Pre‐procedure

ActionRationale

1. 1.Show
   Explain and discuss the procedure with the patient.
   To ensure the patient understands the procedure and gives their valid consent (NMC [159], C).
2. 2.Show
   Wash hands with bactericidal soap and water or bactericidal alcohol handrub.

   Clean trolley (or plastic tray in the community) with chlorhexidine in 70% alcohol with a paper towel.
   To minimize cross‐infection (Preston [177], C).

   To provide a clean working surface (Parker [167], E).
3. 3.Show
   Open dressing pack.
    

Procedure

1. 4.Show
   Wash hands and remove tape and dressing from catheter insertion site.
   To minimize risk of cross‐infection (Preston [177], C).
2. 5.Show
   Wash hands with bactericidal handrub. Put on gloves and personal protective apron.

   Gently, in one swift movement, remove the catheter.

   Check that the catheter is intact. This can be done by observing that the tip of the catheter is marked blue and that the 1 cm marks along the length of the catheter are all intact.
   To minimize the risk of microbial contamination

   (Loveday et al. [125], E).

   To ensure the catheter is removed intact with the minimum of discomfort to the patient. E
3. 6.Show
   Clean around the catheter exit site using skin‐cleaning agent.
   To minimize contamination of site by micro‐organisms. E
4. 7.Show
   Apply an occlusive dressing and leave in situ for 24 hours.
   To prevent inadvertent access of micro‐organisms along the tract. E

Post‐procedure

1. 8.Show
   The epidural/intrathecal tip may be sent for culture and sensitivity if infection is suspected, or according to local policy.
    
2. 9.Show
   Remove gloves and apron and dispose of all material in the clinical waste bag. Wash hands with soap and water.
   To prevent environmental contamination (Preston [177], C).
3. 10.Show
   Document that the catheter was removed intact in nursing notes.
   To maintain accurate patient record.