Catheters in Pregnant Pt going for US??

nuangel1, BSN, RN · Dec 29, 2010

thats not the case in my ed .we do not place catheters in hcg pos pts at all.ie not for sole purpose of a pelvic u/s .its not necessary.

VICEDRN, BSN, RN · Dec 30, 2010

we do not routinely place catheters at my facility either.

ERpsychRN · Dec 30, 2010

so glad to see this question, i have always thought it was bad practice to place catheters routinely, one ed i worked in they acted like i was crazy for thinking so, the large teaching hospital i worked in did not do this and the reason was they did lady partsl ultrasounds, i think this is more advanced than the traditional one and the traditional ultrasound (and probably cheaper one) requires the catheter to instill fluid in the bladder in order to see an early pregnancy. SO if a facility routinely uses a catheter my opinion is they are either cheap or behind the times.

Dazglue, ADN, BSN, MSN, RN · Dec 30, 2010

At our hospital we just started any female over the age of 18 gets cath b/c a lot of patients were contaminating the clean catch urine specimens. I understand the rationalization but I think they should have AT LEAST focused on patient teaching first. Of course the patient has the right to refuse (I WOULD)

jjvemiller · Dec 30, 2010

Thanks for all the feedback. I am a new RN and was lucky enough to be hired into an ED right our of school. I have been there for just over a year now.

The question of the foley placement has been a contention with US since I started and all the RN's complain about this policy. I finally wrote to the director of infection prevention and notified her of this practice - she was surprised and started looking into it. Hopefully this will end soon!

I understand that it's easier for the US tech to see an ectopic or early pregnancy but if there is any question they always do a transvag US also...which of course doesn't need a foley. I think it is is a waste of resources and puts the pt at risk for infection. I'm sure there are some pt when this might have to happen...but really...on everyone? I don't think so.

Editorial Team / Moderator · Dec 30, 2010

I hope it changes .... we definitely do NOT do this!

back2bRN · Dec 31, 2010

Does not have a policy to DO this, however there have been instances (rarely and long ago) where a foley was placed in npo pts to expedite an U/S and assess viability of the pregnancy....had VB ect. So have done it,not routinely and would definitely question the practice as protocol.

KansasNurseD · Dec 31, 2010

We also don't place catheters where I work. However, if the patient is in their first trimester they are supposed to have a full bladder prior to going to US. We don't scan their bladders or anything to be sure its full- its just kind of a "Let me know when you need to pee"measure of bladder fullness.

runnergirl28 · Jan 25, 2011

A few years ago we always did place a foley to fill the bladder for the ultrasound. At the present time we do not. We ask the patient to drink if truly necessary. Also changed is the "convenient" placement of catheters in the patient instead of using a bedpan - due to increaded infection rates. While I am glad we don't have to fill the bladder any longer, it's sometimes a pain to keep assisting a patient on the bedpan every 5 minutes or changing their depends every 5 minutes!

Larry77, RN · Jan 25, 2011

We also still do this bad practice...it comes from our old fashioned radiologists...we've tried to fight it in the past and got nowhere. Someday they will join the 21st century and end this.

DeadHeadRN, BSN, RN · Jan 26, 2011

At our hospital we just started any female over the age of 18 gets cath b/c a lot of patients were contaminating the clean catch urine specimens. I understand the rationalization but I think they should have AT LEAST focused on patient teaching first. Of course the patient has the right to refuse (I WOULD)

That's seems very strange to me! First, in my ED it is not the policy to place Foleys or straight cath pts with a + UCG. Second, why would any facility promote catheterizing a pt unless ABSOLUTELY necessary? Not best practice by any means. No matter how careful you are, there is always a chance of a UTI with any catheterization. Why would we put the pt at risk without a damn good reason, ESPECIALLY a pregnant pt? I don't like that policy at all. I agree, the focus should be educating the pt regarding how to do a clean catch.

Also, I can't imagine the Joint Commission would agree that unnecessarily catheterizing a pt simply because she has a + UCG is best practice, or in line with all known evidence-based practice regarding infection prevention.