Foley sterile field

[AJPV]

I'm practicing for a school checkoff doing a foley. Sterile technique is the biggest thing we're focusing on. There is a tray that sits in the top part of the box that the cath comes in. The tray contains the cotton balls & iodine. The catheter sits below the tray in the box itself. I realize that I have to don the sterile gloves, then test the cath balloon & apply lube to the cath (which is below the tray), then when everything is ready, I can finally prep & use the cotton balls (which is when I will contaminate my non-dominant hand).

My question relates to the fact the the catheter is initially inaccessible due to the tray being over the top of it. After donning the sterile gloves, is it okay to remove the tray from the top of the box and set it on the bed between the pt's knees (on the sheet and not on top of the sterile drape due to the size of the drape not accomodating the box and tray side by side)? I have to somehow get the tray out of the way to access the cath so I can test the ballon and lube the tip - BEFORE I use the cotton balls and thus contaminate my non-dominant hand. But if I move the tray and set it down on the sheets (not on the sterile drape) does that make the cotton balls contained in the tray officially "contaminated" because the tray is not sitting on top of the sterile drape?

Any tips would be great - thanks!

[Biffbradford]

Funny story: while in school clinicals, we asked another student to get us a kit for changing the dressing on a central line. We opened it up and ... ??? ... cotton balls???

That was our inside joke for the longest time.

[roser13, ASN, RN]

We could all give you tips, no doubt. But on a skills check-off, the only "tips" that count are the ones that your instructor gives you. Ask him or her.

[AJPV]

Yeah, you didn't know you could cut a slit in a foley bag and use it as a really big central line dressing??? But really, anyone with tips on how to handle the tray in the foley kit?

[Esme12, ASN, BSN, RN]

Great video!!

https://youtu.be/YACtesAiLlU

[nurse2033, MSN, RN]

Yes, you have already opened the outer wrapper, the inside of which is sterile. It is big enough to hold both the box and tray. Once your hands are gloved, pick up the tray and set it in front of the bottom part. Another tip, instead of squeezing the lube onto the tip, pull open the lube syringe and stick the tip into the lube, that helps keep it clean, covers it with lube, and gives it some weight so it doesn't fly around. Oh the Foley fun goes on and on...

[AJPV]

You must have a bigger sterile drape then what our kits have. I found it really difficult to get the cath box and the tray side by side on the sterile drape - all of which is between the pt's thighs!

[Gently.me]

I do not recommend sticking everything between the pts thighs... most patients do not want a catheter, and LOTS of patients like to kick... there goes the sterile field.

Most of the catheters we do are fem-caths, but wouldnt it be ok to place the tray in a non-sterile field as long as the contents inside the tray remain sterile?

My trick... Most of the gloves in a catheter setting do not fit me well at all, so I get my own pair 6 1/2 sterile gloves. If you do it this way, you can use the sterile glove package as a sterile tray.....

[AJPV]

Good tip to not put everything between the pt's thighs! I agree that the contents of the tray should be sterile even if you set the tray on top of a non-sterile surface, but I'm not sure if our instructors will get their undies in a bundle over that. I'll have to ask...

[Gently.me]

Yes ask!!! It is hard enough having to worry about getting it in the correct hole (sometimes on elderly ladies, anatomy is not what it should be), but something so stupid as to where to put the sterile tray....

Dont worry, in the real-world of nursing, practicality trumps "the way they teach you in nursing school". But since you are in training, do it their way, period. Even if it is stupid....

[GGT1]

I put both boxes side-by-side on the wrapper that it comes in, which is sterile. I do not place it on the "sterile drape" because that is the piece that is to go slightly under the buttocks and only allows for a little room.

Practice makes perfect...and personally I enjoy doing foleys...wierd, I know

[bjaeram]

I just lift the top tray and pull out the tubing a ways and place the top tray back where it was. Stick the end of the foley in the goop. After I place the catheter I throw out the top tray and then pull the foley bag out of the bottom.