Catheterisation in Adults - the Royal Cornwall Hospitals Trust ...

4.21 FluidsUnless restricted for medical reasons, an adequate fluid intake should be encouraged per 24hours, as this maintains a flow of uri ne through the bladder and helps prevent constipation.There is no evidence of long-term benefit or ap propriate dosage of cranberry juice with useof catheters. Furthermore, caution should be exercised for those patients taking warfarin(Suvarna et al 2003). However, citrate-based d rinks are recommended as these have beenfound to positively affect the pH of the urine.4.22 Link drainage systemThe drainage bag sho uld not be disconnected from the catheter, b ut the night bag isconnected to the drainage tap. Patients in Care Homes (both residential and those thatprovide nursing) and in hospital must have a n ew single-use night drainage bag every nightwith disposal of the used bag. T here is minimal research regarding the issues on infectioncontrol for patients in their own homes who reuse their night bags for 5 – 7 nights (they areencouraged to rinse through with f reshly drawn tap water and left to drain). Se lf-caringpatients are more suite d to drainable bags than those who require carers to manage thecatheter system. However, should care needs change and the patient is no longer able toself-manage their catheter system, then switchi ng to single-use night drainage bags will benecessary.4.23 Storage of cathetersExcess quantities of stored catheters can in crease the risk of damage to the product orpassing the expiry date. For exa mple, latex catheters h arden when they are old and ifinserted after the expiry date, the risk of perforating the bladder is increased.It is important that equipment is available withi n the patient’s home, which will ensure thatthe correct catheter is used for individual needs. In the community, it is recommended thatpractitioners document that new stock has been ordered to replace what has been used. Inthe hospital environment, safe storage and stock rotation of the catheters is expected.4.24 Catheter-lifeThere are two distinct groups of patients to describe a catheter-life, that is, those who wear acatheter that blocks an d those tha t don’t (non -blocking). The main cause of a blockedcatheter is encrustation. Non-blocking catheters are those which maintain the patency of thecatheter for the duration of the catheter-life expectancy, such as 12 weeks for a long-termcatheter.Encrustations usually form on the tip of the catheter, the balloon area th at is bathed in urineand the lumen of the catheter. They are not usually found on the side of the balloon that isagainst the bladder mucosa or the surface that is in contact with the urethra.The duration of time that the catheter can be left in place before it becomes blocked, leaks oris pulled o ut by the patient is refe rred to as t he catheter-life. Monit oring this w ill helpeffective planning to reduce the risk of blockage as opposed to crisis intervention.Persistent blockage and other complications such as r ecurrent symptomatic CAUTI orhaematuria, may require investigation and refe rral for investigation. Cystoscopy should beconsidered to rule out t he presence of bladder stones. Th ere is no evidence that sendingcatheter tips to Clinical Microbiology is beneficial.10 of 16