Skill Page - Female Catheterization

06 MAR 2015

FEMALE URINARY CATHETARISATION

Ms Niketha, Staff Nurse

CONTENT    

1. Introduction.
2. Definition.
3. Indication.
4. Contra indication.
5. Equipments.
6. Procedure.

Introduction

1. Catheterisation is a commonly performed procedure in clinical practice
2. Urethral catheterisation of both male and female patients is a nursing procedure
3. The nurse needs an awareness of the anatomy and physiology of the urinary system

Definition
Urinary catheterization is the insertion of a catheter into a patient's bladder. The catheter is used as a conduit to drain urine from the bladder into an attached bag or container.

Indications

1. Retention of urine
2. Obstruction of the urethra by an anatomical condition
3. Urine output monitoring in a critically ill or injured person
4. Nerve-related bladder dysfunction, such as after spinal trauma, or intractable incontinence.

Contraindications

1. History of pelvic or perineal trauma
2. History of urethral strictures or anatomically false passages.

Equipments

1. Catheter pack
2. Water soluble lubricant
3. Sterile water
4. 20cc syringe
5. sterile gloves (size appropriate to user)
6. non sterile gloves
7. One 2 way Foley’s catheter appropriate size, type
8. Catheter fixation device e.g. Catheter strap
9. Appropriate drainage device(urometer,urobag,)
10. Specimen jar (if required)
11. Protective Personal Equipment (PPE)
12. Kidney tray

Preparation

1. Explain the procedure
2. Check for allergies to latex and iodine
3. Arrange all articles
4. Wash your hands
   

Procedure

1. Explain the procedure to the patient and gain informed consent
2. Take the pre prepared trolley to the bedside and place on left or right depending on nurses dominant hand
3. Raise the bed to an appropriate height and ensure a good light source
4. Expose the genital area with consideration for patient dignity and place a disposable pad beneath the patient
5. Ensure asepsis is maintained and open packs and equipment onto the trolley
6. Open the catheter but do not remove it from the internal wrapper and place it in the sterile receiver on the trolley
7. Pour an appropriate cleanser into the galipot
8. Open the catheter bag and arrange it on the side of the bed, ensuring the attachment tip is accessible and remains sterile
9. Squeeze  small amount of lubricant or anaesthetic gel onto a gauze swab
10. Draw up the amount of sterile water to inflate the balloon
11. Wash hands again and put on two pairs of sterile gloves
12. Place the sterile dressing towel between the patients legs and over the patients thighs
13. Using a gauze swab and the non dominant hand retract the labia minora to expose the urethral meatus. This hand is used to maintain labial separation until procedure is completed
14. Clean the perineal area using a new gauze swab for each stroke cleansing from the front towards the anus
15. Place the receiver holding the catheter on the sterile towel between the patients legs
16. Expose the tip of the catheter by pulling off the top of the wrapper at the serrated edge
17. Lubricate the catheter tip with anaesthetic or lubricating gel
18. Hold the catheter so the distal end remains in the receiver
19. Gradually advance it out of the wrapper into the urethra in an upward and backward direction for approximately 5-7cm or until urine flows
20. Advance a further 5 cm, do not force the catheter
21. Inflate the balloon with the correct amount of water
22. Attach the catheter drainage bag and position so there is no pulling on the catheter