14 Inserting a Straight or Indwelling Catheter with the use of Sterile Gloves

Implementation

1. Performed hand hygiene, provided privacy, raised bed to appropriate height.
2. Arranged equipment.
3. Placed pad under client; positioned and draped client correctly.
4. Provided peri care if required.
5. Performed hand hygiene.
6. Prepared urinary drainage container; maintained sterile asepsis while opening catheter kit.
7. Applied sterile gloves appropriately:
   1. Performed hand hygiene.
   2. Removed outer glove wrapper.
   3. Opened inner package, keeping gloves on wrapper’s inside surface, and laid package on clean, dry surface at waist level.
   4. Identified right and left gloves.
   5. With non-dominant hand, grasped inside edge of cuff of glove for dominant hand.
   6. Carefully pulled glove over dominant hand with thumb and fingers in proper spaces.
   7. With gloved dominant hand, slipped fingers under cuff of second glove.
   8. Pulled glove over non dominant hand without contaminating gloved dominant hand.
   9. Interlocked fingers of gloved hands to ensure proper fit.
8. Organized supplies on sterile field.
9. Lubricated catheter tip.
10. Applied sterile drapes to client appropriately.
11. Cleaned urethral meatus and/or glans penis correctly maintaining sterile asepsis of dominant hand.
12. Inserted catheter correctly while asking client to bear down gently.
    1. Female client: Advanced catheter a total of 5 to 7.5 cm (2 to 3 inches) in adult or until urine flowed from catheter’s end. As soon as urine appeared, advanced catheter another 2.5 to 5 cm (1 to 2 inches). Did not force against resistance. Placed end of catheter in urine tray receptacle. Released labia and held catheter securely with non-dominant hand.
    2. Male client: Advanced catheter 17 to 22.5 cm (7 to 9 inches) in adult or until urine flowed from catheter’s end. If resistance was felt, withdrew catheter; did not force it through urethra. When urine appeared, advanced catheter to the bifurcation of the drainage and balloon inflation port. Lowered penis and held catheter securely in non-dominant hand. Placed end of catheter in urine tray receptacle. Repositioned the foreskin.
13. Collected urine specimen if needed.
14. Allowed bladder to empty no more than 800 mls. According to institution policy.
15. If using straight single-use catheter, withdrew it slowly and smoothly. If using indwelling catheter, inflated balloon correctly and gently pulled catheter back into place.
16. Attached end of catheter to collecting tube and secured catheter or applied Velcro tube holder.
17. Assisted client to comfortable position.
18. Washed and dried perineal area as needed.
19. Removed gloves appropriately:
    1. Grasped outside of one cuff with other gloved hand, without touching wrist.
    2. Pulled glove off, turning it inside out, and placed in palm of gloved hand.
    3. Slid fingers of ungloved hand underneath cuff of gloved hand and pulled remaining glove off inside out and over glove in palm of hand.
    4. Discarded gloves in receptacle.
    5. Disposed of equipment properly.
20. Performed hand hygiene.