12.6.4: Procedure- Assisting with Cleaning the Skin and Catheter Tubing
Providing personal hygiene care is an important part of the Home Health Aide/Personal Care Aide’s job. Cleaning the catheter tubing should be completed on a daily basis when providing bathing and perineal care for the patient.
- Explain the procedure to the patient.
- Wash and dry your hands. Apply gloves.
- Gather equipment and supplies needed (soap, wash cloth, towel, and waterproof pad).
- Raise the bed to a safe working height. Lock brakes.
- Provide for patient privacy. Expose only the genital area.
- Position the patient on their back to expose the perineal area and catheter tubing.
- Place a towel or disposable protective pad under the patient.
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Wash the patient’s genital area gently with soap and warm water (no greater than 105 degree Fahrenheit).
- For males : start at the meatus (urinary opening) and clean outward in a circular motion. Clean the shaft of the penis with downward strokes. For uncircumcised males, gently push back on the foreskin to clean under this area. You should use a clean area of the washcloth with each stroke. Remember to replace the foreskin.
- For females : separate the labia and using a clean part of the washcloth, wipe from front to back on each side, using a clean part of the washcloth for each stroke. Wipe from top to bottom down the middle to the opening of the vagina. Clean the area between the vagina and anus last, washing from front to back. Never move from back to front.
- Take care to not pull on the catheter at any time , as this could cause injury to the patient . The catheter tip is inside the bladder. Pulling on the tubing could cause injury to the bladder.
- Hold the tubing with one hand, close to the meatus, while gently cleansing the length of the tubing, starting from the point of entry (urinary opening) and moving down the tubing.
- A warm soapy washcloth can be used, unless otherwise directed in the Care Plan. Replace with clean washcloths as needed. When done washing the tubing, use a clean, wet washcloth to rinse the tubing. Always move from the urinary opening downward. Never clean the bottom part of the tubing and move toward the urinary opening. This could introduce bacteria into the urinary system.
- Observe the genital area around the catheter for sores, swelling, crusting, leakage, or bleeding. Document and report these observations.
- Ensure the catheter tubing is taped or that a catheter securement device is in place, according to the Care Plan.
- Position the patient so that the catheter tubing does not kink or pull. The urinary drainage bag should be below the level of the patient’s bladder.
- Dispose of dirty linens and water. Remove the bed protector or towel from under the patient.
- Lower the bed to its lowest setting and ensure side rails are up for patient safety.
- Discard gloves and wash your hands.
- Record time of procedure and any observations or changes in behavior or condition.