sterile technique of Foley Catheter

virgolove34 · Oct 7, 2012

Im surprised your teacher didn't give u any instruction on what to do better. My instructor said I was reaching over my field too but we were able to make 3 mistakes. She stopped me and showed me a better way. My kit is in between the mannequins legs and the trash is on the side closer to me right outside of her leg closer to her hip. So say im cleaning with iodine, I swab one area then instead of coming across my field to throw it away, I go under her leg closer to her hip area and drop. Its hard to explain without showing you. Hawknurse I think on youtube is awesome with the catheter.

CCua · Oct 7, 2012

Thanks so much! The video was very helpful. I'm still unsure about the gloved and ungIoved part. When you were doing yours, was it only your gloved hand over the sterile field or was there some part of your ungloved wrist over the sterile field?

The instructor that checked me off just said that I kept reaching over my sterile field probably because my bed was too high. So next time I'll have my bed lower but I'm covering all bases because I only have 2 tries left.

CCua · Oct 7, 2012

Oh that cleared up my confusion about that part. I have one more question :)

I now know that we shouldn't allow any ungloved body parts to pass over the kit that contains the supplies but I'm confused over that shiny drape that's underneath the kit. The drape is considered too be non sterile right because it's touching the patients legs?

Thanks!

allnurses Guide · Oct 7, 2012

You know what, I have done more caths than I can count and I never heard about the sterile ball trick. You learn something new everyday.

Sterile fields require a constant awareness that really comes with experience and likely a few embarrassing errors. I was tossed out of my first surgical assist because in an effort to retract a awkward angle I passed behind another assist without going back to back. I almost cried it was so embarrassing but I have never made that particular mistake again. :)

NuGuyNurse2b · Apr 8, 2014

I didn't want to create another topic for this, but I have foley test out and in our class, for the male insertion, we are being taught to inject the whole syringe of lubricant into the urethra as opposed to lubricating the tip of the catheter like you do for the female. I really think this causes trauma to the urethra cause the tip of the syringe, even if it's blunt, is still much bigger than the opening of the urethra. I even asked my instructor if squeezing a little bit of lubricant to ease insertion of the syringe into the urethra was acceptable and she said no! I feel like this is an unsafe practice. Does anybody know why we do it that way? I found older threads where other schools are doing it also, so it must be some new innitiative but I can't wrap my head around why we would do it this way, instead of like the female way.

Esme12, ASN, BSN, RN · Apr 8, 2014

Anatomical differences. The male has a long pathway to travel to the bladder than females. While this may be offensive to your male sensibilities....the syringe tip isn't that big and it will fit into the tip of the member. To lubricate the tip of the syringe increases the chance of contamination and the danger of inserting the syringe tip too far increases.

The reason it isn't wise to lubricate just the tip of the foley is because the urethra in males is MUCH longer that a females. In the days we didn't do this routinely it was difficult to insert foleys as they would run out of lubrication long before reaching the bladder and cause the patient discomfort but getting "stuck" along the urethra as well of being out of lubricant when you need it most in males...the prostrate. In female, this path is a much shorter to the bladder.

So....it was decided, by evidenced practice, that the best practice was to lubricate the entire length of the foley. Well.... let me tell you a fully lubricated foley is difficult to hold onto and maintain sterility under the best of circumstances.

Then finally it was decided, by evidence practice, that by Injecting the lubricant into the tip of the meatus delivering the 100 cc's of lubricant is the best way to lubricate the length of urethra ensuring the least amount of discomfort to the patient.

I hope this helped you understand.

NuGuyNurse2b · Apr 8, 2014

Thanks!

Esme12, ASN, BSN, RN · Apr 8, 2014

You are welcome :)

NuGuyNurse2b · Apr 9, 2014

LOL I didn't even catch that the first time. But I knew she meant 10cc...which I got corrected on by my instructor when I was verbalizing my steps. It's 10mL now, we don't say cc no mo'.