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 [165], C).
2. 2.Show
   Ensure a suitable private location.
   To maintain patient privacy and dignity. E
3. 3.Show
   Ensure the patient is in a comfortable position (sitting up, supported by pillows) and that the stoma is easily accessible.
   For patient comfort and to allow access to the stoma. E
4. 4.Show
   Prepare equipment and place on sterile trolley.
   To prepare equipment for use. E

Procedure

1. 5.Show
   Wash hands with bactericidal soap and water and dry, or decontaminate physically clean hands with alcohol rub. Put on non‐sterile gloves.
   To prevent cross‐contamination (NHS England and NHSI [155], C).
2. 6.Show
   Remove the appliance from stoma. Decontaminate hands, apply gloves and place sterile towel/pad under stoma.
   To absorb any spillage from the stoma. E
3. 7.Show
   Clean around the stoma with sterile water or 0.9% sodium chloride from the centre outwards.
   Cleaning of the area reduces the risk of introducing surface pathogens into the ileal conduit. E
4. 8.Show
   Apply gentle skin traction to make the stoma opening more visible.
   To avoid the catheter coming into contact with the external surface of the stoma. E
5. 9.Show
   Insert the catheter tip gently into the stoma to a depth of 2.5–5 cm only.
   Gentle handling reduces the risk of ileal perforation and is more comfortable for the patient. E
6. 10.Show
   Allow approximately 10 mL of drain through into a sterile specimen container.
   To avoid contamination and to allow for accurate microbiological processing (PHE [190], C).
7. 11.Show
   Remove the catheter and discard.
   As catheter is no longer required. E
8. 12.Show
   Change gloves, attend to stoma and apply new stoma appliance.
   To ensure patient comfort. E

Post‐procedure

1. 13.Show
   Dispose of waste, remove apron and gloves, and wash and/or decontaminate hands.
   To ensure correct clinical waste management and reduce the risk of cross‐infection (DH [48], C).
2. 14.Show
   Label sample immediately and complete microbiological request form (including relevant clinical information, such as signs and symptoms of infection, and antibiotic therapy).
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
3. 15.Show
   Dispatch sample to laboratory immediately (within 4 hours) or refrigerate at 4°C.
   To ensure the best possible conditions for microbiological analysis and to prevent micro‐organism proliferation (PHE [190], C).
4. 16.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).