Foley Catheter Insertion

[DabaLou]

I'm looking for input on maintaining sterility during Foley insertion. Here's the process as per my lab instructor: Don sterile gloves, then place the sterile drape between patient's legs, then place the fenestrated drape over the patient's perineum. Our lab instructor stated that if the fenestrated drape doesn't sit quite right after you place it (like if its covering part of the perineum), that you can adjust it with your hands because you're wearing sterile gloves and the fenestrated drape is sterile. That sounds like sterile-to-sterile, but I'd still like to know what the consensus is on that?

[Nonyvole, BSN, RN]

As long as you don't grasp the edges, yes.

Although the Foley kits at my facility have the sterile drape packaged before the gloves, so we end up shopping that with clean, not sterile, gloves.

That is, of we even bother with those annoying things.

[Nonyvole, BSN, RN]

Shopping, placing...all the same in auto correct.

[KelRN215, BSN, RN]

That is, of we even bother with those annoying things.

Yeah, I don't think I've ever used one in real life...

[DabaLou]

Thank you, Nonyvole, so much for your feedback on this!

[Nonyvole, BSN, RN]

You're welcome. (Great question, by the way)

The thing to remember about sterile fields is that about an inch in from each side is considered to NOT be sterile. Doesn't mean you want to go and put things on it and touch it, but it can be considered a buffer zone. Same with any part of the drape that is hanging off the edge of the table. You can't see it, it's dirty.

And you'll learn that there is the book way, and there is the "street" way. Street...not completely by-the-book, because the book assumes that you are in an ideal environment, with a very cooperative patient. So "street" foleys? Don't use the drapes, don't squeeze out the lube (stick the end of the foley into its container), and use an assistant to help hold the invariable masses of flesh out of the way, as well as controlling hands and one leg. Then yell at the doctor for trying to "help" by inflating the balloon before you're 100% sure that you're completely in the bladder. While you're in school, no matter what people might say, do it by the book, because that's what you're being tested and evaluated on and there's nothing worse than flunking a class because of the little things.

Yelling at doctors is never in the book. Ever. Only yell at a doctor if you've a good working relationship with them, because half the time they don't know any better about skills that they did in medical school and never since.

[applesxoranges, BSN, RN]

Well, you don't normally want them to inflate the balloon unless you're certain you're in the bladder. It's very bad practice to do otherwise. Although if you're in the lady parts it doesn't matter as much as if you're in a guy and in the wrong place. The tip about the lube only applies if you have a syringe of lube. A lot of facilities use one that is shaped so even if you take the tip off, you won't get the foley in it.