Improper Positioning of Indwelling Urinary Catheter Tubing
Penalty
Summary
A deficiency was identified when a resident with an indwelling urinary catheter was observed with the catheter tubing positioned above the bladder and kinked, preventing the free flow of urine. The tubing was seen protruding from the top of the resident's shorts and connected to a drainage bag anchored on a walker. The resident reported blood in the urine, and it was noted that urine was not flowing freely due to the kinked tubing. The resident had a history of benign prostatic hyperplasia with obstructive uropathy and urinary tract infection, and required supervision or assistance for toileting hygiene and catheter care. The care plan indicated the resident had a tendency to touch or reposition the catheter, sometimes placing it above the bladder level, despite instructions to keep it below the bladder to prevent complications. Staff interviews confirmed that the best practice for catheter positioning is to secure the tubing to the thigh and keep the drainage bag below the bladder to prevent backflow. However, the facility did not have a specific policy regarding the proper positioning of indwelling urinary catheters. The facility's existing policy only addressed routine catheter care but did not specify positioning requirements. At the time of the survey, four residents in the facility had indwelling urinary catheters.