question about foley catheter insertion

safewaygreenbox · Feb 6, 2005

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

Brickman · Feb 6, 2005

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 lady parts. 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 · Feb 7, 2005

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 · Feb 7, 2005

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 · Feb 7, 2005

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.

traumacoordinator · Feb 7, 2005

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 lady parts. 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?????????

DelightRN · Feb 7, 2005

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.

enfermeraSG · Feb 7, 2005

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

haras regnurps · Aug 5, 2007

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

well golllooooolllllyyyyy

IV antibiotics are expensive too. maybe the nurse that can't insert a foley owns stock in Lilly or Merck!

suanna · Aug 5, 2007

You say the patient has to be cathed daily. I wonder if she could be a chronic "self cath" patient at home. Doesn't cathing become a clean-not sterile- proceedure for patients that cath themselves daily? I'm not an expert-I work in Open Heart Recovery. Just trying to give the RN the benifit of the doubt. In the hospital, I would still get a new cath if I missed reguardless of the patients history.

WDWpixieRN, RN · Aug 5, 2007

I saw someone I was training with recently do this with an indwelling. I had missed the first time, so she grabbed the tubing from me, wiped it on some used cotton balls w/betadine, re-lubed, then went for it. I was rather grossed out as we were clearly taught in school not to do this. I thought maybe I was a little paranoid and she actually knew what she was doing. UGH!!

haras regnurps · Aug 6, 2007

self cath patients when in the hospital still have to follow the hospitals nursing protocol. so what does the good book say about cath procedures. politely read it in front of the nurse that kept missing maybe she will get the hint. if that doesn't work talk to your manager because i wouldn't think they would want her precepting anymore new nurses..................................... :nono: