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Suprapubic catheter use and administration requires that the person overseeing the process possess specific knowledge about how to maintain, change, and remove the device. Without proper treatment of the device and the area in which it is inserted, the catheter may fail to perform properly, infection may occur, and serious illness can result. The following information is designed to provide basic guidelines and techniques concerning catheters, however, it is not intended to replace professional training or instruction.

Suprapubic Catheter Care

It’s important that procedures for suprapubic catheter care be followed and that care occurs in a timely manner. Care includes the daily changing of dressing, the examination of the area in which the device is located, and ensuring that the catheter is properly anchored in the abdomen. If there is no drainage in the area of insertion after 5 to 7 days, dressings may no longer be required. Within 5 to 7 days of insertion, one always needs to use sterile medical gloves and proper cleaning techniques when caring for the device.

Supplies for care

The following supplies are needed to properly care for a suprapubic catheter.

• Medical gloves, sterilized
• Standard dressing supplies
• Sterilized cotton tipped swabs or gauze measuring 2” x 2”
• Sterile Sodium Chloride (0.9%)
• 4” x 4” drain sponges
• Catheter anchoring device
• Tape

Warning Signs and Cautions

When caring for a suprapubic catheter one wants to be aware of possible problems that may be developing. Never remove dressing with scissors, as this can cause problems related to the insertion area as well as promote infection. In caring for this device, it’s essential that the area be inspected for possible infection.

Signs of infection include patient discomfort due to pressure being applied to the site. Also of concern would be any slippage of the catheter, which would result in the device being partially or completely disengaged from the stoma. Notify a physician if there are any signs of infection or if the device has slipped. Never try to fix such problems on your own, as consequences can be serious.

Removal

Removal of a suprapubic catheter must be done carefully. Often a device is removed in order to replace it with a new one. Prior to performing this procedure make sure to confirm that you have the proper replacement model. Also, before engaging in the removal assess the following in terms of how it is secured:

• Held in place by a balloon
• Sutured into place
• Secured using tape
• Internally held in place by a basket-like implement

The method used to hold it in place will influence how it is removed. However, the following procedure serves to provide you with general guidelines for such removal.

Supplies

Eye and face protection and medical gloves
Standard dressing supplies
Sterile Sodium Chloride (0.9%)
Pad for incontinence
Gauze dressing and cotton tipped swabs, sterilized
Tape
If balloon involved, a 10mL luer lock syringe to deflate such
If sutures used, stitch cutter or sterilized scissors

Process

After properly performing hand cleansing, put on eye and face covering and gloves. Then proceed in the following manner:

• Secure incontinent pad under patient.
• Carefully remove dressing and device used for anchoring.
• Cleanse site using Sodium Chloride.
• Carefully remove sutures if present.
• If present, deflate catheter balloon.
• Firmly grip the catheter and carefully pull out using a straight steady motion.
• The site should be inspected for drainage and any signs of infection such as redness.
• If not inserting a new catheter, dress with sterile gauze.
• Change dressing as necessary, as urine may leak from site for the initial 24 hours or longer after the removal of the suprapubic catheter.
• Take care to document the process on the Progress Report.
• Continue to monitor for urine leakage, any signs of infection, and how often the person voids.
• Report any signs of infection to physician.

Changing a Device

If you are removing a suprapubic catheter and replacing it with another, please remember that the area will begin to close within hours. The new catheter should be replaced with a new device within a few minutes.

Supplies

• Utilize eye and face protection, gown, and 2 pairs of sterile medical gloves.
• Set up the sterile catheterization tray.
• Incontinent pad
• 2 catheters, sterilized (1 of current size and 1 a size smaller)
• Sterile Water (10mL)
• Irrigation solution
• Catheter tip syringe (60 mL) used for irrigation
• Urine drainage bag of the appropriate size
• Cotton balls, sterile
• Gauze dressing, sterile
• Tape
• Appropriate catheter anchoring method

Process

After utilizing hand cleansing according to accepted standards begin the process of replacing the device.

Patient should be in a supine position
Incontinent pad is placed under patient
Sterilize the area around the stoma
Place suprapubic catheter in the area so that it is handy
Put on protective equipment as well as sterile gloves
Place drape over patient
Apply Sodium Chloride to cotton balls and clean site
Prior to replacing, inspect the catheter
If it is in working order, lubricate the catheter tip
If catheter presently being used has not yet been removed from patient do so now
Inspect old catheter for area of color change, as this will guide you in terms of the length of the insertion of the new one and the suprapubic catheter placement.
Change gloves
Slowly insert catheter carefully and gently while holding it at a 90-degree angle (length of insertion is usually 3 to 4 inches or 8 to 10 cm).

Always Follow Proper Procedures

When caring for, removing, or changing a suprapubic catheter always follow proper sanitary and sterilization procedures and utilize appropriate techniques and equipment. It is also important to inform patients as to how the procedure will be done and the effect it may have on them.