SDE: Clinical Guidelines Ch7D

Clinical Procedure Guidelines for Connecticut School NursesPrintable version | Back to Contents
7
Specialized Health Care Procedures

D. Catheterization: Clean Intermittent

Definition

Clean intermittent catheterization is done with or for students who are either unable to completely empty their bladders or unable to void independently (AUA Foundation, 2011).

Purpose

  1. To allow students to completely empty their bladders on a periodic basis to prevent urinary tract infection or bladder leakage.
  2. To assist students who do not have bladder control to empty their bladders on a periodic basis to prevent leakage.
  3. The ultimate goal is for the student (if able physically and cognitively) to become independent in this procedure.

Equipment

Gloves, clean or sterile straight catheter, disposable wipes or soap and water, urinal or receptacle for urine if procedure is not performed on the toilet, water based lubricant, disposable towel or Chux to place under student if procedure is done on a cot.

Procedure

Male Catheterization

  1. Wash hands.
  2. Grasp sides of penis below the glans.
  3. Clean the tip of the penis and urethra.
  4. Retract foreskin if uncircumcised.
  5. Gently stretch the penis upward.
  6. Generously lubricate the catheter.
  7. Have student take a deep breath.
  8. Slowly insert the catheter until urine begins to flow and then about an inch more.
  9. If you meet resistance before urine flows, have the student take another deep breath and continue with insertion (resistance in male catheterization is normal at about the level of the prostate).
  10. If resistance continues or the student experiences pain, stop insertion, never force the catheter.
  11. When urine flow has stopped, pinch the catheter and remove it slowly when urine flow has stopped.
  12. Measure urine per studentís order.
  13. Discard bodily fluids and catheter per infection control procedures and school district policy.
  14. Wash hands.
  15. (American Academy of Pediatrics, Healthychildren, 2012).

Female Catheterization

  1. Wash hands.
  2. Prepare equipment: Using clean techniques open the urine catheterization package and lubricating jelly.
  3. Place within easy reach.
  4. Prepare the student.
  5. Expose the urethral opening.
  6. Clean the vulva and urethral opening from front to back, starting over the urethral meatus, then each side.
  7. Continue to keep one hand in place exposing the urethral opening.
  8. Generously lubricate catheter.
  9. Separate the labia minora to clearly see the urinary meatus.
  10. Have the student take a deep breath.
  11. Slowly insert the catheter until urine begins to flow, then advance about an inch more.
  12. Pinch the catheter and remove it slowly when urine flow has stopped.
  13. Maintain clean environment.
  14. Wash hands.
  15. (American Academy of Pediatrics, Healthychildren, 2012).

Delegation Considerations

This procedure may be performed by a school nurse, RN, or LPN.

Select Nursing Considerations

  • Assess area for redness, breakdown, swelling, or discharge.
  • Note change in urine color, clarity, or odor, report signs and symptoms of urinary tract infection.
  • Never use non-water-soluble lubricant.
  • Some students will use a new catheter each time, others will need to wash and reuse catheters.
  • Follow health care providerís orders (such as as frequency; strict measuring of output).

References

AUA Foundation. (2011). Bladder augmentation. Retrieved January 3, 2012.

Centers for Disease Control. (2009). Guideline for Prevention of Catheter-associated Urinary Tract Infections. Retrieved January 14, 2012.

American Academy of Pediatrics. Healthychildren. 2012. Clean Intermittent Catherization.

Resources

Centers for Disease Control. (2009). Guideline for Prevention of Catheter-associated Urinary Tract Infections, 2009. Retrieved January 14, 2012.

Bray, L., and Sanders, C. (2007). Teaching children and young people intermittent self-catheterization. Urologic Nursing, 27, 203-9, 242.

Infectious Disease Association of America, American Hospital Association, Centers for Disease Control, (n.d.). FAQs about catheter associated urinary tract infection. Retrieved January 14, 2012.

 




Content Last Modified on 7/23/2014 1:25:35 PM