HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 5-6
Genitourinary: Intermittent Self-Catheterization __RN
PURPOSE:
Note: Patients conducting their own self-catheterization
procedure do not need to wear gloves.
To completely empty the urinary bladder on a regular,
intermittent basis. 5. FEMALE:
a. Separate vaginal folds with one hand.
CONSIDERATIONS:
1. Clean technique is used. Bacteria introduced during
catheterization will not cause a urinary tract infection
if bladder is kept empty on a regular basis.
2. It is essential that the schedule for regularity of
emptying the bladder be followed regardless of
patient's location and availability of soap and water.
This is usually 4 times daily during waking hours.
3. It is important to have a daily fluid intake of 3000cc
unless contraindicated.
4. A catheter can be used until it becomes too difficult
to use, e.g., either too soft, too stiff.
5. If for any reason the catheter cannot be inserted,
stop the procedure, have patient sit in a warm tub of
water and try again.
6. The water-soluble lubricant must not become
contaminated, and the tube opening should be
wiped with an antiseptic before each time the
contents are used.
7. For the patient with reduced mobility, dexterity or
both, the nurse must determine the optimal position
for catheterization and ascertain the patient's ability
to manipulate clothing and adequately expose the
urethral meatus for catheter insertion.
EQUIPMENT:
Urinary catheter of prescribed size AFTER CARE:
Water-soluble lubricant/individual packets are
recommended
b. Use downward strokes with wet soapy
washcloth to thoroughly cleanse the urinary
meatus.
c. Rinse well with clean water.
MALE:
a. Pull back foreskin.
b. Wash the head of penis thoroughly with wet
soapy washcloth.
c. Rinse well with clean water.
6. Pick up catheter 3 to 4 inches from tip and hold as if
it were a pencil. Lubricate the catheter thoroughly.
7. Insert the catheter into the urethral meatus until
urine flows into the toilet or container. Use mirror if
necessary to visualize meatus.
a. FEMALE: Insert catheter approximately 3
inches.
b. MALE: Insert catheter approximately 7-10
inches.
8. Allow urine to flow until it stops flowing. It might be
necessary to massage lower abdomen to be
assured all urine has been emptied from the
bladder.
9. Remove catheter, dry area around meatus.
10. Replace foreskin forward if uncircumcised male
patient.
11. Discard soiled supplies in appropriate containers.
1. Cleanse catheter and rinse inside and out. Dry with
a clean towel.
Receptacle for urine (bedpan/toilet) 2. Place catheter in a clean plastic bag, a clean dry
Soap and water
covered container or roll in clean dry towel for use at
Clean towel (washcloth)
next catheterization.
Magnifying mirror (optional)
Carrying case/baggie
3. Document in patient's record:
a. Procedure and observation.
b. Patient's response to procedure.
Impervious trash bag c. Instructions given to patient/caregiver.
Gloves
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain procedure to patient.
3. Assemble and arrange equipment on clean surface
and squeeze lubricant onto clean towel. If using a
tube of lubricant, wipe opening into an antiseptic,
discard small amount of lubricant before squeezing
lubricant onto towel.
4. Instruct patient to sit on the toilet or assume a semisitting
position on a low chair.
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