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24 Ensure that the glans penis is clean and then reduce or reposition the foreskin. Retraction and constriction of the foreskin behind the glans penis (paraphimosis) may occur if this is not done (Pomfret 2003, E).

Postprocedure

25 Make the patient comfortable. Ensure that the area is dry. If the area is left wet or moist, secondary infection and skin irritation may occur (Pomfret 2003, E).

26 Measure the amount of urine. To be aware of bladder capacity for patients who have presented with urinary retention. To monitor renal function and fluid balance. It is not necessary to measure the amount of urine if the patient is having the urinary catheter routinely changed (Pomfret 2003, E).

27 Take a urine specimen for laboratory examination, if required (see Chapter 11). For further information, see Procedure guideline 11.1

28 Dispose of equipment in an orange plastic clinical waste bag and seal the bag before moving the trolley. To prevent environmental contamination. Orange is the recognized colour for clinical waste (DH 2005a, C).

29 Draw back the curtains.

30 Record information in relevant documents; this should include:

reasons for catheterization

date and time of catheterization

catheter type, length and size

amount of water instilled into the balloon

batch number

manufacturer

any problems negotiated during the procedure

a review date to assess the need for continued catheterization or date of change of catheter.

To provide a point of reference or comparison in the event of later queries (NMC 2009, C).

Procedure guideline 6.5 Urinary catheterization: female

Essential equipment

Sterile catheterization pack containing gallipots, receiver, low-linting swabs, disposable towels

Disposable pad

Sterile gloves

Selection of appropriate catheters

Sterile anaesthetic lubricating jelly

Universal specimen container

0.9% sodium chloride or antiseptic solution

Bactericidal alcohol handrub

Hypoallergenic tape or leg strap for tethering

Sterile water

Syringe and needle

Disposable plastic apron

Syringe and needle

Drainage bag and stand or holder

Preprocedure

Action Rationale

1 Explain and discuss the procedure with the patient. To ensure that the patient understands the procedure and gives her valid consent (NMC 2008a, C).

2 Screen the bed. To ensure patient’s privacy. To allow dust and airborne organisms to settle before the sterile field is exposed (Fraise and Bradley 2009, E).

3 Assist the patient to get into the supine position with knees bent, hips flexed and feet resting about 60 cm apart. To enable genital area to be seen. E

4 Do not expose the patient at this stage of the procedure. To maintain the patient’s dignity and comfort (NMC 2008b, C).

5 Ensure that a good light source is available. To enable genital area to be seen clearly. E

6 Wash hands using bactericidal soap and water or bactericidal alcohol handrub. To reduce risk of cross-infection (Fraise and Bradley 2009, E).

7 Put on a disposable apron and two pairs of sterile gloves. To reduce risk of cross-infection from micro-organisms on uniform (Bardsley and Kyle 2008, E; Fraise and Bradley 2009, E).

Procedure

8 Prepare the trolley, placing all equipment required on the bottom shelf. (Also see Catheter selection.) To reserve top shelf for clean working surface. E

9 Take the trolley to the patient’s bedside, disturbing screens as little as possible. To minimize airborne contamination (Fraise and Bradley 2009, E).

10 Open the outer cover of the catheterization pack and slide the pack on the top shelf of the trolley. To prepare equipment. E

11 Using an aseptic technique, open supplementary packs. To reduce risk of introducing infection into the urinary tract. E

12 Remove cover, maintaining the patient’s privacy, and position a disposable pad under the patient’s buttocks. To ensure urine does not leak onto bedclothes. E

13 Remove top pair of gloves and dispose. Gloves may have become contaminated by handling outer packs (Bardsley and