Suprapubic Catheter, Insertion of

Suprapubic Catheter Insertion Policy 

Goal 

• To maintain constant urinary drainage when the urinary tract is obstructed. 

• To facilitate frequent bladder irrigations. 

• To facilitate the instillation of drugs as ordered. 

Equipment 

• Sterile catheter insertion set. 

• Sterile indwelling catheter of the size and type ordered by the physician. 

• Sterile water for inflation of the balloon. 

• Sterile gloves. 

Procedure 

Preparation: 

4. Check the physician’s order for catheter change, size of catheter, and balloon to be used. Note that the catheter is to be changed only upon the order of a physician. 

5. Assist the resident to the dorsal recumbent position and drape for privacy. 

6. Peel back the wrapper of the catheter insertion set without contaminating the contents. Place it on a working surface. 

7. Open the sterile wrap to provide a sterile field. 

8. Put on sterile gloves. 

9. Place a protective pad below the opening for the catheter. 

10. Place a sterile drape over the opening for the catheter. 

11. Open lubricating jelly and squeeze it onto the catheter tip. 

Cleansing: 9. Using a clean cotton ball for each cleansing, clean the edges and skin around the opening to the catheter with antiseptic solution. Begin at the edges of the opening and cleanse in concentric circles moving outward. 10. Clean directly over the opening with the last cotton ball and antiseptic solution, taking care not to let the solution run into the opening. 

Insertion: 11. Gently, without force, insert the lubricated catheter into the opening about one to one-and-one-half inches until urine flows. If any difficulty or resistance is encountered, stop and call the physician. 12. Place the other end of the catheter into the catheter tray or specimen container. 13. After obtaining the specimen (if required), inflate the balloon to capacity as stated on the catheter. 14. Attach the catheter to the drainage bag. Properly position the bag below the level of the bladder (it must not touch the floor) and secure it to the bed frame. 15. Check the flow of urine, noting the color, amount, and consistency. 16. Leave the resident clean, dry, and in a comfortable position with the call light within reach. 

Documentation: 

• Document the date, time, and catheter size. 

• Include additional documentation as follows: 

• Procedure details. 

• Amount of urine obtained, if a specimen was taken. 

• Color and consistency of urine. 

• Condition of the orifice and skin around the orifice. 

• How well the resident tolerated the procedure. 

• Intake and output records. 

References 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.