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11/13/24, 7\:21 PM Guide | Male catheterisation

Male catheterisation

Table of contents
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Gather equipment

1. Clean the top of a procedure trolley using a disinfectant wipe.
2. Collect the equipment required for the procedure and place it within reach on the clean trolley\:
Plastic apron
Two pairs of sterile gloves
Sterile water-
0.9% sodium chloride (10mls)
Lidocaine (1%) anaesthetic lubricating gel for insertion into the urethra.
Male urinary catheter (12/14 french)
Catheter pack\: including cotton wool balls, sterile gauze, sterile drapes, absorbent pad and gallipot (a.k.a. a small pot).
Catheter bag
Urine collection bowl (a.k.a. a receiver)
3. Check the expiry date on the catheter, sterile water, normal saline and lidocaine gel.
4. Ensure a clinical waste bin is placed nearby.
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Clean a trolley using disinfectant wipes

Introduction

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.
Don PPE if appropriate.
Introduce yourself to the patient including your name and role.
Con
Brie
" T o d a y I n e e d t o i n s e r t a c a t h e t e r . T h i s w i l l
i n v o l v e i n s e r t i n g a t h i n
s h o u l d n' t b e p a i n f u l . I' l l i n s e r t s o m e l o c a l a n a e s t h e t i c i n t o t h e p e n i s t o m a k e t h e p r o c e d u r e a s c o m f o r t a b l e a s p o s s i b l e .
"
Explain the need for a chaperone\:
c h a p e r o n e , w o u l d t h a t b e o k ?”
“ O n e o f t h e o t h e r s t a
Gain consent to proceed with catheterisation.
Check if the patient has any allergies (e.g. latex).
Ask the patient if they have any pain before continuing with the clinical procedure.
Explain to the patient that they’ll need to remove their underwear and lie on the clinical examination couch, covering
themselves with the sheet provided. Provide the patient with privacy to undress and check it is ok to re-enter the room
before doing so.

Equipment preparation

Setting up the sterile
1. Set up the sterile
the corners without touching the inner surface of the
the sticky label containing the details of the catheter into the patient's notes.
2. Using aseptic non-touch technique (ANTT) place the catheter, lidocaine gel syringe, sterile water syringe and sterile gloves
onto the
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3. Pour the 0.9% sodium chloride solution over the cotton balls which should already be located within the gallipot of the
catheter pack.
Wash your hands

Positioning the patient

1. With the patient lying supine, ensure the bed is at an appropriate height for you to comfortably carry out the procedure.
2. Wash your hands again and don a pair of sterile gloves.
3. Ask your chaperone to remove the sheet covering the patient's genitals to allow you to maintain sterility.
4. Place a sterile absorbent pad underneath the patient's genital region, ensuring you maintain sterility.
Wash your hands
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Cleaning the penis

1. Hold the penis with your non-dominant hand using some sterile gauze and ensure the patient's foreskin is retracted (if
present).
2. With your dominant hand, pick up a cotton ball and use a single stroke moving away from the urethral meatus to clean an
area of the glans. Dispose of the
cotton ball each time until all areas of the glans have been cleaned.
3. Discard your used gloves, wash your hands again and don a new pair of sterile gloves.
4. Place the sterile drape over the patient's penis, positioned such that the penis remains visible through the central aperture of
the drape. Some drapes come with a hole already present for this purpose, whereas others will require you to create one.
5. Place the sterile urine collection bowl below the penis but on top of the sterile drape.
Clean the penis

Inserting the local anaesthetic

1. Hold the penis vertically with your non-dominant hand using a piece of sterile gauze.
2. Warn the patient that the anaesthetic gel might initially sting, but then should quickly cause things to become numb.
3. With your dominant hand place the nozzle of the syringe of anaesthetic gel into the urethral meatus.
4. Empty the entire 10mls of anaesthetic gel into the urethra at a slow but steady pace.
5. Continue to hold to the penis in the vertical position to ensure the gel remains within the urethra and allow 3 to 5 minutes for
the lidocaine gel to reach its maximum e
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Inject local anaesthetic into the penis

Inserting the catheter

Preparation

1. Pick up the catheter which should be on your sterile
2. Remove the tear-away portion of the wrapper near the catheter tip, making sure not to touch the catheter.
3. Hold the penis again using sterile gauze with your non-dominant 'dirty hand'
.

Insertion

4. Warn the patient you are about to insert the catheter.
5. Insert the exposed catheter tip into the urethral meatus using your dominant 'clean hand'
.
6. Advance the catheter slowly whilst gradually removing more of the wrapper to expose more of the catheter. The key to
removing the wrapper without also pulling the catheter back out is to ensure you have a good grip on the penis as you gently
pull back on the wrapper. As you pass the prostate you may note some resistance and the patient may experience some
discomfort. If the resistance is signi
consider a repeat attempt or specialist input from urology.
7. You should continue to advance the catheter until it is fully inserted into the penis. As you enter the bladder urine should
begin to drain from the catheter.

Balloon in

8. Once the catheter is fully inserted, in
bladder. Before doing this, ask the patient to let you know immediately if they experience any discomfort as you inject the
water. If the patient begins to experience discomfort during the injection of the water stop immediately as this may indicate the
tip of the catheter is within the urethra.
9. Once the balloon is fully in
the catheter is held securely within the bladder.

Attaching the catheter bag

10. Attach the catheter bag tubing to the end of the catheter securely.
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11. Position the catheter bag below the level of the patient to facilitate e

Final steps

12. Replace the patient's retracted foreskin (if present) as failure to do so can result in the development of paraphimosis.
13. Clean away any urine spillage or excess lubricating gel and cover the patient with the sheet.
14. Dispose of your equipment into a clinical waste bin.
15. Provide the patient with privacy to get dressed.
Open the catheter wrapper

To complete the procedure...

Explain to the patient that the procedure is now complete and that they should seek review if the catheter becomes painful
or if they begin to feel unwell.
Dispose of PPE appropriately and wash your hands.
Ask the nursing sta
Document the details of the procedure in the patient's notes\:
Your personal details including your name, job role and GMC number.
The date and time the procedure was performed.
Con
The details of the chaperone who was present including their name and job role.
The indication for catheterisation.
The volume of water injected into the catheter balloon (e.g. 10mls).
The size of the catheter inserted (e.g. 14 french)
The type and volume of local anaesthetic used.
Any complications experienced during the procedure.
The residual volume of urine drained.
The appearance of the urine drained (e.g. straw-coloured, blood-stained).
A
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Source\: geekymedics.com
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