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catheterizations

Catheterizations

Catheterization of an Artificial Bladder Channel

PROCEDURE SKILL COMPETENCY

  1. Review IHP and/or healthcare provider’s order
  2. Gather equipment and place on clean surface
  3. Explain the procedure to the student at his/her level of understanding
  4. Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills
  5. If the student is completing procedure or assisting in procedure, have student wash hands
  6. Assist student with undressing, as needed
  7. Position the student
  8. If student is lying on a cot/bed, place a disposal pad under the student
  9. Wash hands
  10. Arrange equipment
  11. Put on gloves
  12. Lubricate the tip of the catheter with a water soluble lubricant and place on a clean surface
  13. Wash the stoma with soapy cotton ball, cleansing wipe, or student specific cleaning supplies in a circular motion, moving from the opening out
  14. Repeat procedure a total of 3 times
  15. Slowly insert the catheter into stoma until urine begins to flow
  16. Insert the catheter 1-2 inches further
  17. Having the student contract their abdominal muscles or crede bladder may assist in removing all the urine from the bladder
  18. When urine flow has stopped, slowly pull catheter out. You may notice more urine starting to flow into the container as you pull it out. Continue to drain the bladder and completely remove catheter
  19. Remove gloves
  20. Wash hands
  21. Reapply bandage or gauze on stoma if present
  22. Assist student in dressing, as needed
  23. Have student wash hands
  24. Put on gloves
  25. Assess urine for cloudiness and/or foul smell
    • If present, assess student for signs of urinary tract infection:
      • chills
      • vomiting
      • blood in urine
      • abdominal pain
      •  fever
  26. Measure urine per student’s order
  27. Discard bodily fluids and catheter per infection control procedures and school district policy
  28. Wash the used catheters with warm soapy water
  29. Rinse them thoroughly with water
  30. Let them air dry on a clean surface
    • Catheters should be discarded if they:
      • can no longer be thoroughly cleaned
      • smell bad
      • become too stiff (brittle)
  31. Remove gloves
  32. Wash hands
  33. Document assessment, intervention and outcome in student’s healthcare record
  34. Update student’s parents/guardian and healthcare provider, as needed

Cleaning for catheter that will be used again during the school day:

  1. Put on clean gloves
  2. Clean catheter with mild soap and warm water
  3. Forcefully rinse the catheter lumen with tap water
  4. Place catheter on clean surface and allow to air dry
  5. Remove gloves
  6. After equipment is dry, store as appropriate
    • Catheter can be used for up to a month
    • Should be discarded if becomes too stiff or has any discoloration

If ordered by healthcare provider, sterilize the catheters once a day:

  1. Put on clean gloves
  2. Clean the catheter as above with soap and water.
  3. Prepare a solution of 1 teaspoon liquid bleach to 8 ounces water in a clean, tightly covered container
    • Use a pure, fragrance-free and additive-free bleach, such as Hilex® or Clorox®
    • Prepare a new solution every day.
  4. Soak catheters in bleach solution for at least 30 to 60 minutes
  5. After soaking, rinse well with warm water and air dry on a clean towel

Clean Intermittent Catheterization- Female

Please Read

  • Depending on the student’s underlying health condition, their urinary anatomy may have been altered surgically so may not have the typical appearance
  • For a student who has a history of intermittent catheterization there should not be any pain associated with performing the procedure. 

Procedure Skill Competency:

  1. Review IHP and/or healthcare provider’s orders
  2. Gather equipment and place on clean surface
  3. Explain the procedure to the student at her level of understanding
  4. Encourage the student to assist in the procedure as much as she is able to help student learn self-care skills
  5. If the student is completing procedure or assisting in procedure, have student wash hands
  6. Assist student with undressing, as needed
  7. Position the student
  8. If student is lying on a cot/bed, place a disposal pad under the student
  9. Wash hands
  10. Arrange equipment
  11. Put on clean gloves
  12. Lubricate the tip of the catheter with a water soluble lubricant and place on a clean surface
    • Use a generous amount of lubricant along the length of the catheter since dry catheters may cause excoriations in the urethra, leading to an entry point for bacteria contamination
  13. Separate the labia (vaginal lips) and hold open with fingers
  14. Wash the area with cleaning wipes, disposable wash cloth, mild soapy cotton ball or student specific cleaning supplies starting at the top of the labia moving toward the anus
  15. Repeat procedure a total of 3 times, once down each side and once down the middle, using a clean cotton ball (wipe or wash cloth) each time
  16. Locate the urinary meatus
  17. Gently insert the catheter until there is urine
    • Helpful hint: urinary meatus is located just under the clitoris above the vaginal opening.  If the catheter is inserted and there is no return of urine, leave the catheter in place and use another catheter to locate the meatus.  DO NOT reintroduce the first catheter into the urinary meatus.
  18. If you meet resistance try the following:
    • Rotate the catheter
    • Have the student sit or lie in a different position
    • If you are still unable to insert the catheter or the student experiences pain remove the catheter and follow up with parents/guardian and healthcare provider
  19. When urine begins to flow, insert the catheter one inch further
  20. When urine flow has stopped remove the catheter slowly
  21. Remove gloves
  22. Wash hands
  23. Assist student in dressing, as needed
  24. Have student wash hands
  25. Put on clean gloves
  26. Assess urine for cloudiness and/or foul smell
    • If present, assess student for signs of urinary tract infection:
      • fever
      • abdominal pain
      • blood in urine
      • vomiting
      • chills
  27. Measure urine per healthcare provider’s order
  28. Discard bodily fluids and catheter per infection control procedures and school district policy
  29. Remove gloves
  30. Wash hands
  31. Document assessment, intervention and outcome in student’s healthcare record
  32. Update student’s parents/guardian, as needed

Cleaning for catheter that will be used again during the school day:

  1. Put on clean gloves
  2. Clean catheter with mild soap and water
  3. Forcefully rinse the catheter lumen with tap water
  4. Place catheter on clean surface and allow to air dry
  5. Remove gloves
  6. After equipment is dry, store as appropriate
    • Catheter can be used for up to a month
    • Should be discarded if becomes too stiff or has any discoloration

If ordered by healthcare provider, sterilize the catheters once a day:

  1. Put on clean gloves
  2. Clean the catheter as above with soap and water.
  3. Prepare a solution of 1 teaspoon liquid bleach to 8 ounces water in a clean, tightly covered container
    • Use a pure, fragrance-free and additive-free bleach, such as Hilex® or Clorox®
    • Prepare a new solution every day.
  4. Soak catheters in bleach solution for at least 30 to 60 minutes
  5. After soaking, rinse well with water and air dry on a clean towel

Page last updated: August 21, 2017

Clean Intermittent Catheterization- Male

PROCEDURE/SKILL COMPETENCY

  1. Review IHP and/or healthcare provider’s orders
  2. Gather equipment and place on clean surface
  3. Explain the procedure to the student at his level of understanding
  4. Encourage the student to assist in the procedure as much as he is able to help student learn self-care skills
  5. If the student is completing procedure or assisting in procedure, have student wash hands
  6. Assist student with undressing, as needed
  7. Position the student
  8. If student is lying on a cot/bed, place a disposal pad under the student
  9. Wash hands
  10. Arrange equipment
  11. Put on clean gloves
  12. Lubricate the tip of the catheter with a water soluble lubricant and place on a clean surface
    • Use a generous amount of lubricant along the length of the catheter since dry catheters may cause excoriations in the urethra, leading to an entry point for bacteria contamination
  13. Grasp sides of penis below the glans
  14. Gently retract foreskin if uncircumcised
  15. Wash the glans with soapy cotton ball or student specific cleaning supplies
  16. Begin at urethral opening and in a circular motion wash away from the meatus toward the base of the penis
  17. Repeat procedure a total of 3 times, using a clean cotton ball each time
  18. Gently stretch the penis upward
  19. Have student take a deep breath and do other relaxation techniques
  20. Slowly insert the catheter until urine begins to flow and then about an inch more
  21. If you meet resistance try the following (resistance in male catheterization is normal at about the level of the prostate):
    • Rotate the catheter
    • Have the student sit or lie in a different position
    • If you are still unable to insert the catheter or the student experiences pain remove the catheter and follow up with parents/guardian and healthcare provider
  22. If resistance continues or the student experiences pain, stop insertion, never force the catheter
  23. When urine flow has stopped, pinch the catheter and remove it slowly
  24. If student is uncircumcised, pull the foreskin over the glans when finished
  25. Remove gloves
  26. Wash hands
  27. Assist student in dressing, as needed
  28. Have student wash hands
  29. Put on gloves
  30. Assess urine for cloudiness and/or foul smell
    • If present, assess student for signs of urinary tract infection:
      • chills
      • vomiting
      • blood in urine
      • abdominal pain
      • fever
  31. Measure urine per healthcare provider’s order
  32. Discard bodily fluids and catheter per infection control procedures and school district policy
  33. Clean and store equipment as appropriate
  34. Remove gloves
  35. Wash hands
  36. Document assessment, intervention and outcome in student’s healthcare record
  37. Update student’s parents/guardian, as needed

Cleaning for catheter that will be used again during the school day:

  1. Put on clean gloves
  2. Clean catheter with mild soap and warm water
  3. Forcefully rinse the catheter lumen with tap water
  4. Place catheter on clean surface and allow to air dry
  5. Remove gloves
  6. After equipment is dry, store as appropriate
    • Catheter can be used for up to a month
    • Should be discarded if becomes too stiff or has any discoloration

If ordered by healthcare provider, sterilize the catheters once a day:

  1. Put on clean gloves
  2. Clean the catheter as above with soap and water
  3. Prepare a solution of 1 teaspoon liquid bleach to 8 ounces water in a clean, tightly covered container
    • Use a pure, fragrance-free and additive-free bleach, such as Hilex® or Clorox®
    • Prepare a new solution every day
  4. Soak catheters in bleach solution for at least 30 to 60 minutes
  5. After soaking, rinse well with warm water and air dry on a clean towel

Page last updated: August 21, 2017

 

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