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RN's and specialty catheters

Posted

Specializes in Critical Care, Med-Surg. Has 7 years experience.

Do Nurses place specialty catheters in your facility?

  1. 1. Do Nurses place specialty catheters in your facility?

    • 14
      Yes, both Coude and three-way (irrigation) catheters.
    • 10
      Yes, but only Coude-tip not three-way.
    • 3
      Yes, but only three-way (irrigation) catheters, not Coude.
    • 0
      No, only providers place specialty catheters.
    • 0
      I'm not sure.

27 members have participated

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).

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

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.

AnthonyD

Specializes in Critical Care, Med-Surg. Has 7 years experience.

Thanks Commuter :)

Farawyn

Has 25 years experience.

Home care. Coude for the first time by the doc, if needed again by the RN. Same deal when I worked on the floors.

Only docs did the 3 way.

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 16 years experience.

OR. Regular foley or coude. Three way foley always placed by urologist- typically because the patient is having some sort of bladder or prostate resection via cystoscopy. Not sure if floor nurses are allowed to place irrigating foleys.

KatieMI, BSN, MSN, RN

Specializes in ICU, LTACH, Internal Medicine. Has 8 years experience.

LTACH. Whatever type provider wants, we do it. Three-ways placed by nurses with doc on stand-by somewhere near and/or with one of other nurses with urology experience.

Population is mostly like the one Commuter described, but we also receive quite a few of bleedings.

Karou

Specializes in Med-Surg. Has 1 years experience.

Med-surg here. Nurses can do three ways and coude's. Need an order for a three way but not a coude. If someone is having trouble then they call the urology floor and get a nurse from there. If they still can't get it then the urologist has to come and do it.

AnthonyD

Specializes in Critical Care, Med-Surg. Has 7 years experience.

Thanks! Great info so far, I appreciate it.

AnthonyD

Specializes in Critical Care, Med-Surg. Has 7 years experience.

Keep the responses coming :)

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience.

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

We insert all 3, the 3 way for our caregivers who need to perform daily irrigations. Home health.

AnthonyD

Specializes in Critical Care, Med-Surg. Has 7 years experience.

Thanks, this is all great info!

Farawyn

Has 25 years experience.

We insert all 3, the 3 way for our caregivers who need to perform daily irrigations. Home health.

Libby, as a HHRN would you most likely insert the initial Coude as well as the 3 way?

Libby, as a HHRN would you most likely insert the initial Coude as well as the 3 way?

Im not sure if we've inserted the initial coude, I actually never thought about it. There's nothing different re the 3 way as far as insertion goes and have initiated it for frequent irrigations.

RN inserts all 3 catheters based on MD order. Foley vs coude is based on evaluation of patient. We have other types as well. 3-way catheter placed only for continuous bladder irrigation. Urologist consult by MD to place catheter usually only if multiple RN's have tried unsuccessfully already or patient has known problems with catheter placements in the past.

Lev, BSN, RN

Specializes in Emergency - CEN. Has 7 years experience.

We place all 3 in the ER. When i worked m/s full time, RNs did not insert coudes or 3 ways because if there was trouble we got a urology consult.

I have placed both coudes and three-way, but with that said if they need a three way its because of clots or bleeding and I prefer urology to do it.