Monday, May 27, 2024

CATHETERIZATION OF A FEMALE PATIENT

Table of Contents

REQUIREMENTS #

  1. A trolley containing the following:
    1. Top Shelf: A sterile pack or field containing the following:
      • Two gallipots
      • Three sterile drape, one sterile fenestrated drape
      • Sterile cotton wool swabs
      • Artery forceps
      • Kidney dish
    2. Bottom Shelf : Various catheters of different sizes used
      • 14″ and 16″ for female
      • 18″ and 20″ for male
      • 8″ and 10″ for children
      • Lubricant (e.g. K.Y. or xylocaine jelly)
      • Diluted antiseptic solution
      • Receiver for used swabs
      • Mackintosh and dressing towel
      • Urine bag
      • Sterile water
      • Specimen bottles if necessary
      • Hypo-allergic tape or plaster
      • Hand lamp if necessary
      • Sterile gloves
      • 10-20mls syringe and needle
      • Spigot if necessary
      • Jug of warm water and bowel/bucket
      • Soap and towel
      • Bedpan
      • Intake and output chart

STEPS #

  1. Review doctor/physician’s order for catheterization
  2. Establish rapport with patient (Refer to steps)
  3. Explain procedure to patient (Refer to steps)
  4. Provide privacy
  5. Perform hand hygiene
  6. Prepare and send trolley to the bedside
  7. Protect bed with mackintosh, dressing towel and ensure adequate lighting
  8. Perform hand hygiene and wear gloves
  9. Turn back sheet covering the patient or ask an assistant to do this if available or necessary
  10. Instruct assistant to place patient in the supine position with knees flexed and legs separated
  11. Place bedpan under patient and wash perineum thoroughly with soap and water
  12. Clean patient and remove bedpan
  13. Remove the gloves and perform hand hygiene
  14. Open the packs of sterile dressing and catheter container and place the contents onto the sterile field
  15. Drape the patient with a sterile towel and place the fenestrated drape over the perineum exposing the urinary meatus
  16. Wear new sterile gloves
  17. Use the non-dominant hand to part the labia and establishes a firm but gentle position
  18. Pick a cotton wool ball soaked in antiseptic solution with forceps in the dominant hand and swab one side of the labia majora from top to bottom, uses a new ball for opposite side
  19. Repeat procedure for the labia minora, uses another cotton wool ball to clean over the meatus
  20. Lubricate catheter with K.Y. or xylocaine jelly
  21. Retract the labia to fully expose the urinary meatus with your non-dominant hand
  22. Insert catheter into the urethral orifice and then gently push it in an upward and backward direction for about 5-7.5cm (2-3inches) leaving the open end in the receiver between the patient’s thighs
  23. Inflate the balloon of the catheter with the sterile water according to manufacturer’s direction
  24. Collect a urine specimen if necessary and allows 20 – 30mls to flow into bottle without bottle touching the catheter
  25. Connect catheter to urine bag
  26. Hang urine bag to the bed and secure in position
  27. Observe colour and note amount of urine
  28. Remove drapes, mackintosh and dressing towel
  29. Remove gloves and perform hand hygiene
  30. Assist patient into a desirable position
  31. Dispose off used items, decontaminate instruments and trolley
  32. Perform hand hygiene
  33. Document the procedure, urine output and any abnormalities in the nurses’ note, intake and output chart (manual or electronic)