PROCEDURE GUIDE

URINARY CATHETERIZATION (PERMANENT AND

INTERMITTENT)

I.- Sondaje vesical masculino

Preparation beforehand

Take the necessary measures to

prevent risks labor del
professionals linked to safety, hygiene and
ergonomics.
Place the patient in a supine position.
Handwashing 2,3,4 according to protocol
from the hospital and wearing gloves NO
sterile.
Washing of genitals with water and soap
Drying the area with sterile gauze.
Open the packages so that the professional performing the sterile technique
prepare the field and the necessary material.
Help the professional performing the sterile technique during the procedure.

Professional who performs the sterile technique

Take the necessary measures to prevent risks labor del

professionals related to safety, hygiene, and ergonomics.
Hand washing according to hospital protocol.
Hand hygiene with alcoholic solution and putting on gloves
sterile.
Preparation of the sterile field and necessary materials.
La manipulación del catéter siempre se realizará de forma aséptica, usando
sterile equipment and gloves
 Connect the catheter to the collecting system. Use closed drainage systems.
avoiding the disconnection between probe, tube, and bag
Hold the penis with a gauze, place it in a vertical position and retract the
foreskin.
Lubricate the catheter and urethra abundantly.
Exerting a little traction, gently insert the catheter until it
Urinate. Do not force, to avoid provoking a false route.
Once the catheter is inserted into the bladder, the balloon will be inflated with 8-10 ml of
sterile distilled water (the use of saline solution is not recommended due to its potential)

deteriorate the ball) and it will be slightly pulled until resistance is felt, to
secure your anchoring.
Clean the glans of residues.
Return the foreskin to its position to avoid paraphimosis.
Fix the probe on the anterior thigh after insertion to
avoid movement and urethral traction
The collection bag will be attached to the support.
Hand washing, according to hospital protocol, after the completion of the
technique.

II.- Female bladder catheterization.

Preparation

Take the necessary measures to

prevent labor risks of
professionals related to safety, hygiene
and ergonomics.
Place the patient in supine position
with legs apart.
Handwashing 2,3,4 according to
hospital protocol and placement of
non-sterile gloves.
Washing of genitals with water and soap1,2,3,4 and rinsing with serum
physiological.
 Drying the area with sterile gauze.
Separation of the lips, washing from top to bottom (from the clitoris to the area
perianal) and drying with sterile gauzes.
Open the packages so that the professional performing the sterile technique
prepare the field and the necessary material.
Assist the professional performing the sterile technique during the procedure.

Professional who performs the sterile technique

Take the necessary measures

to prevent risks
professional work related to
safety, hygiene, and ergonomics.
Washing of hands according to
hospital protocol
Hand hygiene with
alcoholic solution and placement
of sterile gloves.
Preparation of the sterile field and necessary materials.
Catheter manipulation will always be performed aseptically, using
sterile equipment and gloves
Connect the catheter to the collection system. Use closed drainage systems.
avoiding disconnection between the probe, tube, and bag
Dab the external genitals with 0.02% chlorhexidine.
Lubricate the catheter and urethra abundantly.
Gently introduce the catheter to avoid causing trauma, through the
I will wait until urine comes out.

Once the catheter is inserted into the bladder, the balloon will be inflated with 8-10 ml of

sterile distilled water will be slightly pulled until noticeable

Resistance, to ensure its anchorage.
Clean the genital area of lubricant residues.
Fix the probe on the inner thigh after insertion to
avoid movement and urethral traction
The collection bag will be fixed to the support.
 Hand washing, according to hospital protocol, after the completion of the
technique.

III.- Waste segregation.

All the consumable materials, once

used, it will be segregated in the deposit
of urban waste: sterile cloth of a
single use, gloves, probes, syringes,
gasas, etc. HEALTHCARE WASTE
ASSIMILABLES A URBAN
(NON-HAZARDOUS RESIDUE) Group II.
In the case of being waste from
defined infectious pathologies in the
Waste Management Program, it
they will deposit in the container of

Hazardous Health Waste (bag

red-green container.
The collected urine will be poured into the designated sites for that purpose.

IV.- Comfort

Once the procedure is completed, we must ensure the comfort of the

patient: position, cleanliness, bed, easy access to the bell and to the objects that
may need.

V.- Maintenance of the bladder catheter

Unless contraindicated, encourage the patient to drink from both.

three liters of liquids daily
Enhance daily hygiene, emphasizing hands and the genital area
in the man insist that after hygiene the foreskin has to return to
his normal position to avoid paraphimosis.
After washing, try to move the probe in a rotational direction, never
from inside out or vice versa, to avoid adhesions and bedsores.
During the patient's care, monitor for possible pressure sores.
produced by the probe.
To mobilize the patient or transfer them, the tube must be pinched, avoiding
always pinching for more than 2 hours
Avoid violent efforts and sudden pulls on the probe due to risk of
injury and bleeding.
Wash your hands before and after any handling of the probe.
Do not perform routine care of the meatus with disinfectants or
topical antimicrobials
Adding antibacterial solutions to drainage bags does NOT reduce the
incidence of infections related to catheterization.
To preserve sterility, the drainage system must be maintained.
closed.
Avoid performing bladder washouts, except in cases of obstruction of the drainage system.
(hemorrhage in prostate or bladder surgery), in order not to disrupt the system of
closed drainage. In case bladder washes are necessary
frequent three-way catheter will be placed.
If irrigation is necessary, an intermittent irrigation method will be used.
Do not practice continuous bladder irrigation as an anti-infectious measure.
routine.
The disconnection of the probe from the system is CONTRAINDICATED except in
the case of irrigation.
In cases where the closed system is interrupted (for example, in the
irrigation), replace the collector system.
The collection bag should also be replaced when the probe is changed.
if it breaks or presents leaks or when sediments accumulate or acquire
a unpleasant smell.
Empty the collection bag regularly (every 8, 12, or 24 hours)
function of diuresis) trying to space it out as much as possible to avoid
unnecessary disconnections and avoiding touching the connection site or that the
exit valve touches the ground while the bag is emptied.
 To empty the collection bag, use an individual container for each
patient4.
Record the collected diuresis.
The collected urine will be poured into the designated sites for that purpose.

Remove the survey as soon as possible

Latex probes are usually changed routinely every 15 days, and
the silicone ones every month. Do not change the sensor repeatedly in
fixed intervals
Urine samples will be obtained using aseptic methods.
Avoid performing urine cultures routinely.
Urine samples for uroculture will be taken from a catheter.
recently placed or by puncture-aspiration of the probe with a sterile syringe in
the most proximal point, disinfecting the point with antiseptic solution
Take. The culture should never be obtained from a urine sample of the
bag.
To obtain larger volumes of urine, one should use the collected urine.
in the newly placed collection bag.
There will always be a constant urinary flow, free of obstacles.
The proper positioning of the catheters to avoid compression
(obstruction of urine flow) can contribute to a reduction
significant of catheter-related infections.
Keep the urine bag below the bladder and placed on its hanger.
to avoid trauma, reflux infections, and to ensure proper
evacuation.
In case of acute urinary retention with overdistension and using catheterization
intermittent, we should not empty the total contents of the bladder (when
exceeding 500 ml in adults), we must perform pinching.
intermittently, until complete emptying, to prevent hemorrhages

VI.- Removal of the bladder catheter

Although there is no conclusive evidence about the benefit of pinching the

probes before its final withdrawal.
Whenever possible, remove the catheter at midnight instead of during the
tomorrow, since it is associated with a

increased urine volume in the

first urination, and in a
earlier recovery of the
normal urinary guidelines5.
Hand washing according to protocol
of the hospital
Prepare all the material and take it.
next to the patient.
Inform the patient.
Preserve your privacy, either in individual rooms or in private areas,
the use of screens or dividing curtains.
Patient placement:
Woman: gynecological position.
Man: supine position, with legs apart.
Place a mattress protector or bed cover under the buttocks of the
patient.
Put on non-sterile disposable gloves.
Proceed to extract the contents of the balloon of the probe with the syringe.
Make sure to extract the total volume of the balloon's content, to avoid
traumas in the urethra.
Some probes do not have a balloon and the fixation is done exclusively with
adhesive tape; therefore, in this procedure, no type of will be performed.
ball extraction.
Remove the probe slowly.
Practice hygiene of the genitals.
Offer the possibility to urinate (in a bottle, urinal, or toilet) if needed.
All consumable material, once used, will be segregated in the deposit of
urban waste: single-use sterile cloth, gloves, probes,
syringes, gauze, etc. WASTE THAT CAN BE ASSIMILATED TO URBAN WASTE
(NON-HAZARDOUS RESIDUE) Group II.
In the case of dealing with waste from defined infectious pathologies in the
Waste Management Program, will be deposited in the container of
Hazardous Health Waste (red bag-green container).
 The collected urine will be poured into designated sites for that purpose.
Hand washing, according to hospital protocol, after the completion of the
technique.
If possible, check the number of urinations, volume, and characteristics.
from the urine after the removal of the catheter.

VII.- Continuity of care.

Once the technique has been performed, make a note in the corresponding register:
date and time of the technique, type of probe (gauge and composition), quantity and
appearance of the drained urine.
Record the expected date of change or withdrawal of the probe.
Carry out interventions to promote self-care among patients and/or
family caregivers, with special emphasis on hygiene in the area
genital, noting in the care records.
Upon discharge, if the patient returns home with permanent catheterization or
intermittent, reflect in the Continuity of Care Report
characteristics of the probe and the expected date for its replacement or withdrawal, thus

as the capacity of the patient and/or caregiver for management

of the same.
 PROCEDURE GUIDE

BLADDER IRRIGATION

Verify the medical indication: based on the Clinical History, the nurse
He will review the patient's data and the aspects related to the technique.
that must be fulfilled.
Identify the patient according to their psychological sphere: they will be asked the
name, once verified, will be inquired about their state of mind and will be
It will explain the technique that will be performed and the advantages it will have for your state.

of health.
Hand washing: a hygienic or medical hand washing will be performed.
hands (the patient's conditions, the area, and according to will be assessed.
the evaluative and critical thinking of nursing will carry out this type of
hand washing.
Prepare the equipment: to avoid interruptions during the procedure and
avoid discomfort for the patient (include the paraban).
Position the patient in the indicated position: the man in supine position and the
woman in supine position with knees slightly flexed and
separated.
Place the sheet and the tight rubber under the patient's hips.
Perform the hygienic or medical hand washing.
Put on the gloves.
Perform the antisepsis of the probe-tubing connection.
Place the kidney-shaped bag or sterile container under the connection.
Load the syringe with saline solution or sterile water (approximately
30 mL.
Carefully disconnect the probe from the tube, making sure that both
the ends of the tube and the probe should be protected with a plug or sterile gauze.
Insert the syringe into the end of the probe (without letting air in) and
gently inject the saline solution or sterile water.
Remove the syringe and let the solution drain into the kidney basin.
If the liquid does not come out, connect the syringe and gently aspirate. Also
The patient can be mobilized by rotating them. This can be attempted.
procedure 2 times more, always trying not to injure and in the face of any
inconvenience to notify the doctor.

Connect the probe-tubing using aseptic technique.

Remove the gloves, place them in the waste container, and carry out the
hygienic or medical hand washing.
If the washing needs to be repeated, a new equipment is used and extracted again.
the solution of the jar.
The general functional invariants that conclude the procedure are:
Arrange the patient according to their psychological sphere: they will be asked about
alguna molestia y se le volverá a explicar los beneficios que tiene para su
health status this technique, as well as any questions or concerns you may have.
Collect the used material: transfer to the treatment or nursing room the
equipment used and the accessories.
Dispose of the non-recoverable material that was used.
Proceed with the cleaning of the equipment and materials that will be allocated to the
disinfection, decontamination and sterilization.
Perform the hygienic or medical handwashing (the following will be evaluated)
patient conditions, of the area and according to the thinking
Evaluative and critical nursing will carry out this type of washing of the
hands).
Record in the medical record the compliance with the indication: so it remains
certificate of the executed action.