Catheter Care Guide: Best Practices for Healthcare Professionals & Home Care

Catheter Care Guide: Best Practices for Healthcare Professionals & Home Care

Urinary catheterization is a common procedure in Canadian healthcare, with approximately 10-15% of hospital inpatients and a significant number of LTC residents requiring catheterization at any given time. Proper catheter care is essential to prevent catheter-associated urinary tract infections (CAUTIs), which account for up to 40% of all hospital-acquired infections in Canada. This guide covers best practices for insertion, daily maintenance, and infection prevention.

Types of Urinary Catheters

Understanding the different catheter types helps clinicians select the right device for each patient:

Figure 1: Bard® Foley Catheter — 2-Way, 16 Fr, 5 mL Balloon. (Source: BD/Bard Medical)

Catheter Insertion Preparation

Proper insertion technique significantly reduces CAUTI risk:

1. Hand hygiene: Perform thorough hand washing and don sterile gloves.
2. Gather supplies: Sterile catheter kit, lubricant, drainage bag, sterile saline for balloon inflation, specimen container (if needed).
3. Patient positioning: Female — dorsal lithotomy position; Male — supine with legs slightly apart.
4. Cleanse perineal area: Use sterile antiseptic solution (chlorhexidine or povidone-iodine) from meatus outward.
5. Lubricate catheter tip: Use single-use sterile lubricant. For male patients, instill lubricant into the urethra for patient comfort.
6. Insert catheter: Female — advance 5-7 cm until urine flows, then advance another 2-3 cm. Male — hold penis at 60-90 degree angle, advance catheter 15-20 cm until urine flows, then advance balloon length.
7. Inflate balloon: Inflate with 5-10 mL sterile water (per catheter specifications). Pull gently to confirm balloon is seated at bladder neck.
8. Secure catheter: Use a catheter securement device to prevent traction and urethral trauma.
9. Connect drainage bag: Ensure bag is positioned below the level of the bladder at all times.

Figure 2: Coloplast SpeediCath® Compact Plus — a popular intermittent catheter in Canada. (Source: Coloplast Canada)

Daily Catheter Care (Indwelling Catheters)

• Perineal hygiene: Cleanse the perineal area and catheter tubing with soap and water twice daily and after bowel movements. Always clean from meatus outward.
• Drainage bag management: Keep bag below bladder level. Empty bag every 4-6 hours or when half full. Each patient should have their own bag. Replace with a new bag every 7 days.
• Catheter securement: Ensure the catheter is secured to the thigh or abdomen to prevent traction.
• Fluid intake: Encourage 1500-2000 mL daily (unless contraindicated) to maintain urine flow and flush bacteria.
• Check urine: Monitor colour, clarity, odour, and volume. Cloudy or foul-smelling urine may indicate infection.

CAUTI Prevention: Evidence-Based Strategies

Healthcare Excellence Canada and the Canadian Patient Safety Institute recommend the following CAUTI prevention bundle:

• Avoid unnecessary catheterization: Use bladder scanners to assess for retention before catheterizing.
• Remove catheters promptly: Use daily "indication checklists" to reassess ongoing catheter need.
• Use closed drainage systems: Never disconnect the catheter and drainage bag unless absolutely necessary.
• Maintain sterile insertion: Use sterile technique for all catheter insertions.
• Consider alternatives: Use intermittent catheterization instead of indwelling when possible (lower infection risk).
• Do not use antimicrobial catheters routinely: Silver alloy or nitrofurazone-impregnated catheters are not recommended for routine use by CADTH.

Signs of Catheter-Associated Infection

Educate patients and caregivers to watch for these warning signs:

• Fever (temperature >38°C) or chills
• New-onset flank or suprapubic pain
• Change in urine character (cloudy, foul-smelling, bloody)
• Increase in white blood cell count
• Delirium or altered mental status (especially in elderly patients)

CliniEco Medical supplies Foley catheters, intermittent catheters, drainage bags, and catheter care kits from leading manufacturers including BD/Bard, Coloplast, and Hollister for Canadian healthcare facilities. Contact our team for bulk procurement and formulary support. Facilities comparing options can review catheter and incontinence supply planning.

Related reading: learn more about Canadian medical procurement in our business hub.

see our related pillar guide.

Related reading

• Catheter Accessories for Canadian Healthcare: Drainage Bags and Tubing Standards