Chapters Transcript Advance™ Foley Catheter Selection, Insertion, Care, and Maintenance mm hmm mm hmm mm hmm. Healthcare associated infections or H. A. I. S. Are a concern for patients and healthcare providers alike. Catheter associated urinary tract infections or C. A. U. T. I. S. Are among the most common H. A. I. S. According to data published by the Us Department of Health and Human Services Scotties are associated with increased morbidity, mortality, length of stay, antibiotic use and costs of more than $500 million dollars annually. Aseptic procedures and proper catheter maintenance play an important role in helping mitigate the risk of kati. This instructional video will provide a step by step demonstration of aseptic technique used to categorize male and female patients with the Bard Advanced fully trade system. This will be followed with a description of some important techniques related to ongoing foley catheter care maintenance and urine sample collection. The Bard Advanced fully trace system is designed to follow the CDC guidelines for prevention of catheter associated urinary tract infections. A foley catheter should be placed only when necessary and discontinued when it is no longer required. Prior to placing the foley catheter, obtain a physician order and confirm the patient meets appropriate indications for CDC guidelines or hospital policy for indwelling urethral catheter, use choose the foley catheter tray which best meets the needs of the patient. Use the smallest foley catheter possible that provides good drainage. If the close monitoring of urine output is required, select a pre connected closed system urine meter tray. Likewise, if the patient requires continuous temperature monitoring a temperature monitoring foley catheter system may be selected. Catheterization should always be preceded by an explanation to the patient. A patient family education card is provided underneath the tray to inform the categorized patient on what it means to have a foley and how they can properly care for or maintain their foley to help prevent copies, ensure the patient's privacy by closing the door to the room and or drawing the curtain. The first step required in any invasive procedure is an antiseptic hand wash hand Antiseptics compliance is a simple yet critical defense measure that protects both the patient and the caregiver. Don clean gloves and preparation for pre cleansing of the perennial area, ensure adequate lighting, arrange for extra nursing personnel to assist as necessary. Position the patient supine with the knees flexed and separated. Open outer packaging of the foley catheter tray, remove the directions for use brochure from the bottom of the tray label an orange sticker sheet from on top of the tray and set aside. Place the foley catheter. Trade between the patient's legs using proper aseptic technique. Open outer wrapping, opening the first fold away from you, remove the under pad found beneath the third fold of the wrap and place it underneath the patient plastic or shiny side down. Open the packet of castile soap, wipes, Remove and unfold all three wipes, cleanse the penis and peri urethral area, discarding each wipe after use. Advance the tray and wrap towards the patient, remove and discard your soiled clubs, perform hand hygiene with the provided alcohol hand sanitizer gel, open the final fold of the rap. Don the sterile gloves while maintaining sterile technique in an area outside of the rap position the administrative drape over the external genitalia so only the penis is exposed. Use caution not to contaminate your sterile gloves, locate the green syringe with lubricant and deposit the full amount of lubricant into the tray. If hospital policy permits injecting lubricant into the male urethra, full amount will not be dispensed at this time. Open the packet of pre saturated POV adonai iodine swabs sticks, remove the top tray and place it next to the bottom tray, keeping both on the outer wrap, attach the syringe filled with sterile water to the inflation report. Please note that it is not necessary to pretest the foley catheter balloon, remove foley catheter from the blue wrap and place it in the lubricant When you are ready to begin prepping. Elevate the penis with non dominant hand, holding it perpendicular to the body without compressing the urethra. This hand is now contaminated and committed to non sterile activity with the uncircumcised patient. The four skin should be gently retracted with the pre saturated POV adonai iodine swabs sticks, cleanse the penis in a circular motion, starting at the urethral me status and working outward, Use all three pre saturated swabs sticks. If hospital policy permits or following physician's orders, inject remaining lubricant into the urethra per established protocol, remove the catheter from the lubricant, insert the foley catheter into the urethra status. Using gentle downward pressure insertion may be eased by instructing the patient to take deep breaths and exhale slowly. If using a codex catheter, insert the catheter tip into the status with the curve facing towards the ceiling. If during insertion there is an obstruction or difficulty stop. Do not force passage, Call for appropriate assistance or follow proper hospital policy. When the catheter tip has entered the bladder, urine will be visible in the drainage tube. Advance the foley to the bifurcation of the catheter or as far as hospital policy permits to assure the balloon is within the bladder, inflate the catheter balloon with the entire 10 mL of sterile water provided in the syringe. Only sterile water must be used to inflate the balloon, remove syringe. Once the balloon is inflated, gently pull the catheter cod really until the inflated balloon is snug against the bladder neck. If successful, catheter insertion is not completed, including breaks in aseptic technique, replace the catheter and collecting system using aseptic technique and sterile equipment. If proper catheterization is not accomplished, use a new catheter system. After inserting the catheter, discard all materials in accordance with hospital policy and remove contaminated gloves. After thoroughly washing hands, Don clean gloves and preparation for pre cleansing of the perennial area, ensure adequate lighting, arrange for extra nursing personnel to assist as necessary. The female patient is best categorized in the dorsal recumbent position an alternate position for the female patient is side lying sims the knees must be adequately separated. To obtain a clear view of the peri urethral area. Open outer packaging of the foley catheter tray, remove the directions for use brochure from the bottom of the tray label and orange sticker sheet from on top of the tray and set aside. Place the foley catheter. Trade between the patient's legs using proper aseptic technique. Open outer wrapping, opening the first fold away from you, remove the under pad found beneath the third fold of the wrap and place it underneath the patient, plastic or shiny side down. Open the packet of castile soap, wipes, remove and unfold all three wipes to cleanse peri urethral area. Use each wipe once in a top to bottom motion. Advance the tray and wrap toward the patient, remove and discard your soiled gloves. Perform hand hygiene with the provided alcohol. Hand sanitizer gel, open the final fold of the rap. Don the sterile gloves while maintaining sterile technique and an area outside of the outer wrap. Position the thinnest rated drape over the perineum, exposing the urethral matus. Use caution not to contaminate your sterile gloves, locate the green syringe with lubricant and deposit the lubricant into the tray. Top open the packet of pre saturated providence iodine swabs sticks, remove the top tray and place it next to the bottom tray. Keeping both on the wrap, attach the syringe filled with sterile water to the inflation. report, Please note that it is not necessary to pretest the foley catheter balloon, remove foley catheter from the blue wrap and place it in the lubricant. Yeah. Using the pre saturated antiseptic swabs sticks, prepare the patient with your non dominant hand carefully retract the labia to fully expose the urethral status. This hand is now contaminated and committed to non sterile activity. Each swab stick will be used for one swipe only. Use the first swap stick to cleanse the labia Menorah furthest from you with a downward stroke and discard. Do the same with the labia menorah closest to you with the last swap stick, cleanse the middle area between the labia menorah, remove the catheter from the lubricant, insert the catheter into the urethra status. Using gentle pressure until you're in a scene in the drainage to after urine has begun to drain. Advance the catheter two more inches or around five centimeters and inflate the catheter balloon with the entire 10 mL of sterile water provided in the syringe only sterile water should be used to inflate the balloon, remove syringe when inflating the balloon, observed the patient. If the patient complains about pressure, stop immediately deflate the balloon, gently advance the catheter and inflated again. Once the balloon is inflated, gently pull the catheter until the inflated balloon is snug against the bladder neck. If successful. Catheter insertion is not completed, including breaks in aseptic technique, replace the catheter and collecting system using aseptic technique and sterile equipment. If proper catheterization is not accomplished. Use a new catheter system after inserting the catheter. Discard all materials in accordance with hospital policy and remove contaminated gloves, mm. Hmm. Hang the drainage bag near the foot of the bed. The bag should always be positioned below the patient's bladder. The bag and tubing should never touch the floor, ensure the drainage bag is completely unfolded. If a urine meter bag is used, you should exercise the spine of the bag, arrange the tubing to ensure proper flow of urine into the drainage bag, utilize the green sheeting clip to secure drainage tube to the sheet and avoid dependent loops, maintain unobstructed urine flow and keep the catheter and collection tube free from Qingqing and dependent loops secure the catheter to the patient's thigh. Using the stat lock fully stabilization device located in a bag hanging from the drainage hanger or with the device currently being utilized at your facility. Proper use of the stat lock stabilization device will be discussed at the end of this video. Complete the orange stickers that were set aside earlier in order to document the procedure. According to hospital policy, it is recommended to maintain a closed drainage system whenever possible by utilizing pre connected sealed catheter tubing junctions. Following physician's orders or per hospital policy, a patient's Foley catheter system should be monitored routinely, which includes evaluating continuing need for an indwelling Foley catheter. The bag should be emptied at regular intervals, drain the urine into a separate clean collection container for each patient. Do not allow the stick it to touch the sides of the container. Follow hospital policy for emptying the foley bag prior to transporting a patient. If you need to obtain a urine sample, start by including the drainage tubing a minimum of 3" below the sample ports. When urine is visible under the sample ports, swab the surface of the bard. Easy lock sampling ports with an antiseptic wipe. Follow the instructions of the antiseptic to ensure optimal result, position the Lord device over the sample port, press firmly and twist gently to open the ports. The pork may also be accessed using a slip tip syringe, aspirate the desired volume. If using a syringe, transfer the specimen into a specimen container, label it and place it in a transport pouch, send the specimen to the laboratory immediately or refrigerate until transported. Following hospital instructions. If using a specimen tube, label the tube and place it in a transport pouch. Follow the hospital specimen handling guidelines. When the patient no longer requires catheterization, remove the catheter. In accordance with hospital policy and physician's orders, remove the stat lock fully stabilization device or other secure mint product Prior to discontinuing the foley catheter. Follow the device specific instructions. You may now remove the foley catheter gently insert a leur lock or slip tip syringe in the catheter valve. Never use more force than is required to make the syringe stick in the valve, allow the pressure within the balloon to force the plunger back and fill the syringe with water. If you notice slow or no deflation receipt the syringe gently use only gentle aspiration to encourage deflation if needed, vigorous aspiration may collapse the inflation lumen preventing balloon deflation. All of the water should be removed from the catheter balloon if the balloon will not deflate and if permitted by hospital policy, the valve arm may be severed. If this fails. Contact adequately trained personnel for assistance as directed by hospital policy. Should balloon rupture occur. Care should be taken to assure that all balloon fragments have been removed from the patient after the balloon is deflated, removed the catheter and discarded according to hospital policy. Place the foley catheter bifurcation into the stat block device retainer. The directional arrow should point towards the catheter, tip the wide channel in the clamp. Should hold the drainage arm and the narrow channel should hold the balloon arm. Be sure the bifurcation hits the post in the clamp to seat the device properly close the lid by placing your fingers under the path and pressing the grip markers at the end of the clamp. With your thumb being careful to avoid pinching the catheter, identify the proper secure mint site by gently laying the stat lock stabilization device straight on the front of the thigh, then back up one inch towards the insertion site. Make sure the patients lag is fully extended. Follow stat locks, stabilization device, instructions for use. Cleanse and decrease the secure mint side with alcohol or per hospital policy. Let's skin dry apply the provided skin protected using both pads in direction of hair growth to an area larger than the secure mint site. Allowed to dry completely approximately 10 to 15 seconds. Using a permanent marker, write your initials and date of application on the stat locked device anchor pad, align the stat lock stabilization device over the secure mint site, leaving approximately one inch of catheter slack between the insertion site and the stat locks stabilization device retainer while holding the retainer to keep the pad in place, peel away paper backing one side at a time and place tension free on skin. To remove the stat block stabilization device open the retainer by pressing the release button with your thumb, Then gently lift to open, remove the foley catheter stack and fold 5 to 6 alcohol pads and wipe the edge of the pad until the corner lifts. Then continue to wipe the under surface of the pad in the back and forth motion by squeezing the alcohol out to dissolve the adhesive pad away from the skin. Foley catheters are intended for use in the drainage and or collection and or measurement of urine. The most common risk is urinary tract infection stat lock stabilization device should be monitored daily and replaced when clinically indicated at least every seven days. Stat lock stabilization devices are contra indicated on patients with known tape or adhesive allergies. Please consult product inserts and labels for indications, contra indications, hazards, warnings, cautions and directions for use barred. Easy lock stat lot are trademarks and or registered trademarks of C. R. Bard incorporated. Created by
