[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:23.08,0:00:26.54,Default,,0000,0000,0000,,When inserting an indwelling urinary catheter,\Nfollow these steps.
Dialogue: 0,0:00:30.64,0:00:35.26,Default,,0000,0000,0000,,Check the healthcare provider’s order to determine the type of catheterization to be performed.
Dialogue: 0,0:00:36.17,0:00:39.98,Default,,0000,0000,0000,,Assess the patient for allergies to latex, povidone iodine, or tape.
Dialogue: 0,0:00:50.49,0:00:53.29,Default,,0000,0000,0000,,Apply clean gloves and drape the patient for privacy.
Dialogue: 0,0:01:10.35,0:01:14.81,Default,,0000,0000,0000,,Provide perineal care and examine the urinary meatus.
Dialogue: 0,0:01:54.35,0:01:57.47,Default,,0000,0000,0000,,Then, remove gloves and perform hand hygiene.
Dialogue: 0,0:02:00.70,0:02:06.84,Default,,0000,0000,0000,,Position the male patient with knees flexed and feet wide apart, or have the patient lie flat with the legs close together.
Dialogue: 0,0:02:13.87,0:02:17.32,Default,,0000,0000,0000,,Remove the catheter kit from the outside plastic packaging.
Dialogue: 0,0:02:24.91,0:02:29.81,Default,,0000,0000,0000,,Turn the edges of the plastic bag to the outside without contaminating the inside of the bag.
Dialogue: 0,0:02:30.82,0:02:34.58,Default,,0000,0000,0000,,Place toward the end of the bed for use as a trash receptacle.
Dialogue: 0,0:02:34.58,0:02:42.66,Default,,0000,0000,0000,,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.
Dialogue: 0,0:02:46.65,0:02:53.13,Default,,0000,0000,0000,,Position the catheterization tray on the bed between the patient’s legs or on the patient’s lap, on top of the thighs.
Dialogue: 0,0:02:54.74,0:02:59.48,Default,,0000,0000,0000,,Open the distal flap of the tray first, then both side flaps,
Dialogue: 0,0:03:02.27,0:03:04.40,Default,,0000,0000,0000,,and the flap closest to you last.
Dialogue: 0,0:03:05.05,0:03:10.79,Default,,0000,0000,0000,,Touch only the 1-inch outer margin of the sterile wrapper with your bare hands to prevent contamination of your sterile field.
Dialogue: 0,0:03:10.79,0:03:15.48,Default,,0000,0000,0000,,Remove the sterile drape from the catheter kit without contaminating the contents of the tray.
Dialogue: 0,0:03:19.52,0:03:24.95,Default,,0000,0000,0000,,Place the sterile drape over the patient’s lap or thighs. Hold it by the 1-inch outer margin.
Dialogue: 0,0:03:30.10,0:03:35.49,Default,,0000,0000,0000,,Remove the fenestrated drape with the diamond-shaped opening in the middle and place it carefully around the penis.
Dialogue: 0,0:03:43.89,0:03:45.25,Default,,0000,0000,0000,,Put on the sterile gloves.
Dialogue: 0,0:04:20.80,0:04:28.80,Default,,0000,0000,0000,,Lift out the plastic tray, and place it on the sterile field, avoiding the 1-inch unsterile outer margin.
Dialogue: 0,0:04:30.02,0:04:36.13,Default,,0000,0000,0000,,From the kit, pick up and open the lubricant and squeeze it onto a section of sterile plastic tray.
Dialogue: 0,0:04:47.83,0:04:51.75,Default,,0000,0000,0000,,Open the package of Betadine, and empty the contents over the cotton balls.
Dialogue: 0,0:04:52.44,0:04:58.21,Default,,0000,0000,0000,,Some kits may be packaged with Betadine swabs instead of cotton balls and liquid Betadine.
Dialogue: 0,0:04:58.53,0:05:02.64,Default,,0000,0000,0000,,Use another type of antiseptic cleanser if the patient is allergic to Betadine.
Dialogue: 0,0:05:07.86,0:05:09.83,Default,,0000,0000,0000,,Lift out the sterile catheter.
Dialogue: 0,0:05:13.51,0:05:18.52,Default,,0000,0000,0000,,Carefully remove the plastic cover from the catheter, maintaining strict asepsis of the catheter.
Dialogue: 0,0:05:29.38,0:05:31.83,Default,,0000,0000,0000,,Drop the plastic off to the side of your sterile field.
Dialogue: 0,0:05:34.58,0:05:39.14,Default,,0000,0000,0000,,Using your dominant hand, pick up the syringe containing sterile water, and screw the Luer-Lok tip
Dialogue: 0,0:05:39.14,0:05:44.82,Default,,0000,0000,0000,,to the colored port on the second lumen of the catheter and leave it attached for inflating the balloon later.
Dialogue: 0,0:05:49.54,0:05:55.11,Default,,0000,0000,0000,,Now place the catheter with attached syringe into the sterile kit box within your sterile field.
Dialogue: 0,0:05:55.11,0:05:58.44,Default,,0000,0000,0000,,Use caution while you position the catheter.
Dialogue: 0,0:05:58.44,0:06:02.73,Default,,0000,0000,0000,,Place the catheter so that the tip is in the lubricant that you opened earlier
Dialogue: 0,0:06:18.29,0:06:20.40,Default,,0000,0000,0000,,Using your non-dominant hand, grasp the penis shaft.
Dialogue: 0,0:06:20.40,0:06:27.68,Default,,0000,0000,0000,,Avoid using one or two fingers and the thumb; apply a full-handed grasp, retracting the foreskin if the man is uncircumcised.
Dialogue: 0,0:06:27.87,0:06:31.87,Default,,0000,0000,0000,,This hand is now unsterile because you have touched the patient’s skin.
Dialogue: 0,0:06:32.26,0:06:37.39,Default,,0000,0000,0000,,Hold the penis at a 90-degree angle to the body while applying gentle traction.
Dialogue: 0,0:06:37.39,0:06:44.13,Default,,0000,0000,0000,,With your dominant hand, pick up the Betadine swab or use the sterile forceps to pick up the Betadine-soaked cotton ball.
Dialogue: 0,0:06:49.58,0:06:55.06,Default,,0000,0000,0000,,Begin cleansing at the urinary meatus, moving in concentric circles until the entire glans penis is cleansed.
Dialogue: 0,0:06:56.88,0:07:03.81,Default,,0000,0000,0000,,Drop the now-contaminated cotton ball or swab in the plastic bag you set up beyond your sterile field.
Dialogue: 0,0:07:03.81,0:07:08.26,Default,,0000,0000,0000,,Use caution to avoid touching the sterile forceps or gloves to any potentially contaminated surface.
Dialogue: 0,0:07:09.94,0:07:14.51,Default,,0000,0000,0000,,Repeat the same cleansing motion three times with three separate cotton balls or swabs.
Dialogue: 0,0:07:14.51,0:07:21.22,Default,,0000,0000,0000,,Remember to use each antiseptic wipe only once, moving in a concentric circle over the meatus and entire glans.
Dialogue: 0,0:07:21.22,0:07:26.70,Default,,0000,0000,0000,,Do not remove your non-dominant hand from the penis after cleaning it to prevent contamination.
Dialogue: 0,0:07:26.70,0:07:33.36,Default,,0000,0000,0000,,Pick up the sterile catheter with your dominant hand, dipping the tip in the lubricant you squirted onto the plastic tray.
Dialogue: 0,0:07:33.98,0:07:41.60,Default,,0000,0000,0000,,Lubricate approximately 5 to 7 inches of the catheter to facilitate insertion and decrease discomfort to the patient.
Dialogue: 0,0:07:41.60,0:07:47.30,Default,,0000,0000,0000,,Some catheter kits include a sterile syringe containing lubricant rather than a package of lubricant.
Dialogue: 0,0:07:47.30,0:07:54.56,Default,,0000,0000,0000,,The tip of the syringe can be gently inserted into the urethra and the plunger depressed to fill the urethra with lubricant.
Dialogue: 0,0:07:54.56,0:07:57.30,Default,,0000,0000,0000,,Follow facility policy.
Dialogue: 0,0:07:57.30,0:08:00.95,Default,,0000,0000,0000,,With your dominant hand, insert the catheter into the urinary meatus.
Dialogue: 0,0:08:05.47,0:08:11.36,Default,,0000,0000,0000,,Advance the catheter 7 to 9 inches until you see urine flowing into the drainage tubing.
Dialogue: 0,0:08:18.16,0:08:23.26,Default,,0000,0000,0000,,Advance the catheter another 1 to 2 inches to ensure that the catheter is fully in the bladder.
Dialogue: 0,0:08:23.26,0:08:28.66,Default,,0000,0000,0000,,If you inadvertently inflate the balloon while it is still in the urethra, you may damage the urethra.
Dialogue: 0,0:08:28.66,0:08:32.08,Default,,0000,0000,0000,,Keep your dominant hand on the catheter
Dialogue: 0,0:08:32.08,0:08:37.20,Default,,0000,0000,0000,,Do not force the catheter if you are unable to gently advance it.
Dialogue: 0,0:08:37.20,0:08:43.20,Default,,0000,0000,0000,,Release the penis and, with your non-dominant hand, inflate the balloon by depressing the plunger on the syringe completely.
Dialogue: 0,0:08:43.20,0:08:49.01,Default,,0000,0000,0000,,Twist the syringe off of the connection port and dispose of it in the plastic bag.
Dialogue: 0,0:08:50.14,0:08:54.11,Default,,0000,0000,0000,,Pull gently on the catheter to seat it at the cystourethral junction.
Dialogue: 0,0:08:58.32,0:09:00.24,Default,,0000,0000,0000,,Replace the foreskin if it was retracted.
Dialogue: 0,0:09:00.25,0:09:05.82,Default,,0000,0000,0000,,If the foreskin is left in the retracted position, particularly with an indwelling catheter in place,
Dialogue: 0,0:09:05.82,0:09:11.46,Default,,0000,0000,0000,,it can cause a stricture-like effect, resulting in edema and possible necrosis of the head of the penis.
Dialogue: 0,0:09:55.15,0:10:00.18,Default,,0000,0000,0000,,Cleanse all Betadine or other cleanser from the urinary meatus and surrounding area.
Dialogue: 0,0:10:23.52,0:10:29.43,Default,,0000,0000,0000,,Secure the indwelling catheter to the patient’s thigh with a leg strap or tape.
Dialogue: 0,0:10:29.43,0:10:31.72,Default,,0000,0000,0000,,Some males may prefer to secure it to the lower abdomen.
Dialogue: 0,0:10:31.72,0:10:35.11,Default,,0000,0000,0000,,If you are not certain, simply ask the patient for his preference.
Dialogue: 0,0:10:35.35,0:10:41.38,Default,,0000,0000,0000,,To ensure adequate catheter length for patient movement, secure the catheter at the Y-junction.
Dialogue: 0,0:10:41.38,0:10:47.91,Default,,0000,0000,0000,,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.
Dialogue: 0,0:10:47.91,0:10:54.20,Default,,0000,0000,0000,,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.
Dialogue: 0,0:10:54.20,0:11:02.15,Default,,0000,0000,0000,,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.
Dialogue: 0,0:11:02.15,0:11:06.45,Default,,0000,0000,0000,,The drainage bag should not be elevated above the level of the patient’s bladder,
Dialogue: 0,0:11:06.45,0:11:10.28,Default,,0000,0000,0000,,to prevent urine from draining from the catheter tubing back into the bladder.
Dialogue: 0,0:11:10.28,0:11:15.44,Default,,0000,0000,0000,,When you finish the procedure, remember the Universal Steps that apply after all procedures.
Dialogue: 0,0:11:15.44,0:11:21.71,Default,,0000,0000,0000,,For example, leave the patient in a safe, comfortable position with the call device in easy reach.
Dialogue: 0,0:11:21.71,0:11:26.08,Default,,0000,0000,0000,,Document the procedure in the electronic health record.