It is imperative that the health care professional has a good understanding of aseptic catheterization procedure principles as this will help to reduce the risk of UTI.
Catheterization with indwelling catheter
- Protect the patient from surrounding bacteria by keeping the catheter sterile throughout the entire procedure
- Keep the patient informed about the procedure and make sure that he or she has given their consent
- It is important to be careful with your own personal hygiene before proceeding
1. Preparations
1.1, Gently pull back the foreskin or separate the labia minora so you can easily access and clean around the urethral opening.
1.2, Anaesthetize the urethra by completely filling it with anesthetic catheter gel. Use 1 gram gel per cm urethra.
- Amount of gel men: 20-30 g gel
- Amount of gel women: 5-7 g gel
Wait at least 60 sec until the gel begins to work. Full effect within 5 minutes.
1.3, Follow the manufacturer’s instructions. The BIP Foley Catheter should be pre-wetted to activate the hydrophilic coating.
2. Catheterization
2.1, Insert the catheter using sterile gloves. Insert the catheter gently.
2.1, Alt 2: Insert the catheter using sterile tweezers.
2.1, Alt 3: Insert the catheter using the sterile plastic wrapping.
2.2, When you feel some resistance the catheter has likely reached the external sphincter muscle. Be extra careful at this point.
3. Fixation
3.1, Insert the catheter all the way to the funnel junction.
- Insert the catheter about 15-20 cm
3.2, Get some urine in exchange before you fill the catheter balloon with the precise amount of fluid that the manufacturer recommends.
3.3, Fill the catheter balloon. Remember to constantly observe the patient; this step should not hurt.
3.4, After you have completed this step, make sure the catheter is positioned correctly and can move freely. Finish by attaching a urinary bag or a valve.
Change of suprapubic catheter
- Protect the patient from surrounding bacteria by keeping the catheter sterile throughout the entire procedure
- Keep the patient informed about the procedure and make sure that he or she has given their consent
- It is important to be careful with your own personal hygiene before proceeding
1. Removal
1.1, It is preferred that the bladder is as full as possible. Fill the bladder using sterile sodium chloride, maximum 3 3 decilitre or until the patient feels the urge to urinate.
1.2, Carefully clean around the insertion hole.
1.3, Deflate the balloon, which is normally filled with 10 ml of fluid. Take a note of how much fluid has been withdrawn for later documentation.
1.4, To remove the catheter, hold one hand against the patient’s abdomen and gently pull the catheter with the other hand. A small cramp in the abdominal muscle might force you to take a short break in the process. Make sure that the patient is relaxed.
2. Preparations
2.1, To prepare for the new catheter, place a hand on the patient’s abdomen and fill the insertion hole with catheter gel. It will prevent pain as well as lubricate the channel for easier catheter insertion. Let it work a little while.
2.2, Follow the manufacturer’s instructions. The BIP Foley Catheter should be pre-wetted to activate the hydrophilic coating.
3. Catheterization
3.1, While you are putting the new catheter in place, observe the patient to make sure he or she does not experience any pain. Be sure to insert the catheter far enough to avoid the balloon from inflating in the abdominal wall.
3.2, Get some urine in exchange before.
3.3, Fill the catheter balloon with the precise amount of fluid that the manufacturer recommends. Remember to observe the patient; this step should not hurt.
3.4, After you have completed this step, make sure the catheter is positioned correctly and can move freely. Finish by attaching a urinary bag or a valve.
Source: All material has been written and reviewed by Märta Lauritzen, registered nurse and urotherapist and Helena Thulin, registered nurse and PhD, Karolinska University Hospital, Stockholm.