RN's and specialty catheters

Posted
by AnthonyD AnthonyD Member Nurse

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 16 years experience. 224 Articles; 27,608 Posts

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

AnthonyD

Specializes in Critical Care, Med-Surg. Has 7 years experience. 228 Posts

Thanks Commuter :)

Farawyn

Has 25 years experience. 12,646 Posts

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 17 years experience. 5 Articles; 10,901 Posts

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 9 years experience. 1 Article; 2,672 Posts

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

Karou

Specializes in Med-Surg. Has 1 years experience. 700 Posts

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

AnthonyD

Specializes in Critical Care, Med-Surg. Has 7 years experience. 228 Posts

Thanks! Great info so far, I appreciate it.

AnthonyD

AnthonyD

Specializes in Critical Care, Med-Surg. Has 7 years experience. 228 Posts

Keep the responses coming :)

blondy2061h

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience. 1 Article; 4,094 Posts

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.

MendedHeart

MendedHeart

663 Posts

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

Libby1987

Libby1987

3,726 Posts

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