Foley Catheter Insertion – Male

Equipment:

  • Catheter kit with all sterile items
  • Sterile drainage tubing and bag (if not included in indwelling catheter insertion kit)
  • Device to secure catheter (if not included in kit)
  • Extra sterile gloves and catheter (optional)
  • Clean gloves, Basin with warm water, washcloth, towel and soap for perineal care
  • Flashlight or other additional light source
  • Bath blanket, waterproof absorbent pad
  • Measuring container

Steps:

  1. WIIAPA:
    1. Wash hands
    2. Introduce self
    3. Identify patient (use 2 identifiers)
    4. Allergies – don’t forget food allergies
    5. Plan of care
    6. Assess patient
  1. Educate patient on catheter insertion and rational.
  2. Provide privacy by closing room door and bedside curtain.
  3. Raise bed to appropriate working height.
  4. Place waterproof pad under patient.
  5. Position patient supine with legs extended and thighs slightly abducted.
  6. Drape patient by covering upper part of body with small sheet or towel; drape with separate sheet or bath blanket so only perineum is exposed.
  7. Position light to illuminate genitals or have assistant available to hold light source.
  8. Clean perineal area with soap and water, rinse, and dry. Use gloves to examine patient and identify urinary meatus. Remove and discard gloves. Perform hand hygiene.
  9. Open outer wrapping of catheterization kit. Placing inner wrapped kit on a clean accessible surface.
  10. Open inner sterile wrap covering tray containing catheterization supplies using sterile technique. Fold back each flap of sterile covering one at a time, ensuring not to extend over sterile contents.
  11. Apply sterile gloves.
    1. **Option: apply sterile under-drape with ungloved hands when drape is packed as first item. Touch only 1” edge of drape and then apply sterile gloves.
  12. Drape perineum, including fenestrated drape. Keep gloves and working surface of drape sterile.
  13. Place sterile tray close patient. Arrange remaining supplies on sterile field, maintaining sterility of gloves.
    1. Place sterile tray with cleaning solution (premoistened swab sticks or cotton balls, forceps and solution), lubricant, catheter, and prefilled syringe for inflating balloon (indwelling catheterization only) on sterile drape.
    2. If kit contains sterile cotton balls, open package of sterile antiseptic solution and pour over cotton balls. If kit contains premoistened swab sticks, open end of package for easy access.
    3. Open sterile specimen container if specimen is to be obtained.
    4. Open sterile wrapper of catheter and leave catheter on sterile field.
    5. Open packet of lubricant and squeeze out on sterile field.
    6. Lubricate catheter tip by dipping it into water-soluble gel.
    7. Attach prefilled syringe to port at end of catheter.
  14. Clean urethral meatus.
    1. With nondominant hand (now contaminated), retract foreskin (if uncircumcised) and gently grasp penis at shaft just below glans. Hold shaft of penis at right angle to body.
    2. Maintain position of nondominated hand throughout of procedure.
    3. Using the sterile, dominant hand, clean meatus with cotton balls/swab sticks, using circular strokes, beginning at meatus and working outward in spiral motion. Repeat cleaning 3 times using clean cotton ball/swab stick each time.
  15. With sterile hand, pick up and hold catheter 7.5-10 cm (3-4 inches) from catheter tip with catheter loosely coiled in palm of hand.
  16. Insert lubricated catheter. Lift penis to position perpendicular (90 degrees) to patient’s body and apply gentle upward traction. Ask the patient to bear down as if to void and slowly insert catheter through urethral meatus. Advance catheter 17 to 22.5 cm (7 to 9 inches) or until urine flows out of the catheter.
  17. Once urine is seen advance catheter to the bifurcation. Do not use force to insert catheter.
  18. Lower penis and hold catheter securely in nondominant hand.
  19. Collect urine specimen as needed (if applicable)
  20. Inflate catheter balloon with amount of fluid designated by manufacturer by continuing to hold catheter with nondominant hand and slowly injecting total amount of solution with free dominate hand.
  21. After inflating catheter balloon, release catheter from nondominant hand. Gently pull catheter until resistance is felt and then advance catheter slightly to avoid pressure on bladder neck.
  22. Secure indwelling catheter with securement device making sure to leave enough slack to allow leg movement and not create tension on catheter. This should be secured on the upper thigh or lower abdomen. If retracted, replace foreskin over glans penis.
  23. Position drainage bag lower than bladder by attaching to bedframe ensuring that it is not attached to side rails.
  24. Check to ensure that there is no obstruction to urine flow.
  25. Provide hygiene as needed and help patient to a comfortable position.
  26. Dispose of supplies in appropriate receptacles.
  27. Measure urine and record.
  28. Remove gloves and perform hand hygiene.
  29. Document

Reference: Laplante, N., Perry, A.G, Potter, P.A., & Ostendorf, W.R. (2022). Clinical Nursing Skills & Techniques. 10th ed. Elsevier