HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 5-9
Genitourinary: Insertion of Indwelling Catheter- Male __RN
PURPOSE:
To provide for continuous urinary drainage through an
indwelling catheter.
CONSIDERATIONS:
1. Catheter may be indicated for either incontinence or
retention.
2. Indwelling catheters must be ordered by a physician
and should indicate frequency of change, size, and
type also, if it is to be irrigated, with what solution
and frequency of irrigation.
3. Catheter changes are usually indicated at one time
per month although certain types such as silicone
may, with physician's approval, remain unchanged
for maximum of 3 months.
4. Patency can be maintained and prolonged by
absence of infection. High intake of fluids, correct
placement, handling, and securing of catheter with a
7. Put on sterile gloves using sterile technique.
8. Place the fenestrated drape from the sterile catheter
pack over the patient's penis.
9. Test balloon of new catheter, keeping catheter
sterile, by injecting 5cc sterile water into the lumen
leading to the inflatable balloon. If no leaks are
found, remove solution.
10. Squeeze liberal amount of sterile lubricant jelly on
the catheter tip.
11. Swab the prepuce with prepping balls and
antimicrobial solution, using one for the base, one
for the central area, and a third for the urethral
opening.
12. Grasp the penis with a slight tension, elevating it at
a right angle to the patient's abdomen.
13. Insert the tip of the catheter into the urethral
opening, being careful to keep the distal end on the
sterile field.
strap will help reduce risk of infection. 14. Continue to insert the catheter until resistance is
5. One spare catheter should be left in the home at all
times.
felt. Ask patient to relax, exhale and advance
catheter another 3-4 inches past the point of initial
resistance. Only 3-4 inches will be left protruding.
EQUIPMENT:
Catheter insertion tray
Sterile gloves
15. Lower penis and place the distal end of the catheter
in the collection basin. The end of the catheter must
be lower than the level of the patient's bladder to
allow for gravity outflow.
Prepping balls 16. Inflate the balloon with indicated amount of sterile
Antimicrobial solution
water.
Waterproof, absorbent underpad
17. Replace foreskin.
Fenestrated drape
18. Connect to drainage bag.
Sterile lubricating jelly
19. Secure tubing to patient's thigh or lower abdomen
Prefilled 10cc syringe of sterile water
Plastic forceps
Graduated basin
with a catheter strap and hang bag for gravity
drainage.
20. Discard soiled supplies in appropriate containers.
Sterile catheter of prescribed size AFTER CARE:
Drainage bag 1. Document in patient's record:
Catheter strap a. Procedure and observation.
Gloves
Impervious trash bag
b.
c.
d.
Characteristics of urine, color, and amount.
Patient's response to procedure.
Instructions given to patient/caregiver.
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain procedure to patient.
3. Position patient on back and wash the perineal area
and penis thoroughly with soap and water, being
careful to retract the foreskin and cleanse the area
underneath.
4. Open the catheterization tray and place the
waterproof, absorbent underpad under the buttocks
extending forward between legs.
5. Place drainage receptacles on towel between
patient's thighs.
6. Open all sterile packets.
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