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Female Catheterization (102.010)

Female Catheterization (102.010) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Clinical Procedure

102.010

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UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: FEMALE CATHETERIZATION

Effective Date: March, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed October, 2003 April, 2005 April, 2008 April 2010 July 2011
March 2012

PURPOSE: To provide guidelines for the catheterization of female patients at UWMF Clinics.

POLICY: The clinical staff will utilize the following guidelines to catheterize a female patient.

DEFINITION: Catheterization of the bladder involves the introduction of a rubber or plastic tube through the
urethra into the bladder.

SUPPLIES: Sterile catheterization tray (if available), Latex free catheter 14 or 16 French (if needed)
OR
Sterile gloves, sterile drapes - one fenestrated (if needed) and one non fenestrated, water soluble
lubricant, antiseptic solution (if not using betadine swabs), cotton balls or gauze sponges, forceps
or betadine swabs, straight or foley catheter (14 or 16 French), gooseneck lamp, receptacle such
as urine hat, chux
Optional: sterile drainage tubing and collection bag, tape
pre-filled syringe with sterile water to inflate balloon (10 cc in 5cc balloon)- if
attaching a urine drainage system
sterile specimen container if collecting urine specimen

PROCEDURE:
1. Wash hands, gather equipment and check provider’s order and clarify any inconsistencies.

2. Identify patient by full name and date of birth

3. Verify patient allergies, specifically to latex and iodine

4. Explain procedure and purpose of the procedure to the patient. Provide privacy.

5. Assist patient to the dorsal recumbent position with knees flexed and feet about 2 feet apart, or dorsal
lithotomy with feet in stirrups.

6. Open sterile catheterization tray using sterile technique.

NOTE: If a catheter tray is not available, establish a sterile field. Using aseptic technique, open and place
prepared sterile supplies on sterile field.

7. Don sterile gloves.

8. Grasp upper corners of drape(s) and unfold without touching unsterile areas.


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9. Fenestrated sterile drape may be placed over perineal area exposing the labia. Non fenestrated sterile drape
may be placed under the patient’s hips.

10. Place sterile tray on drape between patient's thighs.

11. Open/prepare remaining supplies:
a. If catheter is to be indwelling: Test catheter balloon. Remove protective cap on tip of syringe and attach
syringe pre-filled with sterile water to injection port. Inject appropriate amount of fluid. If balloon
inflates properly, withdraw fluid and leave syringe attached to port.
b. Pour antiseptic solution over cotton balls or gauze, unless using betadine swabs.
c. Open specimen container if specimen is to be obtained, maintaining sterile technique.
d. Lubricate 1-2 inches of catheter tip with water soluble lubricant.

12. With thumb and one or two finger(s) of your nondominant hand, spread labia and identify meatus. Be
prepared to maintain separation of labia with one hand until urine is flowing well and continuously.

13. Using sterile cotton balls or betadine swabs, cleanse area three times, each time with a new cotton
ball/swab; right side, then left side, then middle (directly over the meatus).
*Discard each cotton ball or swab after one downward stroke.
NOTE: If patient allergic to iodine, use 4% cholorhexidine gluconate solution for cleaning

14. With uncontaminated gloved hand, place drainage end of the catheter in receptacle.

a. For insertion of an indwelling catheter that is pre-attached to
sterile tubing and drainage container (closed drainage
system), position catheter and setup within easy reach on
the sterile field.
b. For sterile urine specimen collection, place drainage end
of catheter into sterile specimen container. Remember to label
specimen container and place in small biohazard bag.

15. Insert catheter tip into the meatus and advance 5-7.5 cm
(2-3 inches) or until urine flows.
a. To facilitate insertion, ask patient to cough as you insert the catheter.

16. Ask patient to breathe deeply. Rotate catheter gently if resistance is met as catheter reaches the external
sphincter.
a. For an indwelling catheter: Once urine drains, advance catheter another 2.5-5.0 cm (1-2 inches).

17. Hold catheter securely with the non-dominant hand while bladder empties. Collect specimen if required and
allow bladder to empty completely.

18. If catheter was to be a straight catheterization, remove catheter smoothly and slowly.

21. If the catheter is to be indwelling:
a. Inflate balloon according to manufacturer's recommendations (General recommendation is 10 cc in 5cc balloon).
c. Retract catheter after balloon is inflated to feel resistance.
d. Attach catheter to drainage system.
e. Secure to upper thigh with a Velcro leg strap or tape.
f. Leave some slack in catheter to allow for leg movement.
g. Check that drainage tubing is not kinked.


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22. Discard equipment and assist patient to comfortable position.

23. Remove gloves and wash hands.

25. Documentation: HealthLink using .npcath phrase in addition to describing how patient tolerated procedure.


REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator
LaVay Morrison, RN, BSN, Clinical Staff Educator

REVIEWED BY: Tracy Ancheta, RN, Urology
Theresa Ridderbusch, RN, Urology
Donnette Kelly, RN, Department of Urology, 2012


WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support

REFERENCES:
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby
Elsevier.

AUTHORIZATION:

Department of Surgery, Urology Date


Medical Director Date