Accessing the Foley catheter policy/process is quite easy for nurses at my institution since the hospital has fully implemented a directive that all patients requiring catheter be given Foley catheter. Besides, the facility has complied with another requirement that all facilities should have Catheter Associated Urinary Tract Infection (CAUTI) Prevention programs and a specialist designated to manage them (Newman, 2007, p.655).
Registered Nurses easily access the policy since the physician in charge of the CAUTI prevention program has developed a written procedure and a plan normally communicated to the entire clinical staff via memos and departmental meetings. The RNs have always used the Foley catheter policy since it was adopted a standard procedure all nurses need to be familiar with at the facility (Gould et al., 2008, p.23).
The policy used at the facility is evidence based. Considering that studies have indicated that 40% of the nasocomial infections are Urinary Tract infections and that 80% of these are a result of indwelling catheterization, caution has been vital (Gould et al., 2008, p.23). For this reason, the facility always conducts a review of evidence-based researches and on catheterization in a timely manner to update its Foley catheter placement policy.
This first step requires helping the patient suffering urologic problem accept the invasive process. The nurse prepares the patient psychologically by explaining what will happen, like a feeling pressure during catheter insertion. This feeling may even prompt the urge to void, e.t.c (Newman, 2007, p.655).
Equipment: the clinician must gather all the equipment required like the sterile indwelling catheter, sterile syringe, towel, soap and water, clean gloves, antiseptic cleaning agent etc.
Process management: practitioners are required to review the process and familiarize themselves with the purpose of every step of the process and the ensuing physiological impact (the science behind).
Preparing equipment: the clinician then check the patients order to confirm catheter size and other specifications. All appropriate equipments are placed within reach, at the bedside (Ackley et al., 2008, p.44). This requires also having the manual, preparing and setting up the patient.
The process: the nurse washed hands and screened the patient. The RN ensured the patient lied in suitable position. The nurse raised the bed to working height with the patient facing her. The nurse placed a water proof pad is beneath the patient, then draped the patient with clean towel. The clinician wore gloves and used warm water and soap to clean the perineal area. The clinician performed the insertion procedure as specified for male or female patient and secured the catheter to the patient’s thigh and deflates the balloon.
The RN did not deviate from the process because it is standard procedure and deviation from it is a serious violation of the nonnegotiable clinical standard ethics. The deviation could only be acceptable if there are not restrictive measures to preserve the rights of the clients and other people involved in care.
RNs always adhere to the institution’s written policies because nursing profession has some non-negotiable standards like right to standard treatment. The only time when the written procedures are not followed is when a complication emerges that puts many issues under code of ethics in conflict (Ackley et al., 2008, p.48). challenges and opportunities overlap as shown by research. Despite evidence that urological problems and the consequent results are preventable, infections still remain prevalent in health care acquired infections.
Ackley, B.J., Ladwig, G.B., Swan, B.A. & Tucker, S.J. (2008). Evidence-Based Nursing Care Guidelines: Medical Surgical Interventions. St. Louis: Mosby Elsevier.
Gould, C, Umscheid, C, Agarwal, R, et al. (2008). Guideline for the Prevention of Catheter-Associated Urinary Tract Infections 2008, HaH Services (Ed). Atlanta: Department of Health and Human Services Centers for Disease Control and Prevention. pp.1-47
Newman, D.K (2007). The Indwelling Urinary Catheter Principles for Best Practice. Journal of Wound, Ostomy, and Continence Nursing, 34(6), 655-661.