In this section
Note: This guideline is currently under review.
Definition of Terms
Procedure for insertion of urinary catheter
Ongoing nursing management
Removal of urinary catheter
Insertion of an indwelling urethral catheter (IDC) is an invasive procedure that should only be carried out using aseptic technique, Insertion of an indwelling urethral catheter (IDC) is an invasive procedure that should only be carried using aseptic technique, either by a nurse, or doctor if complications or difficulties with insertion are anticipated. Catheterisation of the urinary tract should only be done when there is a specific and adequate clinical indication, as it carries a risk of infection.
To ensure the insertion and care of the urinary catheter is carried out in a safe manner that minimises trauma and infection risks.
Ensure the patient’s privacy is maintained throughout the procedure and that they are kept warm. Ensure there is adequate light to perform the procedure.
Prepare the following equipment:
Use an appropriate size catheter depending on the age of the child. Catheters that are too big or small are at risk of urethral trauma or leakage. The rational for IDC insertion should also be considered when selecting catheter, for example a patient requiring an IDC post kidney trauma may require a larger size to provide adequate drainage of potential blood clots. Consider silicone catheter if for long term use.
The need for an IDC should be discussed with the patients’ medical team
prior to insertion. Medical approval for IDC insertion should be ordered and/or
The following should be completed in line with the RCH Aseptic Technique Procedure.
If unable to pass the catheter seek assistance from treating medical team or Urology registrar. DO NOT use force as you may damage the urethra.
Rapid drainage of large volumes of urine from the bladder may result in hypotension and/or haemorrhage. If concerned clamp catheter if the volume seems excessive. Release clamp after 20 minutes to allow more urine to drain. A medical review of the child should be requested.
For post obstructive diuresis IV replacement of fluid and electrolytes may be required. This should be discussed with the treating medical team.
Insertion of the IDC should be documented in the LDA activity.
Adherence to a sterile continuously closed method of urinary drainage has been shown to markedly reduce the risk of acquiring a catheter associated infection. Therefore breaches to the closed system should be avoided.
Consider changing the catheter tube and/or bag based on clinical indicators including infection, contamination, obstruction or if system disconnects. If the equipment is damaged or leaks, replace system and/or catheter using aseptic technique and sterile equipment.
The following techniques to check for patency and/or flush a catheter should be completed following the Aseptic Technique Procedure.
Other RCH IDC resources available:
Indwelling urinary catheter insertion and management evidence table
Please remember to
read the disclaimer.
development of this nursing guideline was coordinated by Liam Cunningham, RN, Day Medical Unit, and approved by the Nursing Clinical Effectiveness Committee. Updated September 2020.