Name of the Procedure:

Insertion Tray Without Drainage Bag with Indwelling Catheter, Foley Type, Two-Way Latex with Coating (e.g., Teflon, Silicone, Silicone Elastomer, or Hydrophilic, etc.) - HCPCS Code A4311

Summary

An insertion tray for a Foley catheter is used to help medical professionals insert a two-way latex catheter coated with materials like Teflon or silicone. This catheter allows urine to drain from the bladder when a patient cannot do so naturally.

Purpose

This procedure is used to help drain urine from the bladder in patients who may have urinary retention, an obstruction preventing natural urination, or need continuous urinary drainage. The key goal is to prevent urinary tract infections, reduce bladder pressure, and ensure free flow of urine.

Indications

• Chronic urinary retention
• Post-surgical patients unable to void urine
• Patients with severe mobility issues
• In cases of obstruction encompassing conditions like benign prostatic hyperplasia (BPH)
• To accurately measure input and output in critically ill patients

Preparation

• Patients should be informed about the procedure and gain consent.
• No specific fasting or major pre-procedure requirements.
• Local perineal care to ensure cleanliness.
• May require a diagnostic test, like a bladder ultrasound, to determine the need for an indwelling catheter.

Procedure Description

1. The healthcare professional will use the sterile insertion tray.
2. The patient will be positioned comfortably, usually lying on their back.
3. Antiseptic will be applied to the insertion area.
4. The two-way Foley catheter will be lubricated and gently inserted into the urethra until it reaches the bladder.
5. Once urine flow is visible, the catheter balloon is inflated with sterile water to keep it in place.
6. The catheter is then connected to a separate drainage bag if needed.

Duration

The actual insertion typically takes around 10-15 minutes.

Setting

This procedure can be performed in various settings, including hospitals, outpatient clinics, and sometimes at home by trained healthcare providers.

Personnel

• Registered Nurse (RN) or Licensed Practical Nurse (LPN)
• Physician or Urologist (if complications are expected)
• Possibly a medical assistant to aid

Risks and Complications

• Urinary tract infection (UTI)
• Bladder spasms
• Urethral damage
• Discomfort or pain during insertion
• Rarely, blood in the urine (hematuria)

Benefits

• Immediate relief from urinary retention
• Reduced risk of bladder damage
• Continuous drainage helps in monitoring fluid balance
• Prevention of complications related to urinary retention

Recovery

• Post-procedure, patients may experience mild discomfort initially.
• Regular monitoring and catheter care are essential to prevent infections.
• Follow-up depends on the individual case, with possible advice to return for removal or change of catheter.

Alternatives

• Intermittent catheterization: Periodic insertion and removal of a catheter.
• Suprapubic catheter: Surgical placement of a catheter via the abdomen.
• Medication for underlying causes (if applicable).

Patient Experience

During the procedure, patients may experience some discomfort or a mild sensation of pressure. After insertion, patients might feel temporary relief but should be encouraged to report any pain or unusual symptoms. Pain management measures and ensuring the patient’s comfort are key throughout the process.