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question about foley catheter insertion

Hi! I just got home after working tonight as a tech on a med-surg floor. I am a senior nursing student and saw something tonight that I am questioning! I have done a couple of foley's before and I swear that I thought that if you "miss the hole" then you are supposed to get a new one because it is then contaminated from being in the vagina. Well the nurse that I was helping missed the urethra SEVERAL times and just kept fishing until she finally got a return. No wonder this woman has an infection!!! She has to be cathed every pm. So anyway, I am right on my thinking or can you really do that?

Thanks!!!

Hi! I just got home after working tonight as a tech on a med-surg floor. I am a senior nursing student and saw something tonight that I am questioning! I have done a couple of foley's before and I swear that I thought that if you "miss the hole" then you are supposed to get a new one because it is then contaminated from being in the vagina. Well the nurse that I was helping missed the urethra SEVERAL times and just kept fishing until she finally got a return. No wonder this woman has an infection!!! She has to be cathed every pm. So anyway, I am right on my thinking or can you really do that?

Thanks!!!

Once it has been inserted, it is considered used and needs to be replaced, if it didn't get to its proper place. If it didn't go into the urethra, then it other touched skin or went into the vagina, which contaminated it either way. The nurse that you were with was 100% in the wrong.

ItsyBitsySpider, BSN, RN

Specializes in Peds ER.

That's just bad news. I was taught that if you go in the wrong hole you leave the cath in and get a new one and insert it then remove the first. Has anyone else been taught that way?

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

You're right and that nurse was wrong.

I work on a urology ward and ItsyBitsySpider is right. If you insert it into the vagina by mistake you leave it there to help guild you with the next catheter then you take the original one out.

Kay x

lisamc1RN, LPN

Specializes in LTC/Behavioral/ Hospice.

Definitely, if you contaminate, you get another catheter! That poor woman! Is there something you can do about it? Can you report the nurse? She needs to be retrained or something because she is most likely infecting her patients!

CNM-to-be

Specializes in L&D/birthing center.

That's just bad news. I was taught that if you go in the wrong hole you leave the cath in and get a new one and insert it then remove the first. Has anyone else been taught that way?

This is exactly how I was taught. All I can say is I feel sorry for that poor pt. :o

Well, I wouldn't go as far as reporting her. Perhaps you could show her an article with research relating to this area or have a chat when you are alone together. That is what I would like a student of mine to do if she were unhappy with anything regarding my practice. Then take it from there.

Thats what I think anyway.

Kay x

As a first year nursing student--I'm learing that things aren't always done on the clinical unit the way we are taught in class!!! You are right--you leave the cath in and get a new one. This way you won't "hit the wrong hole twice". You take the mistaken one out after you get the cath in properly! I've seen RN's do this without even using sterile technique. I cringed the other week while watching an RN clean a fresh abdominal wound with an alcohol wipe--and not aseptically either!

studentnurse74, LPN, LVN

Specializes in Gynecology/Oncology.

I see this happen ALL the time. I questioned a nurse about it, and she told me they were expensive. :angryfire

I see it all the time- the first time I did was actually when a fellow student of mine did it in clinical! It was awful- I had had the patient the week before, and she was a VERY VERY modest woman preacher, who, I'll admit, was quite quite confused and was in severe stages of dementia.

At any rate, my clinical instructor had a male student nurse attempt to put the foley in, and for 1, the woman resisted and asked for a female nurse, a request that was denied due to her being "confused". Now, confused or not, this poor woman had rights! If she was with it enough to ask for a female, then she was with it enough to get it. But other than that...So, my instructor, Rich, had Brandon insert the foley, and my friend Emily and I hold this woman's legs apart. They inserted it into her vagina and didn't start over.

Two strikes against both of them, eh?

That was last year.

This year, I attempted to put one in a woman who's anatomy was definatly ... less than text book! I missed, and went to waste the contaminated foley, and the nurse who was with me took it, with NONSTERILE gloves, redipped it in the lube, missed twice and finalyl got it in.

No wonder 50% of nosocomial infections are UTIs.

~*Charity*~

ASN Student

Semester 4/4 U. Pitt-Brad

Bring on graduation, baby!

If its an in and out cath. you don't always need to use sterile technique. Most people who self-cath at home don't use sterile anything, many even wash out the catheter and reuse it. They do cost a lot if you are facing a life time of use. Not all insurances will fully cover a year's worth.

Used to work a day program and was always told if they or a family member cath. at home we could use clean technique. And no we didn't have a high UTI rate.

Hi,

Intermitant self catheterisation is a clean technique not sterile. I would say that reusing a catheter is a bit dodgy and less easy as you would have to use a lubricant while the catheters we commonly use are allready lubricated or 'just add water'

Kay x

Hi! I just got home after working tonight as a tech on a med-surg floor. I am a senior nursing student and saw something tonight that I am questioning! I have done a couple of foley's before and I swear that I thought that if you "miss the hole" then you are supposed to get a new one because it is then contaminated from being in the vagina. Well the nurse that I was helping missed the urethra SEVERAL times and just kept fishing until she finally got a return. No wonder this woman has an infection!!! She has to be cathed every pm. So anyway, I am right on my thinking or can you really do that?

Thanks!!!

For me if it is a foley that will be in for an indefinate period of time then it is sterile technique. For an in and out cath, clean technique is fine.

klone, MSN, RN

Specializes in Women's Health/OB Leadership.

For me if it is a foley that will be in for an indefinate period of time then it is sterile technique. For an in and out cath, clean technique is fine.

What if it's a one-time-only straight cath, is it still just clean technique then? (For example, I'm thinking of a woman in labor or immediately postpartum who's having a hard time voiding, but probably won't need catheterization more than once)

Gompers, BSN, RN

Specializes in NICU.

What if it's a one-time-only straight cath, is it still just clean technique then? (For example, I'm thinking of a woman in labor or immediately postpartum who's having a hard time voiding, but probably won't need catheterization more than once)

I'd try to keep things as sterile as possible, if anything just to practice sterile technique. But I wouldn't waste the catheter if you missed, I'd just try again if it was just a straight cath.

Of course if it's for a urine culture, things must be sterile.

meownsmile, BSN, RN

Specializes in Med/Surg, Ortho.

Forget write ups, i still think that is something that gives someone in administration something to shuffle. Go to the infection control nurse and tell her of your concerns. She watches the numbers, temps, antibiotic trends etc and would be able to correlate your information/concerns with problems on the floor. You may not see it, but she would see a trend if this is a usual procedure for the nurses on that floor and would address it.

Even for a straight cath on someone who catheterizes frequently, you still would want to clean the catheter if you missed and entered the wrong place. A little Betadine and sterile water or n/s rinse is all thats needed.

And Klone,, no,, you would definately want to stay sterile in that instance even for a one time order.

Hi! I just got home after working tonight as a tech on a med-surg floor. I am a senior nursing student and saw something tonight that I am questioning! I have done a couple of foley's before and I swear that I thought that if you "miss the hole" then you are supposed to get a new one because it is then contaminated from being in the vagina. Well the nurse that I was helping missed the urethra SEVERAL times and just kept fishing until she finally got a return. No wonder this woman has an infection!!! She has to be cathed every pm. So anyway, I am right on my thinking or can you really do that?

Thanks!!!

Oh man, it so bothers me to see our profession "taking shortcuts". You are absolutely 100% correct, she should have left that cath in place, gotten a new one and reattempted the insertion. Unfortunately, I see many seasoned nurses taking short cuts such as this, it is oh so sad. I bet if it were her mother she would not have done that....that is how we should treat our patients....just as if they were our own family. I work with a CRNA who will do this with IV's also...sickening...and putting the patient at such risk is just beyond my thinking. Makes you wonder what else they do?????????

I work with a CRNA who will do this with IV's also...

Now that is gross. With our myelomeningocele kids (or kids with neurogenic bladders for other reasons), our caths are clean. When they cath themselves, its not sterile. We're lucky if we can get them to wash their hands and not carry used caths around in their pockets.

That's just bad news. I was taught that if you go in the wrong hole you leave the cath in and get a new one and insert it then remove the first. Has anyone else been taught that way?

I was also taught that way. By leaving the used foley in the "wrong" hole, when you make your next attempt (with a clean foley)you know NOT to go in that spot again. Helps you get it in the right spot and not continuously try to put it in the wrong one. SG

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