0:00:23.085,0:00:26.542 When inserting an indwelling urinary catheter,[br]follow these steps. 0:00:30.638,0:00:35.263 Check the healthcare provider’s order to determine the type of catheterization to be performed. 0:00:36.173,0:00:39.981 Assess the patient for allergies to latex, povidone iodine, or tape. 0:00:50.490,0:00:53.290 Apply clean gloves and drape the patient for privacy. 0:01:10.347,0:01:14.811 Provide perineal care and examine the urinary meatus. 0:01:54.346,0:01:57.466 Then, remove gloves and perform hand hygiene. 0:02:00.698,0:02:06.842 Position the male patient with knees flexed and feet wide apart, or have the patient lie flat with the legs close together. 0:02:13.871,0:02:17.323 Remove the catheter kit from the outside plastic packaging. 0:02:24.914,0:02:29.810 Turn the edges of the plastic bag to the outside without contaminating the inside of the bag. 0:02:30.819,0:02:34.578 Place toward the end of the bed for use as a trash receptacle. 0:02:34.578,0:02:42.663 The inside of the bag is still sterile, so if your gloves or forceps accidentally touch the inside as you discard items, they will not be contaminated. 0:02:46.646,0:02:53.126 Position the catheterization tray on the bed between the patient’s legs or on the patient’s lap, on top of the thighs. 0:02:54.743,0:02:59.480 Open the distal flap of the tray first, then both side flaps, 0:03:02.268,0:03:04.396 and the flap closest to you last. 0:03:05.052,0:03:10.794 Touch only the 1-inch outer margin of the sterile wrapper with your bare hands to prevent contamination of your sterile field. 0:03:10.794,0:03:15.485 Remove the sterile drape from the catheter kit without contaminating the contents of the tray. 0:03:19.525,0:03:24.948 Place the sterile drape over the patient’s lap or thighs. Hold it by the 1-inch outer margin. 0:03:30.100,0:03:35.493 Remove the fenestrated drape with the diamond-shaped opening in the middle and place it carefully around the penis. 0:03:43.893,0:03:45.252 Put on the sterile gloves. 0:04:20.804,0:04:28.805 Lift out the plastic tray, and place it on the sterile field, avoiding the 1-inch unsterile outer margin. 0:04:30.022,0:04:36.132 From the kit, pick up and open the lubricant and squeeze it onto a section of sterile plastic tray. 0:04:47.828,0:04:51.750 Open the package of Betadine, and empty the contents over the cotton balls. 0:04:52.438,0:04:58.214 Some kits may be packaged with Betadine swabs instead of cotton balls and liquid Betadine. 0:04:58.532,0:05:02.644 Use another type of antiseptic cleanser if the patient is allergic to Betadine. 0:05:07.860,0:05:09.830 Lift out the sterile catheter. 0:05:13.508,0:05:18.517 Carefully remove the plastic cover from the catheter, maintaining strict asepsis of the catheter. 0:05:29.381,0:05:31.829 Drop the plastic off to the side of your sterile field. 0:05:34.581,0:05:39.141 Using your dominant hand, pick up the syringe containing sterile water, and screw the Luer-Lok tip 0:05:39.141,0:05:44.822 to the colored port on the second lumen of the catheter and leave it attached for inflating the balloon later. 0:05:49.541,0:05:55.110 Now place the catheter with attached syringe into the sterile kit box within your sterile field. 0:05:55.110,0:05:58.438 Use caution while you position the catheter. 0:05:58.438,0:06:02.726 Place the catheter so that the tip is in the lubricant that you opened earlier 0:06:18.288,0:06:20.404 Using your non-dominant hand, grasp the penis shaft. 0:06:20.404,0:06:27.681 Avoid using one or two fingers and the thumb; apply a full-handed grasp, retracting the foreskin if the man is uncircumcised. 0:06:27.872,0:06:31.872 This hand is now unsterile because you have touched the patient’s skin. 0:06:32.258,0:06:37.392 Hold the penis at a 90-degree angle to the body while applying gentle traction. 0:06:37.392,0:06:44.128 With your dominant hand, pick up the Betadine swab or use the sterile forceps to pick up the Betadine-soaked cotton ball. 0:06:49.584,0:06:55.056 Begin cleansing at the urinary meatus, moving in concentric circles until the entire glans penis is cleansed. 0:06:56.881,0:07:03.808 Drop the now-contaminated cotton ball or swab in the plastic bag you set up beyond your sterile field. 0:07:03.808,0:07:08.257 Use caution to avoid touching the sterile forceps or gloves to any potentially contaminated surface. 0:07:09.936,0:07:14.513 Repeat the same cleansing motion three times with three separate cotton balls or swabs. 0:07:14.513,0:07:21.216 Remember to use each antiseptic wipe only once, moving in a concentric circle over the meatus and entire glans. 0:07:21.216,0:07:26.704 Do not remove your non-dominant hand from the penis after cleaning it to prevent contamination. 0:07:26.704,0:07:33.362 Pick up the sterile catheter with your dominant hand, dipping the tip in the lubricant you squirted onto the plastic tray. 0:07:33.984,0:07:41.602 Lubricate approximately 5 to 7 inches of the catheter to facilitate insertion and decrease discomfort to the patient. 0:07:41.602,0:07:47.296 Some catheter kits include a sterile syringe containing lubricant rather than a package of lubricant. 0:07:47.296,0:07:54.562 The tip of the syringe can be gently inserted into the urethra and the plunger depressed to fill the urethra with lubricant. 0:07:54.562,0:07:57.298 Follow facility policy. 0:07:57.298,0:08:00.946 With your dominant hand, insert the catheter into the urinary meatus. 0:08:05.466,0:08:11.357 Advance the catheter 7 to 9 inches until you see urine flowing into the drainage tubing. 0:08:18.157,0:08:23.261 Advance the catheter another 1 to 2 inches to ensure that the catheter is fully in the bladder. 0:08:23.261,0:08:28.658 If you inadvertently inflate the balloon while it is still in the urethra, you may damage the urethra. 0:08:28.658,0:08:32.077 Keep your dominant hand on the catheter 0:08:32.077,0:08:37.197 Do not force the catheter if you are unable to gently advance it. 0:08:37.197,0:08:43.203 Release the penis and, with your non-dominant hand, inflate the balloon by depressing the plunger on the syringe completely. 0:08:43.203,0:08:49.013 Twist the syringe off of the connection port and dispose of it in the plastic bag. 0:08:50.142,0:08:54.109 Pull gently on the catheter to seat it at the cystourethral junction. 0:08:58.317,0:09:00.237 Replace the foreskin if it was retracted. 0:09:00.246,0:09:05.821 If the foreskin is left in the retracted position, particularly with an indwelling catheter in place, 0:09:05.821,0:09:11.464 it can cause a stricture-like effect, resulting in edema and possible necrosis of the head of the penis. 0:09:55.154,0:10:00.183 Cleanse all Betadine or other cleanser from the urinary meatus and surrounding area. 0:10:23.523,0:10:29.428 Secure the indwelling catheter to the patient’s thigh with a leg strap or tape. 0:10:29.428,0:10:31.715 Some males may prefer to secure it to the lower abdomen. 0:10:31.715,0:10:35.106 If you are not certain, simply ask the patient for his preference. 0:10:35.346,0:10:41.379 To ensure adequate catheter length for patient movement, secure the catheter at the Y-junction. 0:10:41.379,0:10:47.908 Hang the catheter drainage bag from a part of the bed that moves with the patient when raised or lowered, avoiding using the bed rails. 0:10:47.908,0:10:54.196 If the drainage bag is hung on the bed rails, it can be elevated above the level of the bladder when the rails are raised. 0:10:54.196,0:11:02.146 Hanging the drainage bag on the side of the bed nearest the door allows you to do a quick visual assessment of the amount and color of urine in the bag. 0:11:02.146,0:11:06.451 The drainage bag should not be elevated above the level of the patient’s bladder, 0:11:06.451,0:11:10.276 to prevent urine from draining from the catheter tubing back into the bladder. 0:11:10.276,0:11:15.443 When you finish the procedure, remember the Universal Steps that apply after all procedures. 0:11:15.443,0:11:21.714 For example, leave the patient in a safe, comfortable position with the call device in easy reach. 0:11:21.714,0:11:26.083 Document the procedure in the electronic health record.