Techniques Used to Insert Catheters
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Insertion on a Female Patient
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Although men and women both can effectively use catheters, the procedure for insertion of a catheter into the bladder is different for each gender. Females have much shorter urethras than men so techniques for inserting a urinary catheter are female- and male-specific.
The first step in inserting a catheter into a woman is to clean the meatus well with soap and water. The meatus is the female genitalia area. Wash your hands well following the cleansing and put on sterile gloves. Cover the perineum with a drape so that the hole of the drape exposes the female genitalia. Next you will need to lubricate the tubing with sterile lubricant approximately three inches up the tubing. Using your non-dominant hand, spread the labia major and minor open wide and in an upward position to expose the opening to the urethra. The hand that is gloved and used, is now considered contaminated. While holding the skin separated and exposing the labia, use a cotton ball that has been soaked in an antiseptic solution and clean the meatus downward toward the rectum. Keep the meatus separated and clean on each side. Never go back over where you have cleaned except in the same direction as before.
While continuing to hold the meatus apart, take the catheter tubing and insert it into the urinary meatus. Angle it so that the catheter follows the route of the of the urinary tract. Do not force it if it will not go. Have the patient take slow breaths and exhale out slowly while inserting. As the catheter is inserted, angle the tubing upward. You should start to see urine flow. When you do, insert the tubing approximately one more inch. You will need to hold the catheter in place while urine is expelled and empties into the urine catch bag.
A balloon is attached to the catheter port. Once you determine that the catheter is in place, you can start to fill the balloon with saline water using a syringe. If the patient complains of pain during the balloon fill, deflate the balloon and insert the catheter a little further.
Once you have determined correct placement, you will need to secure the tubing to the patient's leg. You will also need to connect the drainage bag to the catheter and connect the bag to the patient's bed.
Insertion on a Male Patient
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For a male patient, have him lie on his back with his legs slightly spread, exposing his penis. Wearing gloves, wash and sterilize his penis and dispose of your gloves. Now you will need to put on sterile gloves and place the waterproof drape just under his penis so it rests on his thigh. Do not contaminate the center. Then place the fenestrated drape over his penis. This is the hole in the drape, which will expose his penis for the catheter insertion.
Using your non-dominant hand, gently grasp the shaft of his penis just under the glans. Your hand is now contaminated so do not move it. Using a cotton swab already saturated in iodine, clean the meatus in a circular motion toward the base of the glans. You should do this three times for sterilization and discard the cotton swab. Place the catheter tray between his legs. Using your dominant hand, hold the catheter approximately three inches from the tip. With your non-dominant hand, hold the penis perpendicular from his body and apply a slight traction. Ask him to breathe deeply while you insert the catheter into the meatus. Insert it approximately seven to nine inches, or until you begin to see urine drain. If there is any resistance, slightly rotate the catheter or back it out slightly.
While holding the catheter in place, inflate the balloon. Gently tug on the catheter to make sure it is secure and in place by the feel of resistance. Attach the tubing to his lower abdomen or thigh and attach the bag to the bed, making sure it hangs below bladder level.
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