Foley Catheter insertion question

[MatthewCanUK]

I wanted to ask some UK nurses about the procedure for inserting a foley catheter in either a male or a female. I have read the Royal Marsden but I have to take an OSCE for UK licensure soon and I'm worried that there are some pit-falls hiding in the procedure.

In the US/Canada we would use forceps to clean around the urethra, thus leaving our dominant hand sterile for insertion of the catheter. The non-dominant hand keeps either the member or labia in place for insertion. However, in the Marsden example they simply say "use one hand to hold X and the other to clean. Then insert the foley". My worry is that hidden behind that statement is either a glove change, change in hands, etc...

One thing to point out is that, at least when I was trained, we did not have this idea of "one hand dirty, one hand clean" we used the disposable forceps that come in the tray (both for foley insertion and for dressings) thus you had at least one sterile hand left (for foley insertion) or both sterile (for dressing changes). I was penalised once before for not using this technique. But the way the protocol is written I can't see that I actually have a "clean" hand left after cleansing the area. The simplest solution would seem to be replacing my gloves, which I have seen done in some UK MD videos. But since I will be marked on the "proper" way of doing this I wanted to ask for some advice.

[skylark, BSN, RN]

I'm old school and we were taught to double glove. Remove the outer pair after the cleaning process and then continue.

The clean hand dirty hand refers to picking up cleaning supplies from your sterile field, its not an exact science but the concept behind it is that one hand is 'relatively' clean in that it picks up the gauze from the sterile field, performs the cleaning, and discards the gauze, without directly touching the patient, while the other hand keeps the genitalia out of the way and does not touch the gauze at all.

Of course in the real world the patient moves around when you are removing the outer gloves, and your "assistant" is nowhere to be seen, so you end up going to find a third pair of gloves as you ruined one trying to keep them in position : )

I haven't seen forceps in a cath pack for a while, better to assume that you will double glove?

But like I say, I am old school, I think maybe someone educated this century should contribute here as well!!

[GrumpyRN, NP]

I'm old school and we were taught to double glove. Remove the outer pair after the cleaning process and then continue.

The clean hand dirty hand refers to picking up cleaning supplies from your sterile field, its not an exact science but the concept behind it is that one hand is 'relatively' clean in that it picks up the gauze from the sterile field, performs the cleaning, and discards the gauze, without directly touching the patient, while the other hand keeps the genitalia out of the way and does not touch the gauze at all.

Of course in the real world the patient moves around when you are removing the outer gloves, and your "assistant" is nowhere to be seen, so you end up going to find a third pair of gloves as you ruined one trying to keep them in position : )

I haven't seen forceps in a cath pack for a while, better to assume that you will double glove?

But like I say, I am old school, I think maybe someone educated this century should contribute here as well!!

This is exactly the way I would (do) do it. As you say, last century training.

I have no idea how the new nurses do it and I let them get on with it their own way. My way (your way) works for me and I have had no complaints.

Now, what was it Florence said when I was training with her.