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Cardinal Health™ CAUTI Prevention: Female 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 a 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 female patient including

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 CAUTI associated with indwelling

catheters begins with aseptic insertion

first review the patient's chart to

ensure there is an order for

catheterization based on the indications

we covered in our video segment on

indications and alternatives to

indwelling catheters briefly examples of

acceptable indications include acute

urinary retention or bladder outlet

obstruction need for accurate output

data for critically ill patients vary

operatively and 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 it's 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

an end-of-life care we also want to

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 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 perineal cleansing

supplies in accordance with your

facility's policy and procedure

and additional clean 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

place the tray between the patient's

lower extremities open the outer CSR

wrap away from you so that you're 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 or

use what is it designated by your

facility's protocol and cleanse the

perineal area remove and dispose of non

sterile gloves and perform hand hygiene

using the provided hand sanitizer

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Donn's 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 not

sterile explain to the patient that you

will be prepping for insertion and that

they'll fill your hand and the cool

prepping solution

place the fenestrated drape over the

perineum

connect the prefilled 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 in the container for

placement directly into the viejas

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 in lubricant and tray

prepare the insertion site in a sterile

fashion by retrieving prepping solution

and forceps use the forceps to separate

the cotton balls

open the prepping solution and pour over

the cotton balls saturating them evenly

you

spread the labia using your non-dominant

hand this hand is now no longer sterile

utilizing the forceps wipe a cotton ball

on one side of the labia minora with a

downward stroke utilizing your sterile

dominant hand with the second cotton

ball wipe the other side of the labia

minora again with a downward stroke with

the third cotton ball wipe the center of

the meatus with a downward stroke repeat

wiping until all cotton balls are used

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 with your non

sterile hand part the labia and place

the catheter tip at the meatus slowly

insert the catheter into the meatus with

a firm continuous movement and so you

can see urine in the tubing you may feel

some resistance 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

thigh with a catheter securement device

we'll 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 caution if you insert the catheter

into the wrong orifice do not inflate

the balloon get another tray and start

from the beginning

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 calf 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 site is dry before placement of the

securement device remove the backing and

place 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 perform hand hygiene

for additional information on placement

and care of indwelling catheters please

refer to your facility's policies and

procedures and to your Foley tray insert

or contact your Cardinal health cells

representative we hope you found this

video inserting Foley catheter and

female patient informative and that good

technique will help you to prevent

catheter associated urinary tract

infections thank you for your time

you

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