What is the proper way for a nursing assistant to clean Rinse and dry the catheter tubing?

• Cleaning suction catheters at home
• Clearing the tracheostomy inner cannula tube
• Cleaning the entire trach tube at home

Cleaning suction catheters at home

Suction catheters must be cleaned after each session of suctioning. This helps prevent infection as well as helps cut down costs by reusing the same catheter for one week.

After suctioning the trach tube:

1. Pour a few ounces of hydrogen peroxide into a small clean container.
2. Suction hydrogen peroxide through the catheter until it is free of mucus. Wipe the outside of the catheter with a cloth or gauze wet with peroxide.
3. Suction sterile salt water through the catheter until it is free of peroxide.
4. Suction air until the catheter is free of water.
5. Remove the catheter from the connecting tubing and let it air dry.
6. Wrap it in a clean dry towel.
7. Use it as needed with this cleaning process each time for up to 8 hours, then THROW IT AWAY.
8. Follow manufacturer's instruction for cleaning and disinfecting your suction machine and humidifier. Do not allow water to stand in your humidifier when not in use.

Cleaning the tracheostomy inner cannula tube (for reusable inner cannulas only)

The tracheostomy inner cannula tube should be cleaned two to three times per day or more as needed. Please note that this only applies to reusable inner cannulas.Cleaning is needed more immediately after surgery and when there is a lot of mucus buildup.

Equipment

Trach care kit

• Small brush or pipe cleaners
• Half-strength solution of hydrogen peroxide (1/2 water, 1/2 hydrogen peroxide)
• Saline or homemade sterile salt water
• Two small bowls

Procedure

1. Wash your hands.
2. Place 1/2 strength peroxide solution in one bowl and sterile salt water in second bowl.
3. Remove the inner cannula while holding the neck plate of the trach still.
4. Place inner cannula in peroxide solution and soak until crusts are softened or removed.
5. Use the brush or pipe cleaner to clean the inside, outside and creases of the tube.
6. Do not use scouring powder or Brillo pads.
7. Look inside the inner cannula to make sure it is clean and clear of mucus.
8. Rinse tube in saline or sterile salt water.
9. Re-insert it while holding the neck plate of the trach still.
10. Turn the inner cannula until it locks into position.
11. Double check the locking pulling forward gently on the inner cannula.

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Overview

A urinary catheter is a flexible plastic tube that's used to drain urine from your bladder when you can't urinate on your own. The catheter allows urine to drain from the bladder into a bag.

Two types of drainage bags may be used with a urinary catheter.

• A bedside bag is a large bag that you can hang on the side of your bed or on a chair. You can use it overnight or anytime you will be sitting or lying down for a long time.
• A leg bag is a small bag that you can use during the day. It is usually attached to your thigh or calf and hidden under your clothes.

Having a urinary catheter increases your risk of getting a urinary tract infection. Germs may get on the catheter and cause an infection in your bladder or kidneys. The longer you have a catheter, the more likely it is that you will get an infection. You can help prevent this problem with good hygiene and careful handling of your catheter and drainage bags.

How can you help prevent infection?

Take care to stay clean

• Always wash your hands well before and after you handle your catheter.
• Clean the skin around the catheter daily using soap and water. Dry with a clean towel afterward. You can shower with your catheter and drainage bag in place unless your doctor told you not to.
• When you clean around the catheter, check the surrounding skin for signs of infection. Look for things like pus and irritated, swollen, red, or tender skin around the catheter.

Be careful with your drainage bag

• Always keep the drainage bag below the level of your bladder. This will help keep urine from flowing back into your bladder.
• Check often to see that urine is flowing through the catheter into the drainage bag.
• Empty the drainage bag when it is half full. This will keep it from overflowing or backing up.
• When you empty the drainage bag, do not let the tubing or drain spout touch anything.
• Keep the cap that comes with the tubing, and cover the tip of the tubing when not in use.

Be careful with your catheter

• Do not unhook the catheter from the drain tube until you are ready to change the tubing and bag. That could let germs get into the tube.
• Make sure that the catheter tubing does not get twisted or kinked.
• Do not tug or pull on the catheter. And make sure that the drainage bag does not drag or pull on the catheter.
• Do not put powder or lotion on the skin around the catheter.
• Talk with your doctor about your options for sexual intercourse while wearing a catheter.

How do you empty the bag?

If your doctor has asked you to keep a record, write down the amount of urine in the bag before you empty it.

Wash your hands before and after you touch the bag.

1. Remove the drain spout from its sleeve at the bottom of the drainage bag.
2. Open the valve on the drain spout. Let the urine flow out into the toilet or a container. Be careful not to let the tubing or drain spout touch anything.
3. After you empty the bag, close the valve. Then put the drain spout back into its sleeve at the bottom of the collection bag.

How do you switch to a bedside bag for overnight use?

Wash your hands before and after you handle the bags.

1. Empty the leg bag that is attached to the tubing and catheter.
2. Put a clean towel under the tubing attached to the leg bag.
3. Use an alcohol wipe to clean the tip of the tubing attached to the bedside bag.
4. To stop the flow of urine, pinch the catheter with your fingers just above the tubing connection.
5. Use a twisting motion to disconnect the leg bag tubing from the catheter.
6. Then securely connect the catheter to the tubing from the bedside bag.

How do you clean a bedside bag?

Many people clean their bedside bag in the morning if they switch to a leg bag.

Before you start, clean and disinfect the area where you will be working, such as the sink and counter. Then follow these steps:
1. Wash your hands really well with soap and water or use alcohol-based hand rub.
2. Make sure you have everything you need:

· Clear liquid soap (regular dish soap is fine).
· A clean measuring cup.
· 1:1 water and vinegar solution. Mix together 1 part white vinegar and 1 part water (for example, 1 cup of vinegar and 1 cup of water).
· A clean, 60 mL catheter-tip syringe or a squeeze bottle.
· A clean towel or paper towels for a clean workspace.
· Clean examination gloves (optional).
· Alcohol or chlorhexidine swabs.

3. Put on the gloves (if worn).
4. Empty the drainage bag and disconnect the tube. Connect alternate drainage bag.
5. Add a few drops of liquid soap to 1 cup of water in the squeeze bottle.
6. Squeeze the soapy water into the drainage bag.
7. Gently shake the soapy water around in the drainage bag to loosen anything that might be stuck inside. Rub and shake the sides of the bag. Make sure the whole bag is clean, including the drainage spout and tubing.
8. Pour out the soapy water through the drainage spout and tubing. Flush the drainage bag with tap water, until the water runs clear through tubing and spout. Check to make sure there is no soap left in the bag, spout, and tubing.
9. Put the vinegar and water solution in the syringe or squeeze bottle, and squeeze it into the drainage bag to rinse it out. Shake the bag around and let it sit for 15 minutes. Then rinse the bag out with cool tap water and let it air dry.
10. Empty and wash the squeeze bottle or syringe after every time you use it. Wash it with hot, soapy water, then rinse it and let it air dry. Throw out the syringe or squeeze bottle if it:

· Looks damaged or broken.
· Changes colour (discoloured).
· Feels different than usual (for example, it feels harder, more brittle, or softer).

11. Take off the gloves (if you wore them) and wash your hands. Make any notes your healthcare provider asked you to make.

Important things to remember

When cleaning, check the drainage bag for damage (such as holes or tears) and to see if it’s discoloured.
Throw out the drainage bag and use a new bag every 7 days. Use a new bag right away if the one you’re using is:

· Damaged.
· Discoloured.
· Stiff and brittle.
· Smelly even after you clean it.

Let the drainage bag, spout, and tubing dry on a clean, dry surface after you clean them. Make sure the spout, connector, and tubing don’t touch anything. Wipe all ends with alcohol or chlorhexidine swabs before you reconnect them.

1. Remove the bedside bag and attach the leg bag.
2. Fill the bedside bag with 2 parts vinegar and 3 parts water. Let it stand for 20 minutes.
3. Empty the bag, and let it air dry.

When should you call for help?

Call your doctor or nurse advice line now or seek immediate medical care if:

• You have symptoms of a urinary infection. These may include:
  • Pain or burning when you urinate.
  • A frequent need to urinate without being able to pass much urine.
  • Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
  • Blood in your urine.
  • A fever.
• Your urine smells bad.
• You see large blood clots in your urine.
• No urine or very little urine is flowing into the bag for 4 or more hours.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

• The area around the catheter becomes irritated, swollen, red, or tender, or there is pus draining from it.
• Urine is leaking from the place where the catheter enters your body.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter U010 in the search box to learn more about "Learning About Indwelling Urinary Catheter Care to Prevent Infection".

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