Urine drainage kit for indwelling catheterization consists of a set of instruments used to drain urine by inserting a catheter into the bladder, via the urethra which remains in situ. The kit consists of instruments for adults with quantities estimated for 50 patients. The kit is designed for healthcare facilities in low, middle and high resource settings or for use at home when clinically indicated.

The solution has been adapted from Red Cross & The Royal Children's Hospital Melbourne web information.  

Indwelling catheterization is an invasive procedure, used to drain urine by inserting a catheter into the bladder, via the urethra (the same way as an intermittent catheter) and remains in situ for recommended time period. The catheter is held in the bladder by a water-filled balloon, which prevents it falling out and the catheter drains urine from bladder into a bag outside the body. Common reasons to have an indwelling catheter are urinary incontinence (leakage), urinary retention (not being able to urinate), surgery that made this catheter necessary, or another health problem.  

Important; Catheterization of the urinary tract should only be done when there is a specific and adequate clinical indication, as it carries a risk of infection. Indwelling catheterization should be carried out using aseptic technique either by a nurse, doctor or delegated medical professional. However, if complications or difficulties with insertion are anticipated the process could be done by either a nurse, or doctor. Ensure the patient’s privacy is maintained throughout the procedure and that they are kept warm. Also, make sure there is adequate light to perform the procedure. 

All reusable products should be thoroughly cleaned and disinfected after each use.   

Additional Information:   

Urinary catheters: Catheters are available in different types and different sizes. Based on the patient’s gender and age, catheter should be selected. Usually single-use, two-way (double or triple lumens) Foley catheters are used for indwelling catheterization, one removes urine and the smaller lumen enables balloon water inflation securing the indwelling catheter in the urinary bladder. Triple-lumen catheters are also used for continuous bladder irrigation when instilling medications into the bladder is indicated.  

* The catheter sizes could be modified based on the patient population and clinical indications.    

Urine collection bags: Urine collection bags are designed to collect urine drained from the bladder via a catheter. It is important to position drainage bag to prevent backflow of urine or contact with the floor. Ensure the drainage bag is below the level of the bladder and it is not kinked or twisted and is secured. 

Lubricating gel: Lubricating gel is used to minimized pain and reducing the risk of infection and trauma. If hydrophilic catheter is recommended, then lubricating gel is not required.  

Gloves: Gloves are only recommended for medical staff during catheterization to reducing risk of injury and exposure to blood, other potentially infectious materials. Latex-free gloves are recommended due to allergies. 

* The glove sizes could be modified based on the common size used in the location.     

Syringes: Regular luer slip syringe (20 ml) is used to draw up sterile water into inflation balloon and large luer slip (100 – 150 ml) syringe is used to facilitate bladder irrigation.  

Sterile water: Sterile water is used to inflate the catheter balloon to the volume recommended on the catheter. It is important to avoid using normal saline for the balloon inflation, since it could result in crystal formation ending up in blockage of balloon channel. Also, under and over inflated balloons can cause problems with drainage i.e. eye occlusion, bladder wall irritation and spasms. 

Normal saline: Sodium chloride is used for catheter flush or bladder washout when required. The procedure is carried out using a bladder syringe and 0.9% Sodium chloride flushed through the catheter to remove any debris that may be in the bladder, which can lead to blocking the catheter, preventing it from draining. 

Adhesive tape: Adhesive tape is used to secure catheter to patient’s upper thigh or abdomen. The catheter should be secured to help prevent dislodgement, movement induced urethral trauma and increased risk of urinary tract infection.  

Swabs: Swabs are used to clean the labial folds and the urethral opening before catheter insertion.  

Specimen collection container: Collection containers are used to collect urine samples when required for analysis. Usually, samples should be collected fresh from the needleless sampling port of catheter tubing (not drainage bag) and this should be completed in line with the aseptic technique procedure. 

Biohazard bag: Yellow biohazard bags are utilized to dispose of used articles. 

Hand sanitizer: Alcohol based hand sanitizer to perform hand hygiene before and after catheterization.   

Source: Redcross Catalogue & RCH Hospital Guideline