#8 Difficult foley insertion, CAUTI prevention

Dr. Matthew Truong, urologist, shares some pearls for difficult foley insertion, what CAUTI is, what it is not, and how to prevent it.

URO-jet, Glydo

This is a 2% lidocaine jelly that can be injected straight into the urethra. As a nurse, it would be nice to advocate for this for your male patients who have an anticipated difficult foley insertion (it will need to be ordered by the doctor). 

Cystoscopy

Cystoscopy is endoscopy of the bladder via the urethra. A scope is passed through the urethra with a lens that allows the physician to view the inside of the bladder.

  • Female Cystoscopy
  • Male Cystoscopy
Images from The Mayo Clinic – Cystoscopy

CAUTI Prevention

  • Keep catheter insertion as sterile as possible. If the procedure is problematic and not sterile, it’s worth asking the doctor for prophylactic antibiotics.
  • Make sure the catheter drains well. A well functioning catheter will drain bacteria out. Urinary stasis is a huge risk factor for infection. If the catheter is not draining well, consider irrigating it with normal saline.
  • If your patient is diagnosed with a UTI and already has a urinary catheter, change the catheter out, but prioritize antibiotic administration.
  • Additional Reading: The Internet Book of Critical Care (IBCC) has a great chapter on CAUTI