Chapters Transcript BD SureStep™ Foley Catheter In-Service Video Mhm. Introduction. Healthcare associated infections or H. A. I. S. Are a concern for patients and healthcare providers alike. Catheter associated urinary tract infections or cottage cheese are among the most common H. A. I. S. According to data published by the Us Department of Health and Human Services, cottages are associated with increased morbidity, mortality length of stay, antibiotic use and costs of up to $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 an aseptic technique used to categorize male and female patients with a sure step fully trace system. The sure step fully trade system provides step by step instructions to help standardize insertion technique. The demonstration of the shore step. Foley catheter tray will be followed with a description of some important techniques related to ongoing foley catheter care maintenance and urine sample collection. A fully catheter should be placed only when necessary and discontinued when it is no longer required. Prior to placing the fully catheter, obtain a physician order and confirm the patient meets appropriate indications per CDC guidelines or hospital policy for indwelling urethral catheter. Use the key recommendations for appropriate use that are consistent with the C. D. C. Guidelines are listed on the front of the short step, fully catheter tray, choose the short step fully catheter tray appropriate for your patient unless otherwise clinically indicated. Use the smallest fully catheter possible consistent with 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 and consent by the patient. A patient and family education card provided in both english and spanish is included within the foley catheter tray to inform them on what it means to have a fully and how to properly care for or maintain their catheter to help prevent Cody's. The first step required in any invasive procedure is an antiseptic hand wash. Always follow and comply with your institutions rules and procedures. After thoroughly washing hands. Don clean gloves in preparation for pre cleansing of the perennial area. Male catheterization position the patient supine with the knees flexed and separated open outer packaging of the fully catheter tray, remove the tray and place it between the patient's legs, remove the label patient education insert in the orange sticker sheet and set aside D. F. U. Instructions for catheter insertion and removal and urine sampling are included on the back of the label for reference. The first step of the catheterization procedure should be a soap and water perennial cleanse a peri care kit is provided on top of the wrap of the foley tray with simple instructions. Open the kit and remove the soap wipes and hand sanitizer open the packet of soap, wipes, remove and unfold them cleanse the peri urethral area and discard wipes after use, remove and discard your soiled gloves. Perform hand hygiene with the provided alcohol hand sanitizer gel, position the tray so that the arrow is pointed toward the insertion site, remove the band from around the fully tray. Using proper aseptic technique, Open the CSR Rap. Don the sterile gloves while maintaining sterile technique in an area outside of the outer wrapping, place the under pad beneath the patient, plastic or shiny side down. Use caution not to contaminate your sterile gloves while positioning the under pad, position the feminist rated drape on the patient. The short step, fully tray is labeled to walk you through each step of the catheterization procedure. To reflect best practices. Open the packet of provolone iodine and saturate three foam swab sticks, pour the Pavilion iodine onto the three foam swab sticks. To saturate them, remove the foley catheter from the rap and lubricate the catheter. If hospital policy permits it is possible to inject lubricant directly into the urethra, attach the water filled syringe to the inflation ports. Note it is not necessary to pretest the fully catheter balloon with your non dominant hand. Elevate the penis, 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. Using your dominant hand cleanse the penis with the Pavilion iodine saturated foam swab sticks, twist the swabs to remove them from the tray, started the urethral me status and use swabs sticks one at a time cleansing in a circular motion, remove the catheter from the lubricant, insert the catheter into the urethra me status. Using gentle downward pressure. If using a code a catheter, insert the catheter tip into the media status with the curve facing towards the ceiling insertion may be eased by instructing the patient to take deep breaths and exhale slowly. Some resistance may be felt as the catheter tip meets the external sphincter, slightly twisting the catheter from side to side while advancing. It may help the catheter pass beyond this point, it may be necessary to withdraw the catheter a short distance and attempt to re advance it slowly. When the catheter tip has entered the bladder, urine will be visible in the drainage tube. Advance the foley catheter 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 volume of sterile water provided in the pre filled syringe. Note use of less than the provided volume can result in an asymmetrically inflated balloon. 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. Female catheterization, The female patient is best categorized in the dorsal recumbent position. An alternate position for the female patient is sidelining sims, position The knees must be adequately separated to obtain a clear view of the peri urethral area, open the outer packaging of the foley catheter tray, remove the tray and place it between the patient's legs, remove the label patient, education, insert an orange sticker sheet and set aside D. F. U. Instructions for catheter insertion and removal and urine sampling are included on the back of the label for reference. The first step of the catheterization procedure should be a soap and water, perennial cleanse a peri care kit is provided on top of the wrap of the foley tray with simple instructions. Open the kit and remove the soap wipes and hand sanitizer. Open the packet of soap, wipes, remove and unfold them, cleanse the piri urethral area and discard wipes After use, remove and discard your soiled gloves. Perform hand hygiene with the provided alcohol, hand sanitizer gel, position the tray so that the arrow is pointed toward the insertion site, remove the band from around the fully tray using proper aseptic technique. Open the CSR Rap. Don the sterile gloves while maintaining sterile technique in an area outside of the outer wrapping. Place the under pad beneath the patient, plastic or shiny side down. Use caution not to contaminate your sterile gloves while positioning the under pad, position the finished rated drape on the patient. The short step, fully tray is labeled to walk you through each step of the catheterization procedure. Open the packet of pavilion iodine and saturate three foam swab sticks, pour the Pavilion iodine onto the three foam swab sticks to saturate them, remove the foley catheter from the rap and lubricate the catheter, attach the water filled syringe to the inflation ports. Note it is not necessary to pretest the fully catheter balloon with your non dominant hand, carefully retract the labia to expose the urethral me status. This hand is now contaminated and committed to non sterile activity. Using your dominant hand, twist the first swab stick to remove it from the tray and cleanse the labia Menorah furthest from you with a downward stroke and discard, repeat on the labia menorah closest to you and the area between the labia Menorah, remove the catheter from the lubricant, insert the catheter into the urethra LMI status. When the catheter tip has entered the bladder urine will be visible in the drainage tube. Advance the fully catheter two more inches or as far as hospital policy permits to assure the balloon is within the bladder, inflate the catheter balloon with the entire volume of sterile water provided in the pre filled syringe. Note use of less than the provided volume can result in an asymmetrically inflated balloon. 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, care and maintenance after inserting the catheter, discard all materials. In accordance with hospital policy, the collection system in urine sample cup should be removed by sliding the items from the bottom tray, secure the catheter to the patient's thigh. Using the stat lock fully stabilization device, the stat lock stabilization device may be found in a bag hanging from the drainage hanger. Proper use of the stat lock stabilization device will be discussed. At the end of this video, hang the drainage bag near the foot of the bed. The bag should always be positioned below the bladder and should never touch the floor. Follow physician's orders or hospital policy for emptying the foley bag prior to transporting a patient, arrange the tubing so that it ensures proper flow of urine into the drainage bag. Utilize the green sheeting clip to secure the drainage tube to the sheet, maintain unobstructed urine flow and keeps a catheter in collecting tube free from Qingqing independent loops 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 hospital policy, a patient's fully catheter system should be monitored routinely, which includes evaluating if the patient still requires a fully catheter. The bag should be emptied at regular intervals, drain the urine into a separate clean collection container for each patient sample collection, wash hands and don clean gloves prior to manipulation of the collection system. If you need to obtain a urine sample start by including the drainage tubing below the sampling ports by bending and securing the tubing with a clamping device until urine is visible under the access site. Swab the surface of the bard easy lock sampling ports with antiseptic. As an example site scrub I. P. A device is an effective disinfecting agent for lure hubs. It is recommended to clean the sampling ports for 10 seconds, allowing five seconds to dry position the collection device in the center of the sampling ports. Press the device firmly and twist gently to access the sampling ports. If using the B. D. Vacuum tainer lure lock access device, collect urine into the B. Deve Accutane er tubes. Per hospital protocol. If using a syringe slowly aspirated the urine sample into the syringe and transfer to the collection cup. Or follow hospital protocol. After the sample is obtained, confirmed tubing is unkempt and urine is flowing freely and is not obstructed. Discard the collection device. According to hospital protocol. Follow established hospital protocol for specimen labeling and transport to the lab. Catheter removal. When the patient no longer requires catheterization, remove the catheter. In accordance with hospital policy and physician orders, wash hands and don clean gloves. Prior to manipulation of the collection system, remove the stat lock fully stabilization device or other secure mint product. Prior to discontinuing the fully 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's lumen preventing balloon deflation. All 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, remove the catheter and discarded. According to hospital policy stat lock, fully stabilization device, wash hands and don clean gloves prior to manipulation of the collection system. Place the fully catheter bifurcation into the stat locked 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 pad 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 patient's leg is fully extended. Follow stat lock stabilization device instructions for use, Cleanse and decrease the secure mint site with alcohol or per hospital policy. Let the skin dry, apply the provided skin protectant 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 lock 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 lock stabilization device retainer while holding the retainer to keep the pad in place, peel away the paper backing one side at a time and place tension free on the skin to remove the stat lock stabilization device open the retainer by pressing the release button with your thumb. Then gently lift to open, remove the fully 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 a 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 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. B. Deve Accutane. Our lower lock access device may be used for access of a specimen from catheter ports to be Deve Accutane er urine collection tubes. B. Deve Accutane er urine tubes used for collection and transport of urine specimens. Site scrub I. P. A. Device is intended for use on injection ports and female lure hubs. As a disinfecting cleaner, please consult product inserts and labels for indications, contra indications, hazards, warnings, cautions and directions for use Created by
