1 00:00:23,085 --> 00:00:26,542 When inserting an indwelling urinary catheter, follow these steps. 2 00:00:30,638 --> 00:00:35,263 Check the healthcare provider’s order to determine the type of catheterization to be performed. 3 00:00:36,173 --> 00:00:39,981 Assess the patient for allergies to latex, povidone iodine, or tape. 4 00:00:50,490 --> 00:00:53,290 Apply clean gloves and drape the patient for privacy. 5 00:01:10,347 --> 00:01:14,811 Provide perineal care and examine the urinary meatus. 6 00:01:54,346 --> 00:01:57,466 Then, remove gloves and perform hand hygiene. 7 00:02:00,698 --> 00:02:06,842 Position the male patient with knees flexed and feet wide apart, or have the patient lie flat with the legs close together. 8 00:02:13,871 --> 00:02:17,323 Remove the catheter kit from the outside plastic packaging. 9 00:02:24,914 --> 00:02:29,810 Turn the edges of the plastic bag to the outside without contaminating the inside of the bag. 10 00:02:30,819 --> 00:02:34,578 Place toward the end of the bed for use as a trash receptacle. 11 00:02:34,578 --> 00:02:42,663 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. 12 00:02:46,646 --> 00:02:53,126 Position the catheterization tray on the bed between the patient’s legs or on the patient’s lap, on top of the thighs. 13 00:02:54,743 --> 00:02:59,480 Open the distal flap of the tray first, then both side flaps, 14 00:03:02,268 --> 00:03:04,396 and the flap closest to you last. 15 00:03:05,052 --> 00:03:10,794 Touch only the 1-inch outer margin of the sterile wrapper with your bare hands to prevent contamination of your sterile field. 16 00:03:10,794 --> 00:03:15,485 Remove the sterile drape from the catheter kit without contaminating the contents of the tray. 17 00:03:19,525 --> 00:03:24,948 Place the sterile drape over the patient’s lap or thighs. Hold it by the 1-inch outer margin. 18 00:03:30,100 --> 00:03:35,493 Remove the fenestrated drape with the diamond-shaped opening in the middle and place it carefully around the penis. 19 00:03:43,893 --> 00:03:45,252 Put on the sterile gloves. 20 00:04:20,804 --> 00:04:28,805 Lift out the plastic tray, and place it on the sterile field, avoiding the 1-inch unsterile outer margin. 21 00:04:30,022 --> 00:04:36,132 From the kit, pick up and open the lubricant and squeeze it onto a section of sterile plastic tray. 22 00:04:47,828 --> 00:04:51,750 Open the package of Betadine, and empty the contents over the cotton balls. 23 00:04:52,438 --> 00:04:58,214 Some kits may be packaged with Betadine swabs instead of cotton balls and liquid Betadine. 24 00:04:58,532 --> 00:05:02,644 Use another type of antiseptic cleanser if the patient is allergic to Betadine. 25 00:05:07,860 --> 00:05:09,830 Lift out the sterile catheter. 26 00:05:13,508 --> 00:05:18,517 Carefully remove the plastic cover from the catheter, maintaining strict asepsis of the catheter. 27 00:05:29,381 --> 00:05:31,829 Drop the plastic off to the side of your sterile field. 28 00:05:34,581 --> 00:05:39,141 Using your dominant hand, pick up the syringe containing sterile water, and screw the Luer-Lok tip 29 00:05:39,141 --> 00:05:44,822 to the colored port on the second lumen of the catheter and leave it attached for inflating the balloon later. 30 00:05:49,541 --> 00:05:55,110 Now place the catheter with attached syringe into the sterile kit box within your sterile field. 31 00:05:55,110 --> 00:05:58,438 Use caution while you position the catheter. 32 00:05:58,438 --> 00:06:02,726 Place the catheter so that the tip is in the lubricant that you opened earlier 33 00:06:18,288 --> 00:06:20,404 Using your non-dominant hand, grasp the penis shaft. 34 00:06:20,404 --> 00:06:27,681 Avoid using one or two fingers and the thumb; apply a full-handed grasp, retracting the foreskin if the man is uncircumcised. 35 00:06:27,872 --> 00:06:31,872 This hand is now unsterile because you have touched the patient’s skin. 36 00:06:32,258 --> 00:06:37,392 Hold the penis at a 90-degree angle to the body while applying gentle traction. 37 00:06:37,392 --> 00:06:44,128 With your dominant hand, pick up the Betadine swab or use the sterile forceps to pick up the Betadine-soaked cotton ball. 38 00:06:49,584 --> 00:06:55,056 Begin cleansing at the urinary meatus, moving in concentric circles until the entire glans penis is cleansed. 39 00:06:56,881 --> 00:07:03,808 Drop the now-contaminated cotton ball or swab in the plastic bag you set up beyond your sterile field. 40 00:07:03,808 --> 00:07:08,257 Use caution to avoid touching the sterile forceps or gloves to any potentially contaminated surface. 41 00:07:09,936 --> 00:07:14,513 Repeat the same cleansing motion three times with three separate cotton balls or swabs. 42 00:07:14,513 --> 00:07:21,216 Remember to use each antiseptic wipe only once, moving in a concentric circle over the meatus and entire glans. 43 00:07:21,216 --> 00:07:26,704 Do not remove your non-dominant hand from the penis after cleaning it to prevent contamination. 44 00:07:26,704 --> 00:07:33,362 Pick up the sterile catheter with your dominant hand, dipping the tip in the lubricant you squirted onto the plastic tray. 45 00:07:33,984 --> 00:07:41,602 Lubricate approximately 5 to 7 inches of the catheter to facilitate insertion and decrease discomfort to the patient. 46 00:07:41,602 --> 00:07:47,296 Some catheter kits include a sterile syringe containing lubricant rather than a package of lubricant. 47 00:07:47,296 --> 00:07:54,562 The tip of the syringe can be gently inserted into the urethra and the plunger depressed to fill the urethra with lubricant. 48 00:07:54,562 --> 00:07:57,298 Follow facility policy. 49 00:07:57,298 --> 00:08:00,946 With your dominant hand, insert the catheter into the urinary meatus. 50 00:08:05,466 --> 00:08:11,357 Advance the catheter 7 to 9 inches until you see urine flowing into the drainage tubing. 51 00:08:18,157 --> 00:08:23,261 Advance the catheter another 1 to 2 inches to ensure that the catheter is fully in the bladder. 52 00:08:23,261 --> 00:08:28,658 If you inadvertently inflate the balloon while it is still in the urethra, you may damage the urethra. 53 00:08:28,658 --> 00:08:32,077 Keep your dominant hand on the catheter 54 00:08:32,077 --> 00:08:37,197 Do not force the catheter if you are unable to gently advance it. 55 00:08:37,197 --> 00:08:43,203 Release the penis and, with your non-dominant hand, inflate the balloon by depressing the plunger on the syringe completely. 56 00:08:43,203 --> 00:08:49,013 Twist the syringe off of the connection port and dispose of it in the plastic bag. 57 00:08:50,142 --> 00:08:54,109 Pull gently on the catheter to seat it at the cystourethral junction. 58 00:08:58,317 --> 00:09:00,237 Replace the foreskin if it was retracted. 59 00:09:00,246 --> 00:09:05,821 If the foreskin is left in the retracted position, particularly with an indwelling catheter in place, 60 00:09:05,821 --> 00:09:11,464 it can cause a stricture-like effect, resulting in edema and possible necrosis of the head of the penis. 61 00:09:55,154 --> 00:10:00,183 Cleanse all Betadine or other cleanser from the urinary meatus and surrounding area. 62 00:10:23,523 --> 00:10:29,428 Secure the indwelling catheter to the patient’s thigh with a leg strap or tape. 63 00:10:29,428 --> 00:10:31,715 Some males may prefer to secure it to the lower abdomen. 64 00:10:31,715 --> 00:10:35,106 If you are not certain, simply ask the patient for his preference. 65 00:10:35,346 --> 00:10:41,379 To ensure adequate catheter length for patient movement, secure the catheter at the Y-junction. 66 00:10:41,379 --> 00:10:47,908 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. 67 00:10:47,908 --> 00:10:54,196 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. 68 00:10:54,196 --> 00:11:02,146 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. 69 00:11:02,146 --> 00:11:06,451 The drainage bag should not be elevated above the level of the patient’s bladder, 70 00:11:06,451 --> 00:11:10,276 to prevent urine from draining from the catheter tubing back into the bladder. 71 00:11:10,276 --> 00:11:15,443 When you finish the procedure, remember the Universal Steps that apply after all procedures. 72 00:11:15,443 --> 00:11:21,714 For example, leave the patient in a safe, comfortable position with the call device in easy reach. 73 00:11:21,714 --> 00:11:26,083 Document the procedure in the electronic health record.