Catheter and Ostomy Care

Pre-Procedure

 

#1 Identify the client, according to the employer policy.

#2 Explain the procedure to the client.

#3 Wash Hands and Wear Gloves when necessary.

#4 Collect items for perineal care p. 544

• Wash basin
• Soap
• Four wash cloths
• Bath towel
• Gloves
• Bed protector/Paper towels
• Bath blanket

#5 Provide for privacy (draw curtians on windows, privacy curtain, and close door according to employer policy)

#6 Raise bed to a comfortable working height. Follow the care plan for bed rail use.

Procedure

#7 Lower the bed rail near you.

#8 PUT ON GLOVES.

#9 Cover the client with a bath blanket. Fanfold top linens to the foot of the bed.

#10 Drape the client for perineal care (position blanket like a diamond shape draped from corner of blanket at chest and other corner of blanket at the private area).

#11 Fold back the bath blanket to expose he genital area.

#12 Place the bed protector under the buttocks. ASK the client to flex the knees and raise the buttocks off the bed.

#13 Give perineal care (use clean wet soapy cloth with one gentle swipe down labia on both sides and one gentle swipe down the centre on a female client OR retract the foreskin on a male client, wiping once at the tip of the penis and clean the shaft of the penis with two gentle firm downward strokes, clean the scrotum and rinse well).

 

#14 Be sure to rinse and dry well the perineal are of each client while checking for the presence of crusts and abnormal drainage, or secretions.

#15 Hold the cather near the meatus insertion point (to ensure the catheter is not pulled).

#16 Clean the catheter from the meatus down the catheter about 4 inches (double finger length) with clean wash cloth. DO NOT TUG OR PULL THE CATHETER.

#17 Rinse the catheter. Clean from the meatus down the catheter with one stroke. DO NOT TUG OR PULL THE CATHETER. Ensure the outside of the catheter tubing is dry.

#18 Secure the catheter to the fitted sheet on the bed and hang catheter bag in appropraite spot on lower bed rail. (When reporting and recording of urine is requested by supervisor, include:

• amount of urine measured
• colour clarity and odour of urine
• particles in the urine
• Complaints of pain, burning, irritation, or the need to urinate
• Drainage system leaks

#19 Remove the bed protector.

#20 Cover the client with top sheet and bed spread. Remove the bath blanket.

#21 Remove gloves and wash hands.

Post-Procedure

#22 Provide for safety and comfort.

#23 Place the call bell within reach.

#24 Return the bed to its lowest position. Follow the care plan for bed rail use.*

#25 Clean and return equipment to its proper place. Discard disposable items. (Wear gloves for this step).

#26 Remove privacy measures.

#27 Follow employer policy for soiled linen.

#28 Wash hands with soap and water approximately 20 seconds.

#29 Report and record your actions and observations, according to employer policy.

 

Pre-Proecdure

 

#1 Identify the client, according to the employer policy.

#2 Explain the procedure to the client.

#3 Wash Hands and Wear Gloves when necessary.

4 Collect the following:

• Clean pouch with skin barrier
• Skin barrier as ordered (if not part of pouch)
• Pouch clamp, clip, or wire closure
• Clean ostomy belt (if used)
• 4 to 8 guaze squares
• Adhesive remover (ENSURE CLIENT SKIN INTEGRITY, DO NOT COMPROMISE CLIENT'S SKIN)
• Cotton Balls
• Bedpan with cover
• Waterproof pad
• Bath blanket
• Toilet tissue
• Wash basin
• Soap or cleansing agent (according to the client's care plan)
• Pouch deordorant
• Paper towels
• Gloves
• Disposable bag

Procedure

 

5 Arrange paper towels on a work area. Place items on top of paper towels.

6 Provide for privacy.

7 Raise bed to a comfortable working height. PROTECT YOUR BACK USING PROPER BODY MECHANICS. Follow the care plan for bed rail use.*

8 Lower the bed rail near you, if it is up.

9 Cover the client with a bath blanket. Fanfold linens to the foot of the bed.

10 Place the waterproof pad under the client's buttocks.

11 Put on gloves.

12 Disconnect the pouch from the belt if one is worn. Remove the belt.

13 Remove the pouch gently. Genlty push the skin down and away from the skin barrier. Place the pouch in the bedpan.

14 Wipe around the stoma with toilet tissue or a guaze square. This removes mucus and feces. Place soiled tissue in the bedpan.

15 Ensure skin integrity. Protect skin (it is the largest organ in the body). Moisten a guaze square with adhesive remover. Clean around the stoma to remove any remaining skin barrier. Clean from the stoma outward.

16 Raise bed rails, Cover the bedpan, and take it to the bathroom. (Be sure to raise bed rails before leaving the bedside.)

17 Measure the feces, as directed by the care plan.

18 Note the colour, amount, consistency, and odour of feces. Report any abnormal feces. Then empty the pouch and bedpan into the toilet. Put the pouch in the disposable bag.

19 Remove gloves. WASH HANDS WITH SOAP AND WATER AT LEAST 20 Seconds.

20 Fill the wash basin with warm water. (Check temperature with your wrist or elbow. FOLLOW THE CARE PLAN FOR THE CORRECT TEMPERATURE.) Place basin on paper towels in work area. Lower the bed rail near you, if it it up.

21 Using soap or other cleansing agent, clean the skin around the stoma with water. Rinse and pat dry.

22 Observe the stoma and skin around the stoma. Report and Record any irritation or skin breakdown.

23 Apply the skin barrier, if it is a separate device.

24 Put a clean ostomy belt on the client (if belt is worn).

25 Add deodorant to the new pouch.

26 Remove adhesive backing on the pouch.

27 Centre the pouch over the stoma. The drain points downward.

28 Press around the skin barrier so the pouch seals to the skin. Apply gentle pressure from the stoma outward.

29 Maintain pressure for 1 to 2 minutes.

30 Connect the belt to the pouch (if a belt is worn).

31 Remove the waterproof pad.

32 RAISE BED RAILS ACCORDING TO CARE PLAN AND EMPLOYER POLICY. Remove gloves and WASH HANDS FOR AT LEAST 20 Seconds.

33 Cover the client and remove the bath blanket.

Post-Procedure

34 Provide for safety and comfort.

35 PLACE THE CALL BELL WITHIN REACH.*

36 Return the bed to its lowest position. Follow the care plan for bed rail use.*

37 Remove privacy measures.

38 Clean the bedpan, wash basin, and other equipment. PUT ON GLOVES FOR THIS STEP.

39 Return equipment to its proper place.

40 Discard the disposable bag, according to employer policy. Follow employer policy for soiled linen. REMOVE GLOVES AND WASH HANDS WITH SOAP AND WATER FOR AT LEAST 20 seconds.

41 REPORT and RECORD your actions and observations, according to employer policy.