FOLEY FACTORY ESCAPE GAME - ICU

Foley escape room

start

Follow the protocol to escape the use of a foley!

THE MISSION

You must follow the correct steps to avoid placing a foley catheter in your patient. You will need to know the protocol to escape. If you mess up your patient could end up with a CAUTI.

THE base

Find the clue you need to keep moving forward

QUESTION 1/3

Bladder scan the patient and initiate the urinary retention protocol if needed

You just admitted a 75-year-old female with a SAH who was intubated and sedated before arrival on your unit. The patient has been in the ER for the last 8 hours with no recorded urine output. What do you do next?

Place a foley and ask the provider for an order

QUESTION 2/3

Male

You are preparing your patient for a bladder scan, you were told in report that she has a history of a hysterectomy. Which patient type do you select when setting up the bladder scanner.

Female

QUESTION 3/3

Prepare to place a foley catheter

The bladder scan reveals that your patient has 425ml of urine. What do you do next?

Prepare to perform a straight cath

THE base

Find the clue you need to keep moving forward

QUESTION 1/2

Recent urological surgery or bladder injury

You are preparing to straight cath your patient - what medical history would stop you from proceeding?

Recent gallbladder surgery with foley placement

Recent foot surgery

QUESTION 2/2

Record urine output in the EHR and plan to rescan in 6 hours

You verified that your patient has not had any recent GU/GYN surgeries and proceed with the straight cath. Once completed you measured 475ml of urine. What do you do next?

Dispose of the urine and wait for the patient to pee on their own

Check the MAR for medicaiton due right now

the base

Find the clue you need to keep moving forward

QUESTION 1/3

Continue to monitor for urine output

Six hours have gone by and your patient has not voided. What is your next step?

Perform bladder scan

Place a foley catheter and ask the provider for an order

QUESTION 2/3

Place a foley catheter

You perform the bladder scan and find that your patient now has 575ml of urine. What do you do next?

Bladder scan again, there is no way they have that much urine

Straight cath the patient

QUESTION 3/3

Place a foley -- they are going to need one anyway

You performed the straight cath and got 625ml of urine. Your patient's condition has changed since admission and they are now requiring nicardipine for BP management and increased propofol dose for ICP management. What is your next step?

Continue to monitor for urine output and rescan in 6 hours

Notify the doctor that you had to straight cath te patient

the base

Find the clue you need to keep moving forward

QUESTION 1/3

Place a foley and ask for an order

Continue to monitor for UOP, it is not safe to straight cath again

Six hours have gone by, the patient is still requiring nicardipine and propofol. There has been no urine output since the previous straight cath. What do you do next?

Don't worry about urine output, the patient has too many other things going on

Bladder scan the patient

QUESTION 2/3

Notify the provider of the protocol outcome and request next steps

Place a foley and ask for an order once placed

You perform the bladder scan and it reads that the patient has 450ml of urine. What are your next steps?

Continue to monitor for UOP

Nothing right now, you have to many other things to do.

QUESTION 3/3

Get upset...you don't have time to keep straight cathing the patient

Continue to monitor for UOP and prepare to straight cath in 6 hours

You discuss with the provider the retention protocol outcome. The provider considers the patient's current condition and orders q6h straight caths and request to be notified if amount drained is greater than 600ml. Your next step is to:

Try to convince the provider that a foley is so much better than doing a straight cath

Put a foley in anyway

the base

Find the clue you need to keep moving forward

QUESTION 1/3

Review the urine culture form and proceed with collecting the urine sample

send the urine sample the next time your straight cath

You have been straight cathing your patient for the past 3 days. Your patient has a fever and the provider has requested to send a urine culture. What do you do next?

Forget about the order, someone else will do it

Put in a foley and collect the sample

QUESTION 2/3

Nothing! the patient is finally peeing

Bladder scan the patient to ensure they do not have a post void residual > 300ml

Your patient's condition has improved and you noticed that the patient urinated before your next straight cath time. What do you do next?

Straight cath them on schedule anyway

Put in a foley - its time consuming to clean them up

QUESTION 3/3

Place a foley

estimate the amount on the pad when they pee

You complete the bladder scan on your patient and find they have no urine retaining in their bladder (Hooray!) What options do you have for accurate output measurements?

Place external urinary diversion device on patient or weigh pads for urine amount

document occurances only in the chart

Mission Complete

You've saved the base and avoided placing a foley catheter on your patient. You're a HERO!

START OVER?

Are you sure you want to go out?

You will lose progress

exit

back

MISSION FAILED

You've destroyed the base and your patient declined ......

try again