Catheter maintenance procedure

1 Aim

To provide staff with best practice guidelines for performing catheter maintenance.

2 Scope

This procedure applies to all clinical staff including agency, locum and bank staff working in both the Doncaster mental health care group and Doncaster physical health care group of RDaSH who deliver or provide continence and catheter care to adult patients over the age of 18. For staff working in Rotherham and Scunthorpe, they will need to refer to their local guidelines.

It is recognised that primary care practitioners are also part of the organisation and as such this policy is offered for use by them to adapt to their own practices and organisations as appropriate.

The author of the policy is available to offer help and support to primary care practitioners who wish to use and implement this policy.

As part of good employment practice, whilst undertaking work for RDaSH. Agency workers are also required to abide by the RDaSH policies and procedures, as appropriate, to ensure their health, safety and welfare.

3 Link to overarching policy

Continence manual

3.1 Links to associated documents

Aseptic non-touch technique

4 Procedure

4.1 Catheter maintenance

When considering catheter maintenance, there must be clear evidence to suggest that the patient may benefit from planned use of catheter maintenance solution to extend the life of the urinary catheter, or prior to removal of a urinary catheter to dissolve crystal formation to prevent trauma. Therefore, it is essential that the catheter history is clearly documented inpatient clinical record.

Please see appendix F for the flow chart for the management of blocked catheters.

4.2 Catheter maintenance solution

Catheter maintenance solution should only be used when all other options have been considered.

For catheters that regularly block due to encrustation, try to establish the life of 3 catheters. This will establish a clear pattern. Once the pattern has been established and a clear treatment plan has been written, the use of the appropriate catheter maintenance solution and planned catheter changes can be adopted.

Best practice in the treatment of encrustation is to use two solutions. Current research supports the use of two sequential instillations of a small volume are more effective at dissolving encrustation (Getliffe, et al. 2000). B-Braun Uro-Tainer Twin, has two chambers of 30mls solution, each chamber is instilled for 5 minutes and therefore you are only breaking the closed drainage system the once. Alternative solutions would therefore mean that you would have to break the closed drainage system twice to instil two solutions. By limiting the number of times that the closed drainage system is broken, reduces the risk of introducing infection.

Catheter maintenance in end-of-life patients:

if able to determine the cause of a blocked catheter, use the appropriate catheter maintenance solution, Suby-G for encrustation and PHMB for debris or mucus
if unable to determine cause of the catheter blockage, to administer PHMB twice per week and review (catheter maintenance solution can be administered up to twice per day if required)

If performing catheter maintenance more than once per week, use a Linc medical, bladder infusion kit (BIK).

If Suby-G is being used daily, please consider changing to the Solutio-R catheter maintenance and reduce the frequency of instillation.

Please see appendix G on how to administer catheter maintenance solution.

5 Appendices

Please see continence manual webpage for appendices attached to this procedure.

Appendix F Managing blocked catheters flow chart
Appendix G How to administer catheter maintenance solution

6 References

Getliffe K and Dolman M (2000) Promoting Continence. A Clinical Research Resource. Whurr.
Pannek J, Vestwebster A (2011) Clinical utility of an antimicrobial blocking solution in patients with an indwelling catheter. Aktuelle Urology 42:51-4.

Document control

Version: 2.1.
Unique reference number: 514.
Approved by: Clinical policies review and approval group.
Date approved: 5 March 2024.
Name of originator: Donna Atkinson clinical team lead.
Name of responsible individual: Executive director of nursing and allied health professionals.
Date issued: 2 April 2024.
Review date: 28 February 2026.
Target audience: All clinical staff.

Page last reviewed: August 30, 2024
Next review due: August 30, 2025

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