Name of the Procedure:

Insertion tray with drainage bag with indwelling catheter, Foley type, two-way, all silicone. Commonly referred to as Foley catheter placement or urinary catheterization.

Summary

This procedure involves the insertion of a soft, flexible tube (catheter) into the bladder to drain urine. It uses a Foley type, two-way catheter made entirely of silicone, which remains in place for ongoing drainage.

Purpose

Medical Conditions or Problems Addressed:

• Urinary retention
• Monitoring urine output in critically ill patients
• Providing bladder drainage for immobilized patients
• Managing bladder dysfunction in patients with neurological disorders

Goals/Expected Outcomes:

• Relieve urinary retention
• Accurate urine output monitoring
• Prevent bladder overdistension
• Ensure patient comfort and prevent skin irritation

Indications

Specific Symptoms or Conditions:

• Acute or chronic urinary retention
• Post-surgical recovery when urine output monitoring is essential
• Severe mobility restrictions due to injury or chronic illness
• Bladder obstruction due to prostate enlargement, stones, or tumors

Patient Criteria:

• Inability to void naturally
• Need for accurate urine measurement
• Requirement for continuous bladder drainage

Preparation

Pre-procedure Instructions:

• No specific fasting required
• Inform the healthcare provider of any allergies, especially to latex or silicone
• Empty bladder if possible before the procedure

Diagnostic Tests Required:

• Urine tests (if infection is suspected)
• Bladder ultrasound (to check urine volume)

Procedure Description

Step-by-Step Explanation:

1. Patient Positioning: Patient lies on their back with legs apart.
2. Sterile Field Preparation: Healthcare provider wears sterile gloves and sets up a sterile field.
3. Cleaning: The genital area is cleansed with antiseptic solution.
4. Catheter Insertion: The silicone Foley catheter is gently inserted into the urethra until it reaches the bladder.
5. Balloon Inflation: A small balloon at the catheter tip is inflated with sterile water to keep the catheter in place.
6. Connection: The other end of the catheter is connected to the drainage bag.
7. Securing: The catheter is secured to the patient’s thigh to prevent pulling.

Tools and Equipment Used:

• Foley catheter (two-way, all silicone)
• Sterile gloves and drapes
• Antiseptic solution
• Syringe with sterile water for balloon inflation
• Drainage bag

Anesthesia or Sedation:

• Typically performed without anesthesia
• Local anesthetic gel may be used to minimize discomfort

Duration

The entire procedure typically takes around 10-15 minutes.

Setting

This procedure is generally performed in a hospital, outpatient clinic, or long-term care facility.

Personnel

• A licensed nurse or physician
• Possibly a nursing assistant to help with positioning and comfort

Risks and Complications

Common Risks:

• Discomfort or pain during insertion
• Urinary tract infection (UTI)
• Minor bleeding

Rare Risks:

• Catheter blockage
• Bladder injury
• Allergic reaction to materials used

Possible Complications:

• Persistent pain or discomfort
• Management includes ensuring proper catheter hygiene and immediate medical attention if severe complications arise.

Benefits

Expected Benefits:

• Immediate relief from urinary retention
• Continuous monitoring of urine output
• Reduced risk of bladder overdistension

Timeline for Benefits:

• Benefits are usually realized immediately after the procedure.

Recovery

Post-Procedure Care:

• Maintain catheter and drainage bag hygiene
• Ensure the catheter is secured to prevent pulling
• Monitor for signs of infection or blockage

Expected Recovery Time:

• Most patients can resume normal activities immediately, although some may experience mild discomfort for a few days.

Restrictions or Follow-up:

• Regular catheter care and monitoring
• Follow-up appointments to assess the need for continued catheterization

Alternatives

Other Treatment Options:

• Intermittent catheterization (temporary catheter placement)
• Suprapubic catheter (catheter inserted directly into the bladder through the abdomen)
• Medications to manage underlying conditions (e.g., bladder relaxants)

Pros and Cons of Alternatives:

• Intermittent catheterization reduces the risk of infection but requires frequent insertion.
• A suprapubic catheter is useful for long-term needs but requires minor surgery.
• Medications may address underlying conditions but might not provide immediate relief.

Patient Experience

During the Procedure:

• Possible minor discomfort or pressure during insertion
• Use of local anesthetic gel can reduce pain

After the Procedure:

• Mild discomfort which typically subsides within a day or two
• Instructions provided for catheter care and signs of potential complications

Pain Management and Comfort Measures:

• Over-the-counter pain relief if necessary
• Ensure proper catheter hygiene and securement to prevent discomfort.