Foley Catheter Insertion: Sterile Technique for the Medical Professional
Before you start: Before you insert a Foley catheter there are a few things you need to consider:
*Do you have a Dr.’s order to do so?
*Do you have a built in protocol to do so?
*Do you have the right patient?
Gathering your equipment: You will need the following:
/Foley catheter with urine collection bag attached
/Surgi-lube or KY Jelly
/Cotton balls (at least 3)
/Syringe with water to inflate bulb of catheter
/Specimen cup (if urinary analysis is required)
/Sterile drape (optional)
Introductions and Explanations:
Once the physician or nurse has instructed you to put a Foley catheter in a client you need to gather your equipment. After gathering your supplies enter the room and introduce yourself to the patient. Briefly explain what you are about to do and ask if the patient has any questions.
Examples of introductions and explanations:
“Hi my name is ___________. I’m here to insert a Foley catheter into your bladder.”
Then explain why you’re doing this. See possible explanations below:
* Your physician requested I do this.
* Your nurse asked me to do this.
* This will make it easier for you to urinate with your broken leg/surgery/etc.
* This way we can be more accurate with your input and output.
* This will give you some relief.
* This will help us get a urine sample.
Next take your supplies, which most likely come in a Foley catheter kit. Set them on the table beside the patient’s bed. The gloves included in this kit may not be your size so you’ll want to have an extra pair on hand. (Many times the gloves included in these kits are so wrinkled up it’s hard to remove them from their packaging and don them using sterile technique.
Steps to Insert Foley:
* Don non sterile gloves and help patient remove clothes from the naval down.
* Open Foley kit. (Be sure not to touch anything inside until you have donned your sterile gloves.
* Don sterile gloves.
* Discard unnecessary supplies.
* Place some KY jelly (lubriderm) in one of the sterile carton’s containers.
* Test inflate the catheter by inflating it with the water in the syringe.
* Open sterile betadine in kit and pour over cotton balls in the plastic carton.
* Announce to client that you are going to clean them before inserting the catheter.
Using the plastic tongs pick up the cotton balls one at a time and clean the meatus. In females use one piece of betadine soaked cotton to clean one side of meatus while holding labia open with non dominant hand. Then clean the other. Use the last cotton ball to clean right over meatus. In males just hold shaft of penis in non dominant hand while using tongs to swipe the urethra 3 times. Make sure the last swipe goes over urethra.
Next, depending on gender, hold the penis straight up/hold the labia open. Use sterile hand to grab catheter and stick the tip of it down into the surgi-lube/KY jelly.
Tell client to take a deep breath. From the lubricating gel place the tip of the catheter inside the meatus. Insert catheter until you either meet resistance or get a golden flashback of urine flowing down into the catheter tube. If you get a urine return, keep inserting just a bit before inflating Foley balloon. If you meet resistance you might try swiveling the catheter a bit and inserting once again. As you do, be aware of patient’s discomfort. Don’t use undue force. The patient may have strictures or an enlarged prostate. It’s always much better to ask another person to insert the catheter than to cause the client pain.
Once catheter is inserted and you’re getting urine, insert just an inch further if possible. This may mean the catheter in males gets inserted to the Y-junction of the catheter.
* After this use the syringe to inflate the balloon tip of the catheter, which is now inside the bladder.
* Dispense of the syringe and all the other articles that were used.
* Hang catheter bag in appropriate place on bed.
* Secure catheter to thigh with tape or catheter holding unit.
* Make sure patient is comfortable and modestly covered once again.
* Do your documentation of this procedure. (size of catheter, amount of immediate output, color of urine, clarity of urine, etc.)
* Inform your nurse/physician of the outcome if necessary.