Pre‐procedure

ActionRationale

1. 1.Show
   Catheters can be removed at any time. However, it is sensible to remove them early in the morning.
   So that any retention problems can be dealt with during the day, thus avoiding delays in recatheterization if required. E
2. 2.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed. Inform them of potential post‐catheter symptoms, such as urgency, frequency and discomfort, which are often caused by irritation of the urethra by the catheter.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [178], C).

   So that the patient knows what to expect and can plan their daily activity. E
3. 3.Show
   Wash hands using soap and water and/or an alcohol‐based handrub, and put on personal protective equipment.
   To reduce the risk of cross‐infection (NHS England and NHSI [161], C).

Procedure

1. 4.Show
   If a specimen is required, clamp below the sampling port until sufficient urine collects. Swab the port with an alcohol wipe and take a catheter specimen of urine using the needle‐free sampling port.
   To obtain an adequate urine sample and to assess whether post‐catheter antibiotic therapy is needed (Fraise and Bradley [81], E).
2. 5.Show
   Wearing gloves, use saline‐soaked gauze to clean the meatus and catheter, always swabbing away from the urethral opening. Note: in females, wipe from front to back.
   To reduce the risk of infection (Fraise and Bradley [81], E). To help reduce the risk of bacteria from the vagina and perineum contaminating the urethra. E
3. 6.Show
   Release the leg support.
   For easier removal of the catheter. E
4. 7.Show
   Having checked the volume of water in the balloon (see patient documentation), use a syringe to deflate the balloon.
   To confirm how much water is in the balloon. To ensure the balloon is completely deflated before removing the catheter. E
5. 8.Show
   Ask the patient to breathe in and then out; as the patient exhales, gently (but firmly with continuous traction) remove the catheter. Note: male patients should be warned of discomfort as the deflated balloon passes through the prostate gland.
   To relax the pelvic floor muscles. E

   It is advisable to extend the penis as per the process for insertion to aid removal. E

Post‐procedure

1. 9.Show
   Males: clean the meatus and make the patient comfortable.

   Females: clean the area from front to back and make the patient comfortable.
   To maintain patient comfort and dignity and reduce the risk of cross‐contamination. E
2. 10.Show
   Advise the patient to exercise and to drink 2–3 L of fluid per day.
   To prevent urinary tract infections. E
3. 11.Show
   Dispose of equipment (including apron and gloves) in a clinical waste bag.
   To ensure correct and safe disposal of clinical waste (DEFRA [63], C).
4. 12.Show
   Wash hands thoroughly with soap and water and/or an alcohol‐based handrub.
   To reduce the risk of infection (NHS England and NHSI [161], C).
5. 13.Show
   Record information in relevant documents; this should include:

   • date and time of catheter removal
   • any samples taken and why
   • any problems associated with the catheter removal
   • follow‐up instructions for care after catheter removal.
   To provide a point of reference or comparison in the event of later queries. To ensure the patient has a follow‐up plan clearly documented (NMC [178], C).