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Mini Straight Cath

Specializes in Long Term Care, School Nurse.

I'm a new grad and the Dr. where I work is asking that every time we need a urine specimen we have to do a straight cath. Evidently there have been problems with the specimens being contaminated so she is ordering this on an ongoing basis. I have never been trained on how to do a straight cath and I can imagine that the residents will refuse this when all we need is a urine specimen. Can anyone explain to me how to do this procedure? Also have you had residents refuse this?

Thanks,:confused:

The procedure is the same as for inserting an indwelling catheter. Get your straight cath kit, set up your sterile field. Clean the target area using sterile technique with the solution provided. Then perform the catheterization, catching the urine in the basin. Obtain the specimen, making sure to maintain sterility. It is a good way to make sure that the specimen isn't contaminated. It only takes a few minutes.

Good luck.

GrumpyRN63, ADN, RN

Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.

I would just add to discard the initial urine as you would with a 'clean-catch' and get a mid-stream sample

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Specializes in LTC/SNF, Psychiatric, Pharmaceutical.

I'm a new grad and the Dr. where I work is asking that every time we need a urine specimen we have to do a straight cath. Evidently there have been problems with the specimens being contaminated so she is ordering this on an ongoing basis. I have never been trained on how to do a straight cath and I can imagine that the residents will refuse this when all we need is a urine specimen. Can anyone explain to me how to do this procedure? Also have you had residents refuse this?

Thanks,:confused:

The physicians at one NH I worked at would order routine straight caths. It's a devil trying to get a clean catch specimen out of an incontinent, confused resident, although straight caths were not feasible on some of them either d/t dementia. Generally, if you are professional and matter-of-fact about it, and explain how and why it is being done, you are more likely to obtain their cooperation. Yes, I have had residents refuse this; it is their right to do so.

So, I am a first semester RN student who just began my clinical rotations about a month ago at a nursing home. I did my first straight cath on a male resident, and it was pretty simple; however, I did not use a mini one. Nevertheless, a classmate of mine needed to do a mini straight cath on a female resident with advanced dementia...and it was a nightmare. It took five of us to try to get this poor woman's urine. She kept saying that she could just go in a cup, but we knew the order was for a straight cath sample. And we weren't having such horrible difficulty because we are students because the other nurses were in there helping - it was because this resident was confused and couldn't understand why she couldn't just go to the bathroom and do it with some supervision or help. I understand that a staright cath is going to give a noncontaminated specimen, but I don't think it is necessary for EVERY patient.:down:

Yes...it is the same procedure as inserting a foley except you use a smaller cath and don't have a balloon to inflate.

I think it is abusive to hold down demented residents to get a specimen. Esp when you can smell the urine a mile a way and they are normally + for Ecoli. If you can get a good clean catch...go for that.

chenoaspirit, ASN, RN

Specializes in Med/Surg, Home Health.

If a patient, demented or not, is refusing to be cath'ed then I would call the doc and request an order for a clean catch. Even if a patient is demented, they do have rights. I cant imagine having orders on an ongoing basis for straight cath for urine sample by a doc. Even though it is a sterile technique, there still are risks for contamination and UTI's. If they are incontinent, then understandable.

Thornbird

Specializes in A little of this & a little of that.

I find that using the "mini" cath doesn't work well with confused patients. I can't really say what it is exactly, but I just have far better success with the regular straight caths for these patients. I think may be I have an easier time holding and aiming the longer tube. I really fear contamination with those little kits if the patient isn't entirely able to stay still.

If it is so difficult to get a specimen that restraining the patient in any way would be needed, I report that the patient refused. Confused patients definitely have the right to refuse. Just think about it, if someone doesn't understand what's going on and can't consent, then that procedure is rape. Way too traumatic when the doc can treat based on symptoms which they really have to do anyways due to the high rate of colonization with elderly patients.

There is no way I will EVER have a catheter for ANY reason, least of all to get a sample. The nurses can take a sample when I pee normally or do without.

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