There are several reasons (purposes) that a patient may require a bladder catheterization, including to access the bladder and its contents, to drain or empty the bladder, to monitor the hydration status of the patient, to monitor end-organ perfusion and to aid a doctor in making a diagnosis.
Indwelling Bladder Catheter/Types: Knowledge, Skill and Experience
The ability to insert a urinary bladder catheter correctly is an essential skill in nursing education. Indwelling bladder catheterization is an invasive procedure that is done using sterile technique and follows a universally accepted standard to complete. Indwelling bladder catheters come in different sizes and are sized in units called French. One French equals 1/3 of 1 mm and catheters vary in size ranging from 12fr (small) to 48fr (large). The average is 16 French. There are also different varieties of catheter -- some with and some without balloons with varying balloon sizes --for example, a Coudé catheter or a three-way irrigation catheter.
Nurses are taught proper procedure in nursing school, beginning with: gather necessary equipment (including catheter kit, type and size), explain the procedure to the patient, wash hands, open the catheterization kit, prepare a sterile field, apply sterile gloves, check the catheter balloon for patency, apply a lubricant to the tip or end of the catheter, apply a sterile drape to patient. Continuing, the nurse will decide which hand will remain sterile and which hand “clean” using forceps to wipe periurethral mucosa with a cleansing solution. Cleansing should be front-to-back and inner-to-outer using one swipe per swab.
The purpose of a three-way bladder irrigation system is to prevent blood clot formation, allow free flow of urine and to maintain patency of the catheter.
Bladder catheterization medical expert witness specialties include urology, hospitalist medicine, pediatric hospitalist medicine, nursing, emergency nursing, general surgery, pediatric urology, and urogynecology.