Failure to Maintain Catheter Tubing Free of Kinks or Loops
Penalty
Summary
A deficiency was identified when a resident with an indwelling urinary catheter was observed to have a loop in the catheter tubing, which prevented urine from flowing freely into the drainage bag. During the observation, a CNA confirmed that the tubing contained urine and white sediment, and acknowledged that staff are responsible for ensuring the catheter bag is below the bladder, covered for privacy, and that the tubing is free from kinks or loops. The facility's policy also requires that catheter tubing be kept free from kinking and that the collection bag remain below the bladder level. The resident involved had a history of obstructive uropathy, pneumonia, and type 2 diabetes mellitus, and required varying levels of assistance with activities of daily living due to impaired cognition and lower extremity impairment. Physician orders specified monitoring the catheter and drainage bag for issues such as sediment, foul odor, hematuria, and bladder distention every shift. Both the CNA and the DON confirmed that the presence of a loop or kink in the catheter tubing is contrary to standard practice and facility policy, as it can impede urine flow.