Question

Sara is a new grad nurse working in a surgical unit. Sara has been asked to insert a urinary catheter in a patient who will undergo major abdominal surgery this morning. She has assembled all of her supplies and is ready to begin the procedure. Sara washes her hands and sets up her sterile field. The patient accidentally moves, causing Sara to contaminate the catheter.

As Sara is about to ask someone for a new catheter, her charge RN stops by to tell her that the surgery schedule has been moved ahead and that her patient will be leaving for surgery in the next few minutes. Sara is now anxious and decides to quickly insert the catheter. A few minutes later, a transporter arrives to take the patient to surgery. He appears very impatient. As the patient is moved over to the transport bed, the transporter places the urinary catheter bag on the patient's abdomen. Everyone is in such a hurry that Sara questions whether she should stop the transporter or just remain silent.

What went wrong in this scenario?

What would have been the best course of action for Sara to take regarding the insertion of the catheter? Why?

How should Sara have handled the situation of the transporter laying the catheter bag on the patient's abdomen?

What are some other nursing considerations for transporting a patient with an indwelling catheter?

Answer 1

• While preparing articles for insertion of indwelling catheter always can keep a spare catheter in tray
• Donot insert a contaminated catheter as it may lead to urinary infections
• Donot insert catheter in a hurry , always check for urine after insertion of catheter
• Always keep an assistant before performing any invasive procedure

The catheter bag should be kept below the level of patient and secured to mid thigh .Keeping the bag on abdomen may cause back flow of urine leading to infection

Sara should stop the transporter and ask him to step outside and explain him that donot keep urinary drainage bag above bladder level of patient. She should place the bag below securing it to thigh with tape, empty if there is urine in the bag and also note that there is no kink or looping in catheter.

Always empty the urine in the bag before transporting a patient. Safety of patient is very important .Follow patient safety goals. Handle patient with care so that there is no compromise in aseptic techniques practised.