sterile basin (in hospital) Clean basin (at home) Urinal Lubricant (like Muko Lubricating Jelly that comes in a tube or packet) Soap or wipes to clean your hands Alcohol-based hand rub (70% alcohol) Scent-free wipes (such as baby wipes) Mirror for women (if needed) Step 2: Wash your hands (see diagram for the right way to do this): Use soap and water at the sink if you plan to sit in your wheelchair. If you want to drain your bladder in bed, wash your hands with soap and water before you get into bed. Once you are set up in bed, you can use soap wipes or scent-free wipes to clean your hands. 1
How to handrub? WITH ALCOHOL-BASED FORMULATION How to handwash? WITH SOAP AND WATER Apply a palmful of the product in a cupped hand and cover all surfaces. Wet hands with water apply enough soap to cover all hand surfaces. Rub hands palm to palm right palm over left dorsum with interlaced fingers and vice versa palm to palm with fingers interlaced backs of fingers to opposing palms with fingers interlocked rotational rubbing of left thumb clasped in right palm and vice versa rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa Design: mondofragilis network 10 rinse hands with water dry thoroughly with a single use towel use towel to turn off faucet 20-30 sec 40-60 sec 11 once dry, your hands are safe. and your hands are safe. WHO acknowledges the Hôpitaux Universitaires de Genève (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material. Please note: The steps on the left are for handrub, and on the right are for handwash with soap and water. 2 October 2006, version 1.
Step 3: Arrange clothing, supplies and position yourself: Put all supplies in easy reach before starting. It is not a sterile procedure but you want it to be as clean as possible. Open or lower clothing so that the catheter tube will not touch any soiled (dirty) items or areas. Position your body. Step 4: Set up the catheter: Lay the package on a clean, flat surface within easy reach. Open the package fully without touching the tube or allowing it to touch other surfaces. Squeeze out a little bit of Muko from the tube onto a tissue. Throw the tissue away. Starting at the tip of the catheter, cover the tubing with Muko for about 2-6 inches. Step 5: Wash the area: Wash genital area (privates) with soap and water and rinse, or use an unscented wipe to do the following: Men: hold penis in one hand and wash in a circular manner. Move from the tip of your penis to the base. Men who are not circumcised (foreskin cut off) should pull the foreskin back and wash well. Women: separate the labia (folds of tissue) and wash from front to back. 3
Step 6: Position the collection container: Open the container and put it between your legs or where you can reach it to drain urine the best way. If using a urinal to drain urine, make sure it has been rinsed out between uses. If using a clean container at home, make sure it has been rinsed with boiling water and wrapped in a clean cloth between sessions. Step 7: Sanitize your hands: Once all supplies are in place and you are ready to pick up the catheter, now is the time to use the alcohol hand rub (Cida Rinse ). Put it all over your hands (see diagram for the right way to do this). Step 8: Insert the catheter: Choose one hand to be your clean hand and one hand to be your dirty hand. Men: hold your penis with your dirty hand. Once you are holding your penis, this hand cannot be used to insert (put in) the catheter. Women: with the help of a mirror if needed, use your dirty hand to spread the labia until you can see the urethra opening. Remember, this hand cannot be used to insert (put in) the catheter. With your clean hand, pick up the catheter and do not let it touch any surfaces. Start inserting the catheter, a couple of inches at a time. Do not let your fingers touch your skin as you insert the tube. Insert the catheter and move your fingers along the tube until you feel the catheter enter the bladder or until you get urine flow. 4
Step 9: Drain the bladder: Hold the catheter in place while urine is draining out. This will make sure that the catheter does not move and that the bladder is fully drained. When urine flow stops, slowly start to pull the catheter out, but not all the way out. If more urine begins to flow, let it finish. Step 10: Remove the catheter: Before the catheter is pulled all the way out, you need to stop the urine from flowing back into the bladder. Do this by: pinching the catheter or bending the end over. Once the catheter is bent or pinched, pull it all the way out. Let go of the end of the catheter and allow the urine in the tube to flow into the urine collection container. Throw the catheter in the garbage. Step 11: Clean up: Use the wipes to wash yourself. Adjust your clothing and get dressed. Throw all wipes etc. in the garbage. Put urine into toilet. Measure the urine if you have been asked to do this. The amount should not be more than 500 cc (2 cups) each time. If the amount of urine drained is high during some or all of your sessions, you may need to add extra self-catheterization sessions to your daily schedule. Talk to your health care professional if you have any issues or concerns about measuring your urine. Odds and ends The amount of urine you drain will change with the amount of fluid you drink. Drinking more fluids makes more urine. If the amount of urine you make is low, you may not be drinking enough. You should drink about 2000-3000 ml (2-3 liters or 2-3 quarts) a day. 5
Call your doctor if you notice any signs of infection such as: Unpleasant- or bad-smelling urine. The amount of urine you drain is less. More sediment [deposits or stuff floating in urine]. More bladder spasms. Blood in urine. Pain. Burning. Leaking urine. Notes: 6
Looking for more health information? Contact your local public library for books, videos, magazines, and other resources. For more information go to http://library.novascotia.ca Capital Health promotes a smoke-free, and scent-free environment. Please do not use perfumed products. Thank you! Capital Health, Nova Scotia www.cdha.nshealth.ca Prepared by: Nova Scotia Rehabilitation Centre Illustrations by: Catheter images courtesy of staff; Hand hygiene image courtesy of WHO Designed by: Capital Health Library Services, Patient Education Team Printed by: Dalhousie University Print Centre The information in this brochure is provided for informational and educational purposes only. The information is not intended to be and does not constitute healthcare or medical advice. If you have any questions, please ask your healthcare provider. WJ85-1224 Revised August 2014 The information in this pamphlet is to be updated every 3 years.