Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [129], C).
2. 2.Show
   Wash hands with soap and water or use an alcohol‐based handrub and apply personal protective equipment.
   To reduce the risk of cross‐infection (NHS England and NHSI [122], C).
3. 3.Show
   Clean the trolley or plastic tray following local guidelines for an aseptic procedure.
   To reduce the risk of cross‐infection (Loveday et al. [98], R).
4. 4.Show
   Open dressing pack using an aseptic technique.
   To reduce the risk of cross‐infection (Loveday et al. [98], R).
5. 5.Show
   Ensure the patient is in a comfortable position whereby the catheter is accessible.
   To maintain dignity and comfort (RCN [153], E).

Procedure

1. 6.Show
   Remove the tape and dressing from the catheter insertion site.
   To gain access to the catheter for removal. E
2. 7.Show
   Observe the site for any evidence of infection, such as redness, swelling or purulent discharge.
   If infection is suspected, the tip of the catheter should be sent to microbiology for culture and sensitivity analysis, as per local policy. E
3. 8.Show
   If the exit site appears clean and dry, it is not necessary to clean the skin prior to removal. If the site does require cleaning (e.g. due to exudate or dried blood), use an aseptic non‐touch technique with sodium chloride 0.9% solution and sterile gauze.
   To assess the site and ensure it is clean of any exudate or residue prior to catheter removal. E
4. 9.Show
   Decontaminate hands and apply clean gloves.
   To reduce the risk of cross‐infection (NHS England and NHSI [122], C).
5. 10.Show
   Grasp the catheter as close as you can to where it enters the skin and gently, in one swift movement, remove the catheter. There should be little discomfort or resistance to the removal. A small amount of blood or fluid drainage is normal.
   To ensure the catheter is removed intact with minimum discomfort to the patient. E
6. 11.Show
   Inspect the catheter, ensuring it is intact by observing the markings at the tip (usually blue or black) and checking that the 1 cm markings along the catheter are all intact.
   To ensure the catheter has been removed whole and intact and that part of the catheter has not been left in the patient. E
7. 12.Show
   If required (if an infection is suspected) and as per local policy, send the tip to microbiology for further investigation.
   To assess the catheter as a potential source of infection. E
8. 13.Show
   Apply a transparent occlusive dressing (unless there is exudate, in which case use an occlusive dressing with absorbent pad) and leave it in situ for 24 hours.
   To ensure all bleeding has stopped. To prevent inadvertent access of micro‐organisms along the tract. E
9. 14.Show
   Remove gloves and apron and dispose of all materials as per local policy. Decontaminate hands.
   To prevent cross‐infection (NHS England and NHSI [122], C).

Post‐procedure

1. 15.Show
   Observe the site for signs of infection, such as redness, tenderness, swelling or pus‐like drainage at the insertion site. Also observe for any signs of bleeding at the site.
   To ensure any adverse signs of infection or bleeding are identified and treated early to prevent any further complications. E