Ensure all necessary equipment is available and functioning
2
Cleanse the skin over the bladder with a specified antiseptic agent
3
Administer local anesthetic to the skin and superficial tissue over the bladder
4
Make a small incision in the skin and subcutaneous tissues over the bladder
5
Insert a needle into the bladder and confirm urine return
6
Thread the guide wire through the needle into the bladder
7
Perform a small incision at the needle entry point
8
Advance the dilator over the guide wire into the bladder
9
Place the catheter over the guide wire and into the bladder
10
Remove the guide wire
11
Approval: Surgeon- Confirm that the catheter is in the correct position
12
Secure the catheter with a stitched suture
13
Collect a urine sample for laboratory analysis
14
Cleanse the area with a mild antiseptic
15
Dress the wound with a sterile dressing
16
Dispose of used equipment correctly and efficiently
17
Document the procedure in the patient’s medical record
18
Approval: Nurse- Confirm that all the procedures were followed correctly
Ensure all necessary equipment is available and functioning
Before starting the suprapubic catheterization procedure, it is important to ensure that all the necessary equipment is available and in working condition. This task involves checking the availability of items such as sterile catheterization set, local anesthetic, antiseptic agent, guide wire, dilator, sutures, sterile dressing, and urine sample container. Make sure all the items are present, sterile, and functional to avoid any interruptions during the procedure.
1
Sterile catheterization set
2
Local anesthetic
3
Antiseptic agent
4
Guide wire
5
Dilator
6
Sutures
7
Sterile dressing
8
Urine sample container
Cleanse the skin over the bladder with a specified antiseptic agent
Proper cleansing of the skin over the bladder is crucial to minimize the risk of infection during the suprapubic catheterization procedure. Use a specific antiseptic agent, as recommended by the healthcare facility, to ensure effective disinfection. Thoroughly clean the area around the bladder using gentle circular motions, starting from the center and moving outward. Pay close attention to maintain a sterile environment and prevent contamination.
1
Chlorhexidine gluconate
2
Povidone-iodine
3
Ethyl alcohol
4
Hydrogen peroxide
5
Benzalkonium chloride
Administer local anesthetic to the skin and superficial tissue over the bladder
Prior to making an incision, local anesthesia must be administered to the skin and superficial tissue over the bladder. This ensures patient comfort and pain management during the procedure. Prepare the local anesthetic according to the healthcare facility's guidelines and inject it into the desired area, ensuring proper distribution and adequate numbing. Monitor the patient for any adverse reactions related to the administration of anesthesia.
Make a small incision in the skin and subcutaneous tissues over the bladder
With the area cleansed and the local anesthesia administered, make a small incision in the skin and subcutaneous tissues over the bladder. Use a scalpel or another appropriate cutting tool to create a precise and controlled opening. Take care to avoid excessive depth, as it may damage underlying structures. Maintain a sterile environment throughout the incision process and dispose of any sharps safely.
Insert a needle into the bladder and confirm urine return
After creating the incision, carefully insert a needle into the bladder. Aim for the center of the incision site and advance the needle slowly to prevent injury. As the needle enters the bladder, you should observe urine return, confirming successful entry. Observe the volume and color of the urine to ensure proper bladder drainage and exclude any abnormalities. If there is no urine return, reposition the needle cautiously.
Thread the guide wire through the needle into the bladder
Thread the guide wire through the needle and advance it into the bladder. Maintain steady control of the guide wire to ensure proper placement and prevent complications. Use gentle pressure while advancing the wire and periodically check for any resistance or obstructions. This step helps create a pathway for inserting the catheter into the bladder. Ensure the guide wire remains intact throughout the process.
Perform a small incision at the needle entry point
Once the guide wire is in place, perform a small incision at the needle entry point. This step allows for the insertion of the dilator and ultimately the catheter into the bladder. Make a precise incision of the appropriate size to accommodate the subsequent instruments. Take care to avoid excessive depth or tissue damage. Dispose of any sharps safely after completing the incision.
Advance the dilator over the guide wire into the bladder
With the incision made, advance the dilator over the guide wire into the bladder. Apply gentle pressure while maneuvering the dilator to ensure smooth entry. Proceed slowly and cautiously, monitoring for any resistance or discomfort experienced by the patient. Correct positioning of the dilator allows for successful insertion of the catheter and efficient drainage of urine.
Place the catheter over the guide wire and into the bladder
After inserting the dilator, carefully place the catheter over the guide wire and advance it into the bladder. Use steady and gentle pressure to ensure proper insertion without causing discomfort or trauma to the patient. Monitor the catheter's progress and adjust accordingly to maintain smooth advancement. The correct positioning of the catheter is essential for successful bladder drainage.
Remove the guide wire
Once the catheter is securely in place, carefully remove the guide wire. Pull the guide wire gently while maintaining control to prevent any damage to the surrounding tissues or dislodgement of the catheter. Ensure the removal of the guide wire is smooth and without resistance. Dispose of the used guide wire safely.
Approval: Surgeon- Confirm that the catheter is in the correct position
Secure the catheter with a stitched suture
After confirming the correct placement of the catheter, secure it in place by applying a stitched suture. Choose an appropriate suture material and technique based on the healthcare facility's guidelines. The suturing helps prevent accidental displacement of the catheter and ensures its stability during daily activities. Monitor the patient for any discomfort or signs of catheter movement after securing the suture.
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Absorbable suture
2
Non-absorbable suture
1
Continuous suture
2
Interrupted suture
3
Subcuticular suture
Collect a urine sample for laboratory analysis
Collecting a urine sample during the suprapubic catheterization procedure allows for laboratory analysis and assessment of the patient's urinary health. Use a sterile container to collect an adequate amount of urine for testing. Follow the healthcare facility's guidelines for proper labeling and documentation of the sample. Ensure appropriate storage and transport of the sample to the laboratory.
Cleanse the area with a mild antiseptic
Once the catheter is securely in place, cleanse the area surrounding the insertion site with a mild antiseptic solution. This step helps maintain cleanliness, minimize the risk of infection, and promote proper wound healing. Use a gentle touch and avoid excessive force that could disrupt the catheter's position. Dispose of any used materials properly after cleansing.
1
Saline solution
2
Hydrogen peroxide solution
3
Diluted povidone-iodine solution
Dress the wound with a sterile dressing
After cleansing the area, apply a sterile dressing over the suprapubic catheter insertion site. Use an appropriate sterile dressing that provides a barrier against infection and promotes optimal wound healing. Ensure proper coverage and secure the dressing, taking care not to obstruct the catheter. Monitor the dressing regularly for any signs of contamination or loosening.
1
Transparent film dressing
2
Absorbent pad dressing
3
Hydrocolloid dressing
Dispose of used equipment correctly and efficiently
Dispose of all the used equipment in a correct and efficient manner to maintain a safe environment. Follow the healthcare facility's guidelines for proper disposal methods. Use designated containers or bags for biohazardous waste to prevent any potential hazards. Regularly empty and sanitize the disposal containers to maintain a clean and hygienic environment.
Document the procedure in the patient’s medical record
Proper documentation of the suprapubic catheterization procedure is essential for accurate and comprehensive patient records. Record relevant information such as the date, time, patient's condition during the procedure, any complications encountered, and post-procedure instructions given to the patient. Ensure clear and concise documentation to facilitate effective communication among healthcare professionals and provide a reference for future treatments or assessments.
Approval: Nurse- Confirm that all the procedures were followed correctly
