Inserting an intermittent (in and out) catheter requires a sterile technique to minimize the risk of infection. Here's a breakdown of the procedure:
Steps for Intermittent Catheterization:
- Gather Supplies: Assemble all necessary equipment, including:
- Sterile gloves
- Sterile lubricant (e.g., K-Y Jelly)
- Antiseptic solution (e.g., povidone-iodine or chlorhexidine)
- Sterile wipes or cotton balls
- Sterile catheter (appropriate size for the patient)
- Sterile collection container (if not self-catheterizing directly into the toilet)
- Water-soluble lubricant
- Clean, dry towel
- Prepare the Patient:
- Explain the procedure to the patient and answer any questions.
- Ensure privacy.
- Position the patient appropriately:
- Women: Lying on their back with knees bent and feet flat on the bed (dorsal recumbent position) or in a frog-legged position.
- Men: Lying on their back with legs extended or slightly bent.
- Wash Hands Thoroughly: Perform a thorough hand wash with soap and water or use an alcohol-based hand sanitizer.
- Don Sterile Gloves: Open the sterile glove package and put on the gloves, maintaining sterility.
- Prepare the Catheter: Open the catheter package, being careful not to contaminate the catheter. Lubricate the tip of the catheter generously (approximately 2-3 inches) with sterile lubricant.
- Clean the Urethral Area:
- Women: Using non-dominant hand, gently separate the labia to expose the urethral opening. Using sterile wipes or cotton balls soaked in antiseptic solution, clean the area from front to back (top to bottom) at least three times, using a fresh wipe each time.
- Men: Hold the penis with your non-dominant hand and retract the foreskin (if uncircumcised). Clean the glans penis in a circular motion, starting at the urethral opening and moving outward, using sterile wipes or cotton balls soaked in antiseptic solution. If uncircumcised, return foreskin to its normal position after cleaning and catheter insertion.
- Insert the Catheter:
- Women: Gently insert the lubricated catheter tip into the urethral opening. Advance the catheter slowly and steadily until urine begins to flow.
- Men: Gently lift the penis to a 60-90 degree angle. Slowly insert the lubricated catheter tip into the urethral opening. Advance the catheter slowly and steadily until urine begins to flow. You may encounter resistance at the prostate; if so, pause, take a deep breath, and apply gentle, continuous pressure. Do not force the catheter.
- Advance the Catheter Further: Once urine begins to flow, advance the catheter another 1-2 inches (2-5 cm) to ensure it is properly positioned in the bladder.
- Drain the Bladder: Allow the urine to drain completely into the collection container or toilet. Do not force rapid drainage, as this can cause bladder spasms.
- Remove the Catheter: Once the urine flow stops, slowly and gently withdraw the catheter.
- Clean and Dry the Area: Clean the urethral area with a clean, dry towel.
- Dispose of Materials: Discard the catheter and other disposable materials appropriately according to facility protocol or home-care instructions.
- Wash Hands Again: Perform a final hand wash with soap and water or use an alcohol-based hand sanitizer.
- Document the Procedure: Record the date, time, catheter size, amount of urine drained, and any observations or complications.
Important Considerations:
- Sterility: Maintaining sterile technique is crucial to prevent urinary tract infections (UTIs).
- Patient Comfort: Communicate with the patient throughout the procedure to ensure they are as comfortable as possible.
- Resistance: If you encounter significant resistance during catheter insertion, do not force it. Consult with a healthcare professional.
- Education: Educate patients who perform self-catheterization about proper technique, hygiene, and signs of infection.
This information is for general knowledge and does not substitute for professional medical training. Always follow established protocols and seek guidance from qualified healthcare providers.
