A nurse is preparing to insert an indwelling urinary catheter for a male client

An important nursing skill nursing students learn in nursing school is how to insert a Foley catheter. The process of inserting a catheter is known as catheterization. Nurses must know how to indwell a foley catheter as one of the many duties of nursing. Inserting a Foley catheter is not an easy process and it involves a great deal of precision to perform correctly.

Introduction on How to Insert Foley Catheters

Inserting catheters is a skill that is often used in the medical profession by nurses. Nurses are able to gain access to patients’ bladders and the contents using Foley catheters. Since the catheter can be placed inside the bladder for an extended period of time, it is known as an indwelling catheter. The patient’s urine drains into a bag that is later taken from an outlet device and subsequently drained. Nurses can send the urine samples to the laboratory for further testing for crystals, infections, blood, kidney function, muscle breakdown, and electrolytes. Catheters are also used to treat bladder outlet obstruction and urinary retention in patients.

Steps on How to Inserts a Foley Catheter

Using an indwelling Foley catheter tray, collect all needed supplies.

1. Use two patient identifiers to identify the patient. Discuss all aspects of the procedure with the patient before proceeding. Let first time patients know exactly what to expect from the procedure. Allow time for the patient to ask any questions that he or she may have.
2. Thoroughly wash your hands before coming in contact with materials and the patient to control infection in the facility.
3. Help the patient rest of his or her back and spread the legs for easy access to insert the catheter.
4. Carefully open the catheterization kit, removing the sterile drape and placing it in the procedure area. Before proceeding, place an absorbent pad under the patient to catch any excess fluid during the procedure.
5. Nurses must now apply sterile gloves, open the betadine, and pour it over the cotton balls included in the betadine kit. Carefully remove the plastic that covers the catheter without touching the tube and squirt the jelly on the catheter to lubricate it. Carefully remove the rubber cap on the syringe that contains water.
6. Conduct a test to determine if the balloon inflates or deflates correctly and then attach the included pre-filled syringe to the port and inject all water contained in the syringe. Deflate the balloon without removing the syringe; it must be inflated again after inserting the catheter. NOTE: Bard no longer recommends inflating or pre-testing the balloon prior to insertion.
7. Clean the urinary opening of the female patient. Using the non-dominate hand, gently separate her labia. Do not touch anything after this with the unclean, non-dominate hand. For a male patient, gently clean the peri-urethral mucosa with a cleaning solution. Clean the area using one swipe per swab. Make sure to discard the swab from the sterile area immediately.
8. Using the sterile dominant hand, pick up the catheter with a gloved hand. Holding the catheter loosely, insert it into the urethral opening of a female patient. For a male patient, life his penis to a perpendicular position and lightly apply traction in an upward position using the non-dominant hand. Gently insert the catheter one to two inches past where the patient’s urine is located.
9. Using the correct amount of liquid, inflate the balloon (check the balloon size for the correct amount). After inflating the balloon properly, carefully pull the catheter until it is snug against the neck of the bladder. Connect the drainage system to the catheter. Make sure that the drainage bag in lower than bladder level but not on the floor. Carefully inspect the function of the catheter before ending the process.
10. Remove gloves and dispose of them properly. Wash hands again after the procedure. Nurses should end the catheterization process by documenting the size of the inserted catheter, patient’s responses to the procedure, the amount of water contained in the balloon, and a thorough assessment of the urine.

You can also watch the following video for tips on preparing to insert your Foley:

Tips on Foley Catheter Care

• Never have sexual intercourse with the catheter inserted.
• Alway make sure an indwelling foley catheter is secured with a securement device.
• Maintain the cleanliness of the catheter by cleaning the area around it twice daily with soap and water.
• Never tug or pull the catheter.
• Check the area directly around the catheter for signs of infection or inflammation.
• Never apply any type of lotion to the area around the catheter.

Complications with Inserting a Foley Catheter

Complications may include infection or tissue trauma. Other complications include pyelonephritis, renal inflammation, and nephro-cysto-lithiasis when catheters are left in for extended periods of time. One of the short-term complications includes the inability to insert the Foley catheter.

It is imperative that nurse learn the proper manner in which to insert a Foley catheter so that their patients do not run the risk of infection and trauma. So many patients suffer from conditions that create the need for catheterization so nurses should make their experiences with Foley catheters as comfortable and painless as possible.