WEBVTT 00:00:23.085 --> 00:00:26.542 When inserting an indwelling urinary catheter, follow these steps. 00:00:30.638 --> 00:00:35.263 Check the healthcare provider’s order to determine the type of catheterization to be performed. 00:00:36.173 --> 00:00:39.981 Assess the patient for allergies to latex, povidone iodine, or tape. 00:00:50.490 --> 00:00:53.290 Apply clean gloves and drape the patient for privacy. 00:01:10.347 --> 00:01:14.811 Provide perineal care and examine the urinary meatus. 00:01:54.346 --> 00:01:57.466 Then, remove gloves and perform hand hygiene. 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. 00:02:13.871 --> 00:02:17.323 Remove the catheter kit from the outside plastic packaging. 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. 00:02:30.819 --> 00:02:34.578 Place toward the end of the bed for use as a trash receptacle. 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. 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. 00:02:54.743 --> 00:02:59.480 Open the distal flap of the tray first, then both side flaps, 00:03:02.268 --> 00:03:04.396 and the flap closest to you last. 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. 00:03:10.794 --> 00:03:15.485 Remove the sterile drape from the catheter kit without contaminating the contents of the tray. 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. 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. 00:03:43.893 --> 00:03:45.252 Put on the sterile gloves. 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. 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. 00:04:47.828 --> 00:04:51.750 Open the package of Betadine, and empty the contents over the cotton balls. 00:04:52.438 --> 00:04:58.214 Some kits may be packaged with Betadine swabs instead of cotton balls and liquid Betadine. 00:04:58.532 --> 00:05:02.644 Use another type of antiseptic cleanser if the patient is allergic to Betadine. 00:05:07.860 --> 00:05:09.830 Lift out the sterile catheter. 00:05:13.508 --> 00:05:18.517 Carefully remove the plastic cover from the catheter, maintaining strict asepsis of the catheter. 00:05:29.381 --> 00:05:31.829 Drop the plastic off to the side of your sterile field. 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 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. 00:05:49.541 --> 00:05:55.110 Now place the catheter with attached syringe into the sterile kit box within your sterile field. 00:05:55.110 --> 00:05:58.438 Use caution while you position the catheter. 00:05:58.438 --> 00:06:02.726 Place the catheter so that the tip is in the lubricant that you opened earlier 00:06:18.288 --> 00:06:20.404 Using your non-dominant hand, grasp the penis shaft. 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. 00:06:27.872 --> 00:06:31.872 This hand is now unsterile because you have touched the patient’s skin. 00:06:32.258 --> 00:06:37.392 Hold the penis at a 90-degree angle to the body while applying gentle traction. 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. 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. 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. 00:07:03.808 --> 00:07:08.257 Use caution to avoid touching the sterile forceps or gloves to any potentially contaminated surface. 00:07:09.936 --> 00:07:14.513 Repeat the same cleansing motion three times with three separate cotton balls or swabs. 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. 00:07:21.216 --> 00:07:26.704 Do not remove your non-dominant hand from the penis after cleaning it to prevent contamination. 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. 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. 00:07:41.602 --> 00:07:47.296 Some catheter kits include a sterile syringe containing lubricant rather than a package of lubricant. 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. 00:07:54.562 --> 00:07:57.298 Follow facility policy. 00:07:57.298 --> 00:08:00.946 With your dominant hand, insert the catheter into the urinary meatus. 00:08:05.466 --> 00:08:11.357 Advance the catheter 7 to 9 inches until you see urine flowing into the drainage tubing. 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. 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. 00:08:28.658 --> 00:08:32.077 Keep your dominant hand on the catheter 00:08:32.077 --> 00:08:37.197 Do not force the catheter if you are unable to gently advance it. 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. 00:08:43.203 --> 00:08:49.013 Twist the syringe off of the connection port and dispose of it in the plastic bag. 00:08:50.142 --> 00:08:54.109 Pull gently on the catheter to seat it at the cystourethral junction. 00:08:58.317 --> 00:09:00.237 Replace the foreskin if it was retracted. 00:09:00.246 --> 00:09:05.821 If the foreskin is left in the retracted position, particularly with an indwelling catheter in place, 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. 00:09:55.154 --> 00:10:00.183 Cleanse all Betadine or other cleanser from the urinary meatus and surrounding area. 00:10:23.523 --> 00:10:29.428 Secure the indwelling catheter to the patient’s thigh with a leg strap or tape. 00:10:29.428 --> 00:10:31.715 Some males may prefer to secure it to the lower abdomen. 00:10:31.715 --> 00:10:35.106 If you are not certain, simply ask the patient for his preference. 00:10:35.346 --> 00:10:41.379 To ensure adequate catheter length for patient movement, secure the catheter at the Y-junction. 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. 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. 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. 00:11:02.146 --> 00:11:06.451 The drainage bag should not be elevated above the level of the patient’s bladder, 00:11:06.451 --> 00:11:10.276 to prevent urine from draining from the catheter tubing back into the bladder. 00:11:10.276 --> 00:11:15.443 When you finish the procedure, remember the Universal Steps that apply after all procedures. 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. 00:11:21.714 --> 00:11:26.083 Document the procedure in the electronic health record.