Catheterization, Intermittent, Female Resident



|Catheterization, Intermittent, Female Resident H5MAPR0050 |Level III |

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|Purpose |The purpose of this procedure is to provide guidelines for the aseptic insertion of an intermittent catheter. |

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|Preparation |Verify that there is a physician’s order for this procedure. |

| |Review the resident’s care plan to assess for any special needs of the resident. |

| |Assemble the equipment and supplies as needed. |

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|General Guidelines |Determine if the resident is on intake or output before discarding urine. |

| |Check the urine for unusual appearance. Record findings. |

| |If a bladder training program is being implemented, observe and record the resident’s voiding pattern to assist in|

| |establishing a training schedule. |

| |If lighting is inadequate, place a lamp next to the resident’s bed while performing the procedure. |

| |Use the smallest catheter possible, consistent with good drainage, to minimize urethral trauma. |

| |Maintain an accurate record of the resident’s daily fluid intake and output, if indicated. |

| |Provide perineal care to the incontinent resident to prevent skin rashes and breakdown. |

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|Equipment and Supplies |The following equipment and supplies will be necessary when performing this procedure: |

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| |Sterile catheterization tray; which may include some or all of the following: |

| |Specimen container (if ordered); |

| |Medication (if ordered); |

| |Cotton balls; |

| |Antiseptic solution; |

| |Sterile towels; |

| |Underpad; |

| |Sterile forceps; |

| |Lubricant; |

| |Bath blanket, if indicated; |

| |Fenestrated towel; |

| |Wash basin; |

| |Wash cloth; |

| |Soap and water; and |

| |Personal protective equipment (e.g., gowns, gloves, mask, etc., as needed). |

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|Steps in the Procedure |Place the clean equipment on the bedside stand or overbed table. Arrange the supplies so they can be easily |

| |reached. |

| |Wash and dry your hands thoroughly. |

| |Fill the wash basin one-half (1/2) full of warm water. Place the wash basin on the bedside stand within easy |

| |reach. |

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|Steps in the Procedure (continued)| |

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| |continues on next page |

| |If the resident’s physical or medical condition permits, assist the resident into the dorsal recumbent position |

| |with her knees flexed and separated. Refer to the resident’s plan of care and/or request information from the |

| |nurse supervisor regarding safe positioning for the resident. |

| |Put on disposable gloves. |

| |Fold the top covers down to the foot of the bed. Place a sheet (folded once) across the resident’s chest. Avoid |

| |unnecessary exposure of the resident’s body. |

| |Wash the resident’s genitalia and perineum thoroughly with soap and water. Rinse the area well and towel dry. |

| |Pour the wash water down the commode. Flush the commode. |

| |Discard soiled linen into designated container. |

| |Discard disposable gloves into designated container. Wash and dry your hands thoroughly. |

| |Open the catheter tray using sterile technique. |

| |Put on sterile gloves. |

| |Position sterile drape under buttocks of resident. |

| |Place fenestrated drape over the perineum. |

| |Organize the items on the sterile field. Pour antiseptic solution over the cotton balls. Lubricate the catheter |

| |tip about two inches. |

| |Place sterile tray onto sterile drape between the resident’s thighs. |

| |With nondominant hand, separate the labia. Maintain the position of this hand throughout the procedure. |

| |Assess the urethral meatus. |

| |Use the forceps and cotton balls to cleanse around the meatus. Use only one cotton ball for each downward, |

| |cleansing stroke. Next, cleanse around the urethral meatus. |

| |With your sterile hand, pick up the catheter approximately 3-5 inches from the tip. |

| |Insert the catheter gently into the meatus (approximately 2-3 inches) until urine begins to flow from the bladder.|

| |Place the end of the catheter into the sterile container used to measure output and/or to collect the urine |

| |specimen. |

| |When urine flow ceases, pinch the catheter and remove the catheter gently and slowly. Dry the perineum. |

| |Flush urine (if not retained for specimen collection) into the commode. |

| |Dry resident’s perineal area. |

| |Discard all disposable items into designated containers. |

| |Clean and sanitize measuring device if reusable. Store in designated area. |

| |Clean wash basin and return to designated storage area. |

| |Remove gloves and discard in designated container. Wash and dry your hands thoroughly. |

| |Clean the bedside stand and/or overbed table. Return the overbed table to its proper position. |

| |Wash and dry your hands thoroughly. |

| |Reposition the bed covers. Make the resident comfortable. |

| |Place the call light within easy reach of the resident. |

| |If the resident desires, return the door and curtains to the open position and if visitors are waiting, tell them |

| |that they may now enter the room. |

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|Documentation |The following information should be recorded in the resident’s medical record: |

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| |The date and time the procedure was performed. |

| |The name and title of the individual(s) who performed the procedure. |

| |The amount of urine drained. |

| |The character, clarity, and color of urine. |

| |Any observation of obstruction; evidence of blood, pus, etc. |

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|Documentation (continued) | |

| |continues on next page |

| |Any change in the resident’s condition (e.g., swelling, discomfort, etc.). |

| |Any problems or complaints made by the resident related to the procedure. |

| |The resident’s response to the treatment. |

| |All assessment data obtained during the procedure. |

| |If the resident refused the procedure, the reason(s) why and the intervention taken. |

| |The signature and title of the person recording the data. |

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|Reporting |Notify the supervisor if the resident refuses the procedure. |

| |Notify the physician of any abnormalities (i.e., urine output greater than 800ml, obstruction of catheter, etc.). |

| |Report other information in accordance with facility policy and professional standards of practice. |

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|References |

|MDS (CAAs) |Section H; (CAA 6) |

|Survey Tag Numbers |F315 |

|Related Documents | |

|Risk of Exposure |Blood–Body Fluids–Infectious Diseases |

|Procedure |Date:________________ By: __________________ |

|Revised |Date:________________ By: __________________ |

| |Date:________________ By: __________________ |

| |Date:________________ By: __________________ |

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