A nurse is preparing a sterile field in order to insert an indwelling urinary catheter
When preparing to insert an indwelling urinary catheter, it is important to use the nursing process to plan and provide care to the patient. Begin by assessing the appropriateness of inserting an indwelling catheter according to CDC criteria as discussed in the “Preventing
CAUTI” section of this chapter. Determine if alternative measures can be used to facilitate elimination and address any concerns with the prescribing provider before proceeding with the provider order. In addition to verifying the appropriateness of the insertion of an indwelling catheter
according to CDC recommendations, it is also important to assess for any conditions that may interfere with the insertion of a urinary catheter when feasible. See suggested interview questions prior to inserting an indwelling catheter and their rationale in Table \(\PageIndex{1}\). For males: Do you have any history of prostate enlargement or prostate problems? For females: Have you had any gynecological surgeries? Cultural ConsiderationsWhen inserting urinary catheters, be aware of and respect cultural beliefs related to privacy, family involvement, and the request for a same-gender nurse. Inserting a urinary catheter requires visualization and manipulation of anatomical areas that are considered private by most patients. These procedures can cause emotional distress, especially if the patient has experienced any history of abuse or trauma. Objective AssessmentIn addition to performing a subjective assessment, there are several objective assessments to complete prior to insertion. See Table \(\PageIndex{2}\) for a list of objective assessments and their rationale. Table \(\PageIndex{2}\): Objective Assessment
Life Span ConsiderationsChildren Older Adults Expected Outcomes/Planning
Safety is a priority! Acquire additional staff assistance to help support and position patients who are weak, obese, frail, confused, uncooperative, or have a fractured hip or pelvis. ImplementationWhen inserting an indwelling urinary catheter, the expected finding is that the catheter is inserted accurately and without discomfort, and immediate flow of clear, yellow urine into the collection bag occurs. However, unexpected events and findings can occur. See Table \(\PageIndex{4}\) for examples of unexpected findings and suggested follow-up actions. Table \(\PageIndex{4}\): Unexpected Findings and Follow-Up Actions
EvaluationEvaluate the success of the expected outcomes established prior to the procedure. Why should you use sterile gloves when inserting a urinary catheter?To minimise risk of infection insertion of IDC's must be performed using surgical aseptic technique with single use sterile gloves.
How do you insert an indwelling urinary catheter?Grasp the sterile catheter 2 to 3 inches (5 to 7.5 cm) from the tip and keep it from touching anything. Ask the patient to take a deep breath and slowly exhale while you insert the catheter tip. Advance it 2 to 3 inches until urine flow starts. Advance it another 1 to 2 inches to make sure it's in the bladder.
When placing an indwelling urinary catheter Where should the nurse hold the catheter?When placing an indwelling urinary catheter, where should the nurse hold the catheter? By holding the catheter 2 to 3 in (5 to 7.5 cm) from the tip, it allows for adequate control while decreasing risk of contamination. The catheter should not be held directly at the tip or at 1 in (2.5 cm) to facilitate insertion.
What is a critical step when inserting an indwelling catheter into a male patient?What is a critical step when inserting an indwelling catheter into a male patient? Advance the catheter to the bifurcation of the drainage and balloon ports. Correct. Advancing the catheter to the bifurcation avoids inflating the catheter balloon in the prostatic urethra causing trauma and pain.
|