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We have standard orders to insert a straight cath if a patient is obviously retaining urine and/or a bladder scan reveals a post-void residual of 250cc or greater. The straight cath can be a regular Red Robin or a Coude tip. It's the nurse's choice.
I work at a specialty rehabilitation hospital in Texas with many atonic bladders, hypotonic bladders, and neurogenic bladders due to CVA and/or spinal cord injury.
Our foley order set says "insert Foley catheter, if not easily passed on first attempt on male patient, place coude catheter." Since this policy went into effect I have placed a lot of coude catheters and love them! I can't believe how much easier they are with almost every male >50.
RN's don't really place 3-ways, but I don't think it's against policy. I think it's more a supply issue. They really want all patients having a closed system to prevent CAUTI now, and the three ways don't come in a closed system. Any catheter that doesn't come in a closed system has to be obtained through the urology department now, and really, anyone getting a three way is getting it from CBI, and anyone getting CBI is being followed by urology anyway, and they will usually placed the catheter when they see them. And they're brutal with the hoses they place.
We insert what patient needs. The MD will come in and insert if we can't get it after changing sizes or to Coude
I was taught by the urologist not to inflate Ballon prior to insertion and if patient has BPH etc... to NOT use a coude and to go a size larger in diameter
NC, Acute Care/hospital
AnthonyD
228 Posts
I'm currently looking into some of our nursing standards of care for my hospital, and I have a question:
In your facility, are nurses able to insert Coude catheters and/or three-way (bladder irrigation) catheters? Or do only providers place three-way caths and Coude-tip caths, while nurses only insert standard Foleys?
Any input is appreciated. Thanks! (also if you could mention where you're from and what type of facility and unit you work in thanks).