1. Objective

To provide a safe, sterile, and efficient procedure for changing a urinary catheter, aiming to promote patient comfort, prevent infection, and ensure proper catheter function.

2. Scope

This SOP applies to all licensed healthcare professionals performing urinary catheter changes under Upashay’s doctor services. This SOP covers routine catheter changes and is not intended for emergency catheter replacements.

3. Required Personnel

  • Licensed doctor or registered nurse trained in urinary catheter insertion, care, and management

4. Required Equipment and Supplies

  • Sterile gloves
  • Personal protective equipment (PPE): mask, face shield, gown
  • Sterile catheter kit (catheter of appropriate size, sterile drainage bag)
  • Catheter lubricant (water-soluble)
  • Antiseptic solution (e.g., chlorhexidine)
  • Sterile gauze pads
  • 10 mL syringe (for deflating the balloon)
  • Waste disposal bag (for biohazard materials)

5. Pre-Procedure Preparation

  1. Patient Assessment
    • Review the patient’s medical history, including any known allergies or previous catheter-related complications.
    • Explain the procedure to the patient, discuss expected discomfort, and obtain informed consent.
    • Assess the current catheter’s condition, any leakage, or signs of infection (redness, swelling, or unusual discharge).
  2. Environment Preparation
    • Ensure a clean, well-lit, and sterile environment to minimize infection risk.
    • Gather all necessary equipment within easy reach before beginning the procedure.
    • Position the patient comfortably, typically in a supine (lying flat) position, with legs slightly apart.
  3. Hand Hygiene and PPE
    • Perform thorough hand hygiene before donning sterile gloves.
    • Wear appropriate PPE, including a mask, face shield, and sterile gloves, to protect the patient and healthcare provider.

6. Procedure Steps

  1. Prepare for Removal
    • Explain the removal process to the patient to ensure cooperation.
    • Disconnect the catheter from the drainage bag and close the drainage spout.
  2. Deflate the Balloon
    • Attach a 10 mL syringe to the catheter balloon inflation port.
    • Gently withdraw all fluid from the balloon to deflate it completely. Do not pull the catheter until you are sure the balloon is fully deflated.
  3. Remove the Old Catheter
    • Hold the catheter near the urethral opening and gently pull it out in a slow, steady motion.
    • Immediately dispose of the used catheter and any materials in a biohazard bag.
  4. Clean the Area
    • Clean the area around the urethral opening with antiseptic solution, using sterile gauze pads. Work in a circular motion, moving outward from the urethral opening.
    • Allow the area to dry before inserting the new catheter.
  5. Insert the New Catheter
    • Put on a new pair of sterile gloves and apply a water-soluble lubricant to the tip of the new catheter.
    • Gently insert the catheter into the urethra, advancing it slowly until urine begins to flow.
    • Once urine is observed, advance the catheter about 1–2 inches further to ensure it is fully inside the bladder.
  6. Inflate the Balloon
    • Attach a syringe with sterile water to the inflation port and inflate the balloon according to the manufacturer’s instructions (typically 10 mL).
    • Gently pull back on the catheter until resistance is felt, ensuring the balloon is seated properly at the bladder neck.
  7. Connect the Drainage Bag
    • Connect the catheter to the sterile drainage bag and ensure all connections are secure.
    • Position the drainage bag below the bladder level to allow gravity drainage and avoid reflux.

7. Post-Procedure Care

  1. Patient Education
    • Explain catheter care instructions, such as keeping the catheter and surrounding area clean, avoiding kinks in the tubing, and ensuring the drainage bag is emptied regularly.
    • Advise the patient to monitor for signs of infection, such as fever, unusual discharge, or discomfort, and to contact healthcare professionals if these occur.
  2. Documentation
    • Document the procedure in the patient’s records, including catheter type and size, the amount of fluid used for balloon inflation, patient response, and any post-procedure instructions.
    • Note any complications or additional care provided.

8. Emergency Protocols

  • Be prepared to provide immediate assistance if complications arise, such as discomfort during insertion, resistance while inflating the balloon, or signs of infection.
  • If unable to insert the catheter or if the patient shows signs of severe discomfort, refer to a specialist.

9. Quality Assurance and Safety Compliance

  • Ensure compliance with infection control guidelines, including proper sterilization and disposal of used materials.
  • Conduct regular training and procedure reviews to maintain high standards of care and address any procedural concerns.