Learn the procedures, steps, risks, and requirements for catheterization.
Inserting catheters is an essential skill that is often used in medical environments by nurses. Not only can nurses alleviate discomfort for patients with this procedure, but they can also send the urine samples they’ve gathered for further testing. These tests may look for crystals, infections, blood, kidney function, muscle breakdown, and electrolytes. Catheters are also used to treat bladder outlet obstruction and assist patients with urinary retention issues.
This article will focus on the art of catheterization, one of the most common yet important tasks for medical staff. Healthcare professionals who master this skill can help prevent infection and trauma. They can also contribute to higher rates of patient satisfaction.
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Nurses are frequently tasked with inserting and removing catheters. In fact, some consider catheterization to be one of the key fundamentals of nursing. It is also a particularly critical skill to deliver care in nursing homes.
Definition of Catheterization
What Is a Catheter?
Catheterization is the introduction of a catheter—a soft, hollow tube—through the urethra of a patient and into their bladder so urine can be withdrawn.
Common reasons to use a catheter on a patient:
- To relieve urinary retention
- To gain a sterile urine sample from a female patient
- To measure the residual urine in a patient’s bladder
- To acquire a urine specimen when it can’t be acquired by other means
- To empty a patient’s bladder before/during surgery and before some diagnostic exams
A catheter may also stay in place for reasons like the following:
- The slow decompression of a distended bladder
- Erratic bladder drainage
- Continuous bladder drainage
How Long Does It Take to Insert a Catheter?
On average, it usually takes a few minutes to insert a catheter. Of course, this will also depend on your skillset and experience.
Who Inserts and Removes Catheters?
Generally, doctors, nurses, and other healthcare providers may insert a catheter. In some cases, catheters may be inserted by professional caregivers, home health agencies, and nursing home workers.
Nurses are most commonly tasked with inserting and removing catheters. In fact, some consider it to be one of the fundamentals of nursing. It is an especially critical skill for delivering care in nursing homes.
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Training Requirements for Catheterization
When it comes to catheterization requirements, most licensed professionals such as Registered Nurses and Licensed Vocational Nurses will typically learn how to use catheters through educational programs and medical training.
Catheterization training is also a component of the NCLEX-RN exam. To pass this test and receive your nursing license, you will be expected to demonstrate your knowledge of catheterization.
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Necessary Equipment for Catheterization
Catheters are graded according to the size of their lumen (inner spaces in tubes that move liquids):
- For female adults, No. 14 and No. 16 French catheters are often used.
- For male adults, No.18 and No. 20 French catheters can be used. However, if these are too large, a smaller catheter can also be used.
- For children, No. 8 and No. 10 French catheters are most commonly used.
Detailed Guide to Apply Catheters
By reviewing the following steps, you can begin to learn more about the process of catheterization. Like any other skill, using catheters requires both time and practice to master. While in school, try not to feel disheartened if you don’t get it right the first time, and don’t hesitate to ask for your instructor’s help.
Here are some of the general guidelines that you should follow when using a catheter:
Inserting the Catheter
- Inflate the balloon using the prefilled syringe before inserting the catheter into the patient (this checks for balloon patency). Then, aspirate the fluid back into the syringe.
- Hold the catheter with one hand and inflate the balloon according to the manufacturer’s instructions (once the catheter is in the bladder and urine has started to drain).
- If the patient is in pain after inflating the balloon, let it empty before replacing the catheter with a new one. The balloon may be causing discomfort.
- Apply slight tension on the catheter once the balloon has been inflated to assure proper placement in your patient’s bladder.
- Ensure that the catheter has been connected to the drainage tubing and drainage bag.
- For female patients, tape the catheter along the anterior aspect of the thigh. Make sure there isn’t any tension on the catheter when taping it to your patient.
- Hang the drainage bag on the bed frame, but make sure it’s below the level of the patient’s bladder.
Removing the Catheter and Aftercare
- You must deflate the balloon before removing the catheter. You can do this by either a) inserting a syringe into the balloon valve or b) cutting the balloon valve.
- Ask your patient to take some deep breaths to help them relax. Then, slowly remove the catheter. Wrap it in a towel or disposable drape.
- Disinfect the area at the meatus with antiseptic swabs.
- Ensure that your patient increases their fluid intake and record their intake/output. Tell them to use their bedpan or a urinal.
- Study the urine closely for any complications or signs of abnormality.
- Be sure to record and report any signs of discomfort, a burning sensation when urinating, bleeding, or changes in vital signs. Look carefully for any signs of infection.
Potential Risks or Complications of Catheterization
Though it is unlikely, there are some complications that can occur during catheterization, including:
- Injury to the urethra can occur during insertion or balloon inflation. This is one reason why it’s so critical to only inflate the balloon AFTER the catheter is in the bladder.
- False passage; i.e., the catheter is pushed through the urethral wall.
- Urethral strictures—scarring that restricts the flow of urine—resulting from damage to the urethra, which can become a long-term problem.
- Psychological trauma.
Pro Tips for Catheter Care
Here are a few tips that may assist you or your patients with foley-catheter care in the future. Foley-catheters are the most common type of indwelling urinary catheter.
- Counsel your patients to never have sexual intercourse when the catheter is inserted.
- Always make sure that an indwelling foley catheter has been secured with a securement device.
- Ensure the cleanliness of the catheter by cleaning the area around it twice daily with soap and water.
- Never tug or pull on the catheter.
- Check the area directly around the catheter for signs of infection or inflammation.
- Also, counsel your patients to never apply any type of lotion to the area around the catheter.
Why Should Nurses Master Catheterization?
Catheterization is one of the many responsibilities held by nurses. It’s not always an easy process and necessitates practice and precision to execute correctly.
Nurses must learn how to correctly insert a catheter so that their patients do not experience trauma or infection. Numerous patients suffer from conditions requiring catheterization, so nurses should always strive to make the procedure as comfortable and painless as possible.
While you pursue your nursing education, it’s vital that you reflect on your goals and which specialization is best for you.
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