What are good simulation exercises that use a Foley catheter?

 

Simulation exercises involving Foley catheters are vital for training healthcare professionals in both technical skills and patient communication. Good simulations should replicate real-life scenarios, include clear learning objectives, and provide feedback. Here are several effective exercises categorized by learning goals:

 

1. Basic Insertion Technique

Objective: Learn and demonstrate proper sterile technique with Foley catheter insertion.

Simulation Setup:

  • Use a male and female catheterization task trainer.
  • Provide full catheterization kits.
  • Include policy/procedure and a checklist: hand hygiene, sterile field, correct insertion, balloon inflation, and securing catheter.

Skills Covered:

  • Aseptic technique
  • Identifying urethral meatus
  • Proper insertion techniques
  • Correct securing of catheter

2. Troubleshooting Foley Insertion

Objective: Identify and resolve challenges during Foley placement.

Scenarios:

  • Catheter won’t advance (simulate urethral stricture)
  • Urine not draining (obstructed catheter)
  • Male patient with enlarged prostate

Debriefing Focus:

  • Alternate techniques (e.g., coude tip)
  • When to stop and seek assistance
  • Safe use of lidocaine jelly
  • Obtaining urology consults
  • Enlarged prostates: symptoms and treatment
  • Troubleshooting techniques and alternatives

3. Foley Catheter Care and Maintenance

Objective: Practice ongoing catheter care to prevent infections.

Simulation Setup:

  • Simulated patient (manikin or standardized participant) with catheter in place
  • Include daily care routines and closed system maintenance

Skills Covered:

  • Emptying and documenting output
  • Cleaning insertion site
  • Recognizing and reporting signs of CAUTI (Catheter-Associated Urinary Tract Infection)

4. Patient Communication and Consent

Objective: Practice obtaining informed consent and explaining the procedure.

Simulation Setup:

  • Use a standardized participant
  • Include language barriers, anxiety, or cognitive impairment

Focus Areas:

  • Clear explanation of risks and benefits
  • Empathetic communication
  • Addressing questions and discomfort

5. Emergency Management Simulation

Objective: Respond to complications (e.g., hematuria, catheter dislodgement, retention despite catheter).

Scenario Examples:

  • Post-op patient with no urine output
  • Catheter balloon inflated in the urethra
  • Accidental removal with balloon still inflated

Debriefing Focus:

  • Immediate interventions
  • Recognizing when to escalate
  • Documentation and incident reporting