How to Place a Kit for a Sterile Catheter
Things You'll Need
- Towel
- Sterile drape
- Catheter (Foley or straight)
- 10cc syringe
- Lubricant
- Sterile gloves
- Cotton balls
- Betadine
- Tweezers
Instructions
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Prepping the Patient
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Inform the patient of the procedure, the amount of discomfort he might experience and the reason for performing it. Ask the patient if there are any questions before you proceed.
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2
Raise the bed to your working level, generally at waist height. You do not want to lean too far over the patient or have the bed impair your ability to place the catheter.
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Place a sterile catheter kit on the table and raise it to a comfortable level. The bed should be on your dominant hand side when you are facing the patient.
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4
Place a towel under the patient's bottom. Ask the patient to spread his legs with his feet together, knees apart, facing each wall, like frog legs. Assist the patient in scooting his butt downward to expose the genitalia.
Preparing the Kit
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5
Remove the plastic bag from the sterile catheter kit and set it aside. You can use the bag for collecting any trash throughout the procedure.
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Pull the folded corners of the sterile kit away from its center to access the sterile instruments. All procedures must be sterile from this point on. Do not touch the sterile instruments without sterile gloves on your hands.
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Put the sterile gloves on your hands, whether included in the kit or retrieved separately. Pinch the cuff of the dominant hand glove, touching only the exposed interior, with your non-dominant hand and put on the glove. Fold your thumb inward and let the cuff naturally unroll as you pull it onto your hand. Grab the other glove with your gloved hand by putting your fingers under the cuff, making sure to only touch the sterile exterior. Pull the glove onto your hand. You can touch your gloves together because they are both sterile. Once the gloves touch something that is not sterile, such as the patient, they are not allowed to touch other sterile items, such as the catheter kit.
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8
Lay a sterile drape over the patient's pelvic region, leaving the urethra exposed. Do not touch the patient with your sterile gloves when laying the drape.
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9
Remove the small plastic container with the lubricant, cotton balls, tweezers and Betadine and place it next to the sterile cardboard box it sits on top of. The cardboard box typically holds the catheter and syringe. Keep the boxes in the sterile zone, which is within a 1-inch diameter of the kit's edges.
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10
Verify that the balloon is intact by attaching a 10cc syringe to the Y portion of the Foley catheter and blowing it up. The balloon should easily inflate.
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Open the lubricant and squirt it in the sterile zone. There is usually an indent or small pocket in the paper to hold the lubricant.
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Remove the catheter from its plastic. Lubricate the entire catheter by rolling the tube in the gel. Return the catheter to its initial position in the sterile zone. You can also coat the tube by squirting lubricant directly from its packet onto the catheter.
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13
Open the Betadine and squirt it onto three cotton balls. Use the tweezers to turn the cotton balls, ensuring they are saturated with the sterilizing agent. If the kit includes pre-soaked cotton swabs, remove them from their plastic.
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14
Move the entire kit from the table to between the patient's legs by securely pinching the sides of the sterile kit and slowly moving it into position. The catheter and sterile cotton balls must be close the pelvis to decrease your margin for error when moving between the table and bed.
Inserting the Catheter
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Use your non-dominant hand to spread the labia or hold the tip of the penis, locating the urethra. For a man, this is the opening on the tip of the penis. For a woman, this is the small hole located above the vaginal opening but below the clitoris. Once your hand touches the patient, it is no longer sterile and cannot handle sterile instruments.
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Sterilize the genitalia with the dominant hand. For a man, start at the urethra and use the tweezers to circle the tip of the penis with a cotton ball, making a circle toward the base. Throw the cotton ball away when done. Use the other two cotton balls, one at a time, to vertically then horizontally sterilize the tip, making one swipe each and throwing each cotton ball away when done. For a woman, spread the labia then swipe each cotton ball, one at a time, in a single downward direction. Only go over the area once with each cotton ball to avoid dragging contaminants back into the area after wiping it. Do not remove your hand from this area.
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Grab the lubricated catheter with your sterile hand. Hold the tube 3 inches from the end. For a man, hold the penis firmly then insert the catheter until the Y. Depress the 10cc syringe, blowing up the balloon with sterile liquid in the bladder. Pull back on the catheter, until there is resistance, to ensure proper placement. For a woman, locate the urethra. Hold the catheter 3 inches from the end then insert the tube. Continue the insertion until you see urine enter the tube then insert it 3 to 4 more inches. Blow up the balloon and pull back on it.
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Connect the catheter to the drainage bag. Hang the drainage bag on the side of the bed, below the level of the bladder.
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Secure the Foley tube to the inner thigh or stomach, ensuring there is no tension on the tube.
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20
Remove your gloves and discard the used materials. Wash your hands and record the procedure in the patient's chart, noting the size of the catheter, amount of liquid in the balloon, patient's disposition and your assessment of the urine's color, odor, amount and quality.
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