Question of about indweling foley catheter procedure

[Christylky]

I am a student nurse i have a question about the procedure.I want to know what kind of aseptic solution properly use for cleansing pubic area?As i know aseptic solution are: normal saline ,salvon or hibitane and so onWhich solution is better? Any situation i need to concern ?thx for answer

[CT Pixie, BSN, RN]

This points out the importance of knowing what is in your supplies. You certainly wouldn't want to do a prep with povidone (Betadine) if your patient were allergic to iodine!!!

I couldn't recall the name at that moment but I knew it was iodine based (at least in the kits we use at my facility). And I would know/do know to check to see if it were iodine not only to check to see if there were any iodine in it due to a patient allergy to it but also, since I have an allergy to iodine myself.

[loriangel14, RN]

You can't have a true allergy to iodine. You can have a sensitivity/intolerance to certain formulations that contain iodine for various reasons, but not a true allergy to iodine itself.

You certainly can have an allergy to iodine. I have had a patient that was allergic to it.

[bubblejet50]

I had a patient that was straight cath'ed every 4 hours and had been for years. The doctor okayed it to a clean technique and not sterile. We used benzalkonium wipes for this patient but for indwelling foleys I have only seen the betadine in the kits.

[wanderlust99]

I don't understand questions like these. Don't you have a nursing book with rationale? Would you put boiling water on your urethra? Seriously?

[nurseprnRN, BSN, RN]

I had a patient that was straight cath'ed every 4 hours and had been for years. The doctor okayed it to a clean technique and not sterile. We used benzalkonium wipes for this patient but for indwelling foleys I have only seen the betadine in the kits.

Interestingly, for people who require intermittent catheterization (spinal cord injury, for example) Medicare used to supply a total of four sterile catheters PER MONTH (one a week) and we used to teach people how to clean them with various solutions and store them between uses. Well, surprise: This was one reason it was assumed that SCI meant you would have urinary tract infections, and why the incidence of urosepsis and death was so high in this population.

Somebody finally tumbled to the idea that STERILE supplies would cost a lot less than the infections, and now Medicare pays for 250-- yep, that's two hundred and fifty-- sterile caths per month, enough for what most people need (6-8/day). There are nifty kits that have prep balls and the pre-lubed catheter is completely enclosed in a sterile sheath so it's a no-touch procedure-- and it catches the urine for safe disposal, too. This has freed up a lot of people to be out and about, too. And I had one patient who had no UTIs at all 6 years post SCI...until some new person in home care re-used a catheter (because that's what she thought you did)...and he is now colonized with occasional flares of infection. Bummer.

So yes, even for someone who has been "clean cath is all that is necessary," the standard of care has gone to STERILE. Perhaps your facility can look into getting some of those kits.

[bubblejet50]

Interestingly, for people who require intermittent catheterization (spinal cord injury, for example) Medicare used to supply a total of four sterile catheters PER MONTH (one a week) and we used to teach people how to clean them with various solutions and store them between uses. Well, surprise: This was one reason it was assumed that SCI meant you would have urinary tract infections, and why the incidence of urosepsis and death was so high in this population.

Somebody finally tumbled to the idea that STERILE supplies would cost a lot less than the infections, and now Medicare pays for 250-- yep, that's two hundred and fifty-- sterile caths per month, enough for what most people need (6-8/day). There are nifty kits that have prep balls and the pre-lubed catheter is completely enclosed in a sterile sheath so it's a no-touch procedure-- and it catches the urine for safe disposal, too. This has freed up a lot of people to be out and about, too. And I had one patient who had no UTIs at all 6 years post SCI...until some new person in home care re-used a catheter (because that's what she thought you did)...and he is now colonized with occasional flares of infection. Bummer.

So yes, even for someone who has been "clean cath is all that is necessary," the standard of care has gone to STERILE. Perhaps your facility can look into getting some of those kits.

This patient was already colonized by the time I took care of them. They did have a standing prn order for u/a's. I dont think it was necessarily insurance mandating it but since they were colonized already the doctor just decided to keep it clean and monitor.

[nurseprnRN, BSN, RN]

You can still give the patient / caregiver the information that sterile is the way to go and is now covered by insurance, so they can pursue it after discharge. This will cut down on the risk of infection. You can tell the physician, too, and not just assume that's what he thought-- many physicians don't know about this change either. Nurse as advocate.

[schooldistrictnurse]

Just to be clear here, the caths are sterile but the procedure is clean, ie, no sterile gloves. This is the way we do intermittent caths in school. NON-sterile gloves, lube and pre-cath cleansing, sterile caths for one-time use.

[bubblejet50]

Just to be clear here, the caths are sterile but the procedure is clean, ie, no sterile gloves. This is the way we do intermittent caths in school. NON-sterile gloves, lube and pre-cath cleansing, sterile caths for one-time use.

That is how it was being done with my case. New, sterile cath but clean procedure.

[MunoRN, RN]

You certainly can have an allergy to iodine. I have had a patient that was allergic to it.

Patients will mistakenly claim iodine as an allergy, usually based on the old myth that a seafood allergy equals an iodine allergy. The first problem with this is that iodine is not anywhere complex enough to produce an allergic reaction, it's elemental. Second, you wouldn't survive if you were actually able to avoid iodine, it's like saying you're allergic to potassium.

"According to Dr. Andre Caron of the Association of Allergists and Immunologists of Quebec, iodine is not a substance that causes allergy. This can be confusing, because people will speak of an allergy to iodine when what they really mean is they are allergic to shellfish proteins such as parvalbumin or tropomyosin, that do not contain iodine. People will also say they are allergic to the iodine dye used in radiology procedures. But iodine is an essential element for life, and an allergy to iodine is not compatible with living. Reactions to the dye used in radiology procedures can be very serious, but they are reactions to the radiocontrast materials, not the iodine in the dye."

Read more: Allergies To High-iodine Foods | LIVESTRONG.COM

[Daisy_08, BSN, RN]

Just to be clear here, the caths are sterile but the procedure is clean, ie, no sterile gloves. This is the way we do intermittent caths in school. NON-sterile gloves, lube and pre-cath cleansing, sterile caths for one-time use.

Really? I didn't think I had been out of school very long, I was taught the sterile way. My hospital policy for in dwelling catheters is to be done sterile. In&outs can been done clean and we can use tap water for cleaning

[schooldistrictnurse]

Daisy, I thought I was clarifying, but maybe not! I'm talking about intermittent caths for school children (my work setting). We strayed a bit from the original question about indwelling caths.