Urinary catheter care

Fees, service areas and booking

The points below answer the basic questions people ask most often about our home nursing service. For detailed fees, see the fees page.

Four research findings about catheter care

There are many misunderstandings about catheter care. The four evidence-based figures below show the real picture of catheter infection:

Non-drug measures to prevent catheter-associated urinary tract infection (CAUTI)

Catheter-associated urinary tract infection (CAUTI) is a very common healthcare-associated infection, but the most effective methods of prevention are simple and involve no medication. In fact, antibiotics do not prevent CAUTI. Drawing on CDC and IDSA recommendations, the core measures come down to four steps: place a catheter only with a proper indication, insert it with aseptic technique, keep the drainage system closed throughout, and remove the catheter early.

1. 1
   Keep a catheter in only when clinically needed (indication)

   A catheter should not be inserted when there is no clear clinical need. For each extra day a catheter stays in, the risk of bacteriuria and infection keeps building up, so avoiding a catheter when it is not needed is itself an important preventive measure.
2. 2
   Insert with aseptic technique (aseptic insertion)

   When the catheter is inserted, health staff must follow hand hygiene and aseptic technique strictly. This lowers the chance of carrying bacteria into the urinary tract.
3. 3
   Keep the drainage system closed (closed system)

   Keep the drainage system closed throughout care and do not disconnect the joints casually. The urine bag must hang below the level of the bladder and must not touch the floor, so that urine does not flow back or become contaminated from outside.
4. 4
   Remove early (early removal)

   Whether the patient still needs the catheter should be reviewed every day, and it should be removed as early as possible once it is no longer needed. Research shows that nurse-led assessment and removal protocols effectively lower catheter use and the rate of CAUTI.

Besides keeping the drainage closed, daily care includes securing the catheter well to reduce pulling, cleaning the urethral opening or the skin around the stoma, using aseptic technique when emptying the bag and keeping up thorough hand hygiene. Carrying out these daily details is what gradually lowers the risk of infection.

Telling asymptomatic bacteriuria apart from a urinary infection that needs treatment

This is the most important and most often misunderstood idea in catheter care. A biofilm forms on the surface of a long-term catheter, and bacteriuria in the patient is almost unavoidable. Bacteria in the urine, however, does not mean infection. Whether it is a symptomatic infection that needs treatment depends on whether the patient has clinical symptoms, and not on whether the urine is cloudy or on the culture result alone.

Principles for deciding when a catheter should be changed

“How often does the catheter need to be changed?” is a question almost every caregiver asks. The existing medical evidence does not support a fixed rule of changing “every X weeks”. The Cochrane systematic review included only three small trials with too little statistical power. It found not enough evidence that routine changes at fixed intervals combined with changes as needed reduce symptomatic urinary tract infection more than changing only as clinically needed, and the overall certainty of the evidence is very low.

This service therefore uses a symptom-led professional judgement. The timing of a catheter change is assessed from the clinical situations below, and the calendar is not followed blindly:

Comparing three common ways of managing the bladder: Foley, SPC and intermittent catheterisation

Not every patient suits the same method of catheterisation. The three common methods below differ in how they work and who they suit, but the core principles of care are the same: keep the drainage closed, keep clean, secure the catheter well and watch symptoms closely.

How a nurse home visit works

Care for each patient starts with a full assessment, continues with symptom-led follow-up and gradually helps family members learn everyday care skills:

1. 1
   WhatsApp or phone consultation

   We first find out the type of catheter the patient uses now (Foley or SPC), why it was placed, the problems at the moment and the home environment, and then give initial care advice and a quote.
2. 2
   First home assessment

   At the visit the nurse checks the position and fixation of the catheter, observes the nature and amount of the urine, and assesses for signs of infection or blockage. The nurse also checks that the drainage system is kept closed and that the urine bag is correctly placed.
3. 3
   Professional care

   The nurse uses aseptic technique to clean and secure the catheter, and changes the catheter or the urine bag as clinically needed, to keep the drainage closed. Any problems with the skin or the area around the stoma are dealt with at the same time.
4. 4
   Caregiver education

   The nurse teaches family members in person how to empty the bag while keeping the system closed, how to place the urine bag and secure the catheter correctly and how to recognise abnormal symptoms. The caregiver can then tell clearly which situations can be watched at home and which need help at once.
5. 5
   Symptom-led follow-up

   We arrange regular follow-up visits according to the patient’s individual condition and clinical symptoms, and do not change catheters on fixed calendar days. Through continued monitoring, the nurse can adjust the care plan in good time.

Frequently asked questions