Maintaining Sterility During Foley Catheter Insertion

Scenario

You are inserting a Foley catheter in a female patient for accurate urine output monitoring.
While donning sterile gloves, your gloved hand accidentally touches the patient’s inner thigh, which is not part of the sterile field.

Question: What should you do next to maintain patient safety and procedural integrity?

Best Practice Answer

1. Recognize the Breach Immediately:
   The thigh is considered non-sterile. Once contact occurs, your glove is contaminated, and continuing the procedure would risk introducing pathogens into the urinary tract — a catheter-associated urinary tract infection (CAUTI) risk.
   The correct immediate response: stop the procedure.

2. Corrective Actions:

   • If only the glove is contaminated:
     • Step back, maintain awareness of the field, and ask for assistance or re-glove using sterile technique without contaminating the rest of the kit.
   • If the sterile field or equipment is contaminated (e.g., gloves touch the tray or catheter):
     • Discard the entire kit and open a new one.
     • Recreate a new sterile field from scratch — do not reuse partially contaminated supplies.

3. Maintain Communication and Professionalism:

   • Explain to the patient calmly:

     “My sterile glove touched a non-sterile area, so I’m going to restart with a new sterile kit to ensure your safety.”

   • Transparency builds trust and reassures the patient that sterility is being prioritized.

4. Resume the Procedure Correctly:

   • Wash hands and don new sterile gloves.
   • Reclean perineal area with antiseptic swabs from the new kit.
   • Reinsert the Foley under sterile conditions, anchoring and securing properly post-insertion.
   • Document the procedure and the reason for restarting (e.g., “field contaminated—new kit used”).

Real-World Application

This scenario is commonly tested in clinical checkoffs and interview simulations, particularly in med-surg, ICU, and perioperative nursing.
It demonstrates a nurse’s ability to identify contamination, prioritize infection prevention, and adhere strictly to aseptic protocol even under time pressure.

Breaking sterility is not a “failure” — continuing without correction is.

Tip: Interviewers expect the phrase:
“I would stop immediately, replace the contaminated item, and restart the sterile field.”
It signals strong infection control awareness and zero tolerance for procedural shortcuts.