Intermittent Catheterization: Clean vs. Sterile Introduction Intermittent catheters are commonly used for patients with a neurogenic bladder that may have been a result of spinal chord injury or other neurological disease processes. People that are affected with a neurogenic bladder experience inability to begin voiding or the inability to empty the bladder of all urine. Intermittent catheters can be inserted frequently throughout the day to avoid complications arising from urinary retention, which may include urinary tract infections (UTI). UTI’s occur when a bacterium is introduced into the urethra or bladder and can lead to cystitis, progressive renal deterioration or sepsis (Lemke, Kasprowicz, & Worral, 2005). Although intermittent catheters are preferred, there can be complications associated with them, especially when patients use them long term. Clean or sterile technique can be used for this procedure. It is important for the nurse to use best practice while performing catheter insertion, care, and client teaching to reduce the risk of complications. Current Best Practice The use of a sterile technique is favoured in the hospital setting to reduce the incidence of nosocomial infections. Today, hospitals, sterile intermittent catheterization is preferred over a “in non-sterile procedure because fewer cases of bacteriuria and UTI occur” (Newman & Willson, 2011, p. 12). Due to increased exposure to harmful bacteria with intermittent catheterization the risk for developing a UTI becomes high. Sterile technique includes the use of sterile equipment (one-use catheter, sterile insertion kits and sterile gloves) and maintaining a sterile field. In a home setting clean technique is considered best practice. In the past patients have been encouraged to save and re-use catheters after cleansing them. guidelines released in the “New past three years have recommended changes to the practice of re-using catheters” (Newman &
Intermittent Catheterization: Clean vs. Sterile Introduction Intermittent catheters are commonly used for patients with a neurogenic bladder that may have been a result of spinal chord injury or other neurological disease processes. People that are affected with a neurogenic bladder experience inability to begin voiding or the inability to empty the bladder of all urine. Intermittent catheters can be inserted frequently throughout the day to avoid complications arising from urinary retention, which may include urinary tract infections (UTI). UTI’s occur when a bacterium is introduced into the urethra or bladder and can lead to cystitis, progressive renal deterioration or sepsis (Lemke, Kasprowicz, & Worral, 2005). Although intermittent catheters are preferred, there can be complications associated with them, especially when patients use them long term. Clean or sterile technique can be used for this procedure. It is important for the nurse to use best practice while performing catheter insertion, care, and client teaching to reduce the risk of complications. Current Best Practice The use of a sterile technique is favoured in the hospital setting to reduce the incidence of nosocomial infections. Today, “in hospitals, sterile intermittent catheterization is preferred over a non-sterile procedure because fewer cases of bacteriuria and UTI occur” (Newman & Willson, 2011, p. 12). Due to increased exposure to harmful bacteria with intermittent catheterization the risk for developing a UTI becomes high. Sterile technique includes the use of sterile equipment (one-use catheter, sterile insertion kits and sterile gloves) and maintaining a sterile field. In a home setting clean technique is considered best practice. In the past patients have been encouraged to save and re-use catheters after cleansing them. “New guidelines released in the past three years have recommended changes to the practice of re-using catheters” (Newman &
intermittent_catheterization_research_&_care_plan.docx