Catheter insertion and removal

Patient Interaction and Preparation

• Introduce self and role

  • "My name is Amanda. I'm gonna be your nurse today. Can I get your name, your date of birth, and do you have any allergies?"

  • Verify allergies to iodine, shellfish, or betadine: "Do you have any specific allergies to iodine, shellfish, or betadine?"

Environmental Safety Check

• Check the following:

  • Ampu bag

  • Suction (ensure it is on and functional)

  • Oxygen (ensure it is working)

Procedure Explanation

• Explain the purpose of the procedure:

  • "I'm gonna put in a Foley catheter to help drain your urine since you're currently retaining a lot of urine."

• Describe sensation:

  • "It might hurt a little bit, but it shouldn't be too painful. It will feel like a little pinch."

• Use layman's terms instead of medical jargon:

  • Instead of "urethra", say "I'm gonna put a small tube up into your bladder."

Patient Questions and Education

• Encourage questions:

  • "Do you have any other questions for me?"

• Inform about potential patient education questions during validation.

Peri-Care Procedure

• State the process:

  • "I'm gonna provide peri care. We usually do this four times. It's cleaning the area with towel, soap, and water."

  • Position patient

  • Note on hospital policy: Some may use wipes instead.

• Inform about glove use in the procedure:

  • "Always wear gloves when touching the patient or things in the room."

Setup for Foley Catheter Insertion

• Preparation steps:

  • Ensure the bed is locked.

  • Expose the patient appropriately.

  • Perform hand hygiene after removing gloves.

• Open the Foley catheter kit appropriately:

  • Use a one-inch border to maintain sterility when opening the kit.

• Locate and use the sterile gloves:

  • "Always keep your hands high when putting on sterile gloves."

• Place drapes correctly:

  • "The shiny side goes down to absorb liquid."

Catheter Preparation Steps

• Open necessary supplies:

  • Swabs (three total)

  • Lubricant jelly

  • 10 ml syringe for balloon inflation

  • Collecting container (urine cup)

• Use a trash bag for waste:

  • Place at the foot of the bed for ease.

• Check balloon integrity:

  • Note that evidence-based practice states the balloon should only be inflated once.

Patient Positioning

• Position the patient appropriately:

  • Ensure the legs are properly positioned.

• Confirm with patient:

  • Communicate what you are doing.

Cleaning Process Before Insertion

• Explanation of cleaning steps:

  • Use three swabs to clean:

  • "Clean away from the body first to prevent cross-contamination."

    • First swab: Clean away from you.

    • Second swab: Clean closest to you.

    • Third swab: Clean the middle area.

Foley Catheter Insertion Steps

• Insert the catheter with care:

  • Verify proper sensation and help the patient (e.g., bear down).

• Identify when to stop insertion:

  • Stop at first sign of urine or if resistance is met.

  • Advance the catheter one to two inches if urine is observed.

• Balloon inflation process:

  • Maintain thumb pressure on the syringe during inflation.

  • Check for a tight seal by tugging gently on the catheter afterwards.

Documentation and Post-Procedural Care

• Document urine output immediately after catheter insertion.

• Discuss securement of catheter:

  • Use a stat lock strap to prevent excessive pulling of the catheter.

Discontinuation Process

• Prepare for catheter removal:

  • Explain to the patient:

  • "I'm gonna take out the Foley catheter. It shouldn't hurt. I will first remove the saline from the balloon."

• Document the amount of urine collected in the bag.

Final Steps and Best Practices

• Provide peri-care after catheter removal.

• Repeat documentation of the amount in the bag after removal.

  • Assess urine for color, clarity, and consistency as needed.

• Always verbalize procedural steps when validating practice.

Important Notes on Validation

• Encourage student practice and questions throughout the validation.

• Prepare for various practical scenarios beyond theoretical knowledge.

• Understand critical steps for patient care; ensure patient understanding and comfort at all times.

• Recall potential challenges and best practices through hands-on demonstrations and verbalized explanations.