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Cardinal Health™ CAUTI Prevention: Male Urinary Catheter Insertion

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welcome to our video series covering how

to prevent catheter-associated urinary

tract infections also known as CAUTI I'm

Charles craft registered nurse and

senior consultant for Cardinal Health's

clinical operations team in today's

video we will cover in detail the entire

process of how to insert a Foley

catheter in a male patient including the

pre insertion activities and proper

securement of the Foley catheter proper

technique is critical to avoid

introducing infection causing organisms

during the process bottom-line

minimizing the risk of complications

such as khadi associated with indwelling

catheters begins with aseptic insertion

first review the patient's chart to

ensure there's an order for

catheterization based on the indications

we've covered in detail in our first

video these include acute urinary

retention or bladder outlet obstruction

need for accurate output data for

critically ill patients Perry

operatively

in select procedures including

neurologic surgeries for long surgeries

when large volume infusions or intra

operative administration of diuretics

are anticipated or when monitoring of

intra operative urine output is

necessary other indications include

incontinent patients with open sacral or

perineal wounds patients subject to

prolonged immobilization and lastly as a

comfort measure when needed in

end-of-life care check to see if the

patient has any allergies such as iodine

or latex finally review the chart for

pathological factors that may impede the

passage of a catheter it is important to

assess your patient unless clinically

indicated use the smallest catheter

French size possible consistent with

good drainage to minimize bladder neck

and urethral trauma in this segment we

will demonstrate cleansing the perineal

area with swab sticks perform hand

hygiene immediately before and after

insertion or any manipulation of the

catheter device or site begin by

gathering your supplies you'll need a

Foley catheter closed system tray peer

nail cleansing supplies and accordance

with your facility's policy procedure

and additional cleaning gloves start by

donning non sterile gloves

lower the head of the patient's bed to a

flat position have the patient bend

their knees with their legs spread and

hips externally rotated stand at the

side of the bed in which your dominant

hand is closest to the foot of the bed

remove the patient's bed covers pajama

bottoms or underwear remove non sterile

gloves and perform hand hygiene Don a

new pair of non sterile exam gloves open

the plastic wrap and remove the Foley

kit

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place the tray between the patient's

lower extremities open the outer CSR

wrap away from you so that you are not

leaning over the sterile field remove

the castile soap and hand sanitizer set

them aside open the inner layer and

remove the top drape holding the back

corners and slide it under the patient's

pernil and hip area retrieve the castile

soap provided for use what is designated

by your facility's protocol and cleanse

the perineal area

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remove and dispose of non sterile gloves

and perform hand hygiene using provided

hand sanitizer

Don sterile gloves provided in the

clothes system tray always keep your

hands above your waist and in front of

you do not touch anything that is non

sterile explain to the patient that you

will be prepping for insertion and that

they will feel your hand in the cool

prepping solution

place the fenestrated drape over the

perineum connect the prefilled sterile

water syringe to the inflation port on

the catheter you do not need to pre

inflate the balloon from the tray open

the water-soluble lubricant and squeeze

the bellows syringe into the tray

compartment and discard the empty

container you may also save some

lubricant into the container for

placement directly into the me a dose

with your sterile dominant hand grasp

the catheter and remove it from the tray

with your non-dominant hand remove the

dust cover off the catheter making sure

to keep the catheter over the sterile

field you may wish to coil the catheter

for better control now place the

catheter tip into the lubrication jelly

roll the catheter and coat approximately

three inches of the catheter tip keep

the catheter tip and lubricant and tray

prepare the insertion site in a sterile

fashion by opening the PvP solution

packet removing all three swab sticks

and placing them in the prep train grasp

the penis firmly with your non-dominant

hand if the patient is not circumcised

retract the foreskin until the head is

clearly visible this hand is now

contaminated and should be used to hold

the penis in position for the duration

of the procedure cleanse the head of the

penis with the saturated swab sticks

working from the urethral opening

outward repeat the procedure with the

additional swab sticks always working

from the center outward using a circular

motion use one swab for each circle

explain to the patient that you will now

begin the insertion and that they may

feel some pressure and should take a few

deep breaths caution them to remain

still during the procedure slowly insert

the catheter into the meatus with a firm

continuous movement until you see urine

in the tubing you may feel some

resistance if there's a strong

resistance stop and reassess according

to facility policy if not slowly advance

the catheter another two to three inches

so it is completely in the bladder hold

the catheter firmly in place while you

inflate the balloon with the entire ten

milliliters of sterile water provided in

the tray

disconnect the syringe from the

inflation port gently pull back on the

catheter to ensure that it is in place

against the bladder neck release your

hand from the perineal area hang the

collection bag below the bladder level

and secure the catheter on the patient's

upper thigh with a catheter securement

device we will be reviewing steps to

properly secure the catheter in detail

later in the video using the sterile

drape wipe the perineal area to remove

excess lubricant and prepping solution

using a front to back motion use a

different part of the sterile drape for

each motion dispose of supplies and the

sterile field from the patient's bed

remove sterile gloves and perform hand

hygiene document indication for

insertion date/time size of catheter and

unit there are various catheters

securement devices in the market and you

should follow manufacturer's

instructions we will be demonstrating

one example of a catheter securement

device Cardinal Health's cath secure

advanced the catheter should be secured

to the patient's upper thigh here we're

demonstrating the application of an

adhesive catheter anchor pre attached to

the catheter be sure that the area is

clean of dirt and body oils ensure the

skin is dry before placement of the

securement device remove the backing and

place the adhesive side down so that the

spine of the device follows a natural

path from the insertion point to the

intended location of the hanging

collection device

once the catheter is secured hang the

drainage bag on the rail or footboard of

the bed the drainage bag should always

be below the level of the patient's

bladder to allow adequate urine flow

reposition the patient for comfort

placing the bed in the lowest position

and perform hand hygiene for additional

information on placement and care of

indwelling catheters please refer to

your facility's policies and procedures

and your Foley tray insert for contact

your cardinal health sales

representative we hope you found this

video inserting Foley catheter and male

patient informative and that good

technique will help you to prevent

catheter associated urinary tract

infections thank you for your time

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