03.01 Inserting a Foley (Urinary Catheter) – Female

In this video, we’re going to look at inserting a foley catheter in a female. Of course make sure you’ve verified your order and told the patient what’s happening. You’ll also typically want to perform perineal care before you start.

Then you’ll want to assist the patient into the appropriate position. For females, that’s supine with their knees bent and feet close to their hips - allowing their knees to fall to the side. You may need a helper to help hold the patient in this position.
Then you’ll open the foley kit and remove the package from the plastic bag. Fold the top of the bag over to create a little trash bag and set it beside the patient’s hips near you.
Open the sterile kit on the bedside table, opening the kit away from you. Then pick up the kit from the bottom and place it between the patient’s legs, reminding them not to move their legs or touch the kit.
Carefully grasp the sterile gloves off the top of the package without touching any other items, and apply them… without turning your back on the sterile kit. See the sterile glove lesson if you need more details on this part.
Now you’ll want to grab the full drape and carefully place it under the patient’s perineum, shiny side down. Here’s the tricky part. Your hands should not touch the patient or the sheets… So I will wrap my sterile hands up in the drape and tuck it that way, so my hands are only touching the drape.
Then I grab the drape with a hole in it and place it over the patient’s perineum gently, without touching the patient’s skin.
Now you can slide the kit towards the patient’s feet and remove the plastic tray. Then, put the plastic tray on the sterile field closer to the patient’s perineum - I usually hook it on the side here to keep it steady. So now you’ve set yourself this nice wide sterile field to work with!
Now you’re going to prepare the rest of the items in your kit. You need to lubricate the catheter, so we’re going to show you our favorite trick. Remove the plunger from the lubricant syringe. Then carefully remove the catheter from its package. Careful, it might whip around! Then, place the end of the catheter in the lubricant syringe, then set it down on the tray. Not only does it lubricate it for you - but it also holds it for you! Genius, right!?
Next you will attach the saline syringe to the balloon port, but do NOT inflate. We USED to check the balloon, but evidence shows that is NO longer recommended!
Now you can apply the iodine to the cotton swabs OR open the swabs package. Now - we couldn’t apply the iodine to the mannequin, so for this ONE part, you’ll have to use your imagination, sorry guys!
Okay! Time to insert. Make sure you let the patient know. I usually say something like “you’re gonna feel me touching you now”. Use your non-dominant hand to spread the labia majora and hold them open. Once you do this, that hand is now NON-sterile and you can’t move it once you hold the labia open!
Use your dominant hand to cleanse the meatus. Always move front to back. Start on the right, then the left, then down the center. If you need to, go down the center again. You should look for the ‘wink’ of the urethral opening as you’re cleansing. Remember not to put these back on your sterile field - that’s what your little trash bag was for!
Keep holding the labia open with your nondominant hand, and carefully pick up the catheter out of the lubricant syringe with your dominant hand.
Warn the patient they will feel some pressure and then gently insert the catheter into the urethral opening until you see a flash of urine in the tube.
Once you see it, advance 1 inch further, then inflate the balloon. If you meet ANY resistance, deflate the balloon, advance the catheter 1 more inch, then reinflate. Inflating the balloon should be easy and PAINLESS.
Once the balloon is fully inflated, remove the syringe quickly or it will deflate on its own! Then gently pull the catheter out until slight resistance is felt. That just tells you it’s sitting at the base of the bladder.
Now you can secure the catheter to the patient’s upper thigh, usually with a StatLock or a piece of silk tape. Just make sure you leave enough slack for movement.
Now you can remove the drape and supplies from between the patient’s legs, cover them back up, and then discard your supplies in the appropriate waste container.
And, finally, you want to hang the drainage bag on the bed, below the bladder, but off the floor. Make note of the color and clarity of the urine, as well as how much came out and document the insertion.
So that’s it for inserting a foley in a female. If you want to see how to insert a foley in a male, we have a whole video for that as well!

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