About Your Urinary (Foley) Catheter: How To Clean and Care for It

This information will help you care for your urinary (Foley) catheter.

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About your urinary (Foley) catheter

Your Foley catheter is a thin, flexible tube placed through your urethra (the small tube that carries urine from your bladder to outside your body) and into your bladder. Your Foley catheter drains your urine (pee). It’s held inside your bladder by a balloon filled with water.

How your Foley catheter works

Your urine goes from your bladder and through a drainage tube into a drainage collection bag. The drainage bag stays on your leg with a special tape called Cath-Secure^®.

You will have 2 types of drainage bags:

• A leg bag. This is the bag that you wear during the day. It holds half a liter of urine.
• A night bag. This is the bag you will put on at night before you go to bed. It holds 2 liters of urine.

The parts of the catheter that are outside your body are shown in Figure 1.

Figure 1. The parts of your Foley catheter and drainage bag

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How to take care of your Foley catheter

To take care of your Foley catheter, you will need to:

• Clean your catheter every day.
• Change your drainage bags. You will change your drainage bag 2 times a day:
  • In the morning, change the night bag to the leg bag.
  • At night before you go to bed, change the leg bag to the night bag.
• Replace your drainage bags with new bags once a week. You should also change your drainage bag if it gets clogged or blocked.
• Wash your drainage bags every day.
• Drink 1 to 2 glasses of liquids every 2 hours while you’re awake to keep you hydrated.

You may see some blood or urine around where the catheter enters your body. This may happen when you’re walking or having a bowel movement (pooping). This is normal if there’s urine draining into the drainage bag. If you do not have urine draining into the drainage bag, call your healthcare provider.

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How to comfortably wear your Foley catheter and leg bag

• The tubing from your leg bag should fit down to your calf with your leg slightly bent. If you have extra tubing, you may need to cut it. Your healthcare provider will show you how to do this.
• Always wear the leg bag below your knee. This will help it drain.
• Place the leg bag on your calf using the Velcro® straps your healthcare provider gave you. Use a leg strap to secure the tubing to your thigh.
• If the straps leave a mark on your leg, they are too tight. Loosen them. Leaving the straps too tight can lower your blood flow and cause blood clots.
• Use a water-based lubricant (such as Astroglide® or K-Y®) to keep your penis or vagina opening from getting sore.
• Keep your penis or vagina opening clean by taking a shower every day. This will help prevent infections when your Foley catheter is in place.

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How to shower with your Foley catheter

• You can shower while you have your catheter in place.
• Do not take a bath until your catheter is removed. Taking a bath while you have your catheter in place puts you at risk for infections.
• Make sure you always shower with your night bag. Your night bag is waterproof. Do not shower with your leg bag. Your leg bag has cloth on the side and will not dry as fast.
  • You may find it easier to shower in the morning before you change your night bag to your leg bag.

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How to clean your Foley catheter

You can clean your catheter while you’re in the shower. Follow these instructions.

1. Gather your supplies. You will need:
   • Mild soap, such as Dove®.
   • 1 Cath-Secure®.
2. Clean your hands with soap and water or an alcohol-based hand sanitizer.
   • If you’re washing your hands with soap and water, wet your hands and apply soap. Rub your hands together well for at least 20 seconds, then rinse. Dry your hands with a paper towel. Use that same towel to turn off the faucet.
   • If you’re using an alcohol-based hand sanitizer, cover your hands with it. Rub them together until they’re dry.
3. Using mild soap and water, clean your penis or vagina.
   • If you have a penis, pull back your foreskin (the skin around the tip of your penis), if needed. Clean the area, including your penis.
   • If you have a vagina, separate your labia (the smaller folds of skin around your vaginal opening). Clean the area from front to back.
4. Clean the area where the catheter enters your body. This is called your urethra.
5. Clean the catheter from where it enters your body and then down, away from your body. Hold the catheter at the point it enters your body so that you do not put tension on it.
6. Rinse the area well and dry it gently.
7. If you removed your old Cath-Secure, attach the catheter to your leg with a new Cath-Secure. This will keep the catheter from moving.

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When to change your drainage bags

You will change your drainage bag 2 times a day. Change it:

• In the morning after you shower, change the night bag to the leg bag.
• At night before you go to bed, change the leg bag to the night bag.

Replace your drainage bags with new bags once a week. You should also change your drainage bag if it gets clogged or blocked.

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How to change your drainage bag

This video demonstrates how to change your urinary (Foley) catheter drainage bag.

Video Details

1. Gather your supplies. You will need:
   • A clean cloth (not one you’re using for bathing) or a 4 x 4 piece of gauze.
   • Your night or leg bag (whichever one you are switching to).
   • 2 alcohol pads.
2. Clean your hands with soap and water or an alcohol-based hand sanitizer.
   • If you’re washing your hands with soap and water, wet your hands and apply soap. Rub your hands together well for at least 20 seconds, then rinse. Dry your hands with a paper towel. Use that same towel to turn off the faucet.
   • If you’re using an alcohol-based hand sanitizer, cover your hands with it. Rub them together until they’re dry.
3. Empty the urine from the drainage bag into the toilet. Make sure the spout of the drainage bag never touches the side of the toilet or any emptying container. If it does, wipe it with an alcohol pad for 15 seconds.
4. Place the clean cloth or gauze under the connector to catch any leakage.
5. Pinch the catheter with your fingers and disconnect the used bag.
6. Wipe the end of the catheter with an alcohol pad.
7. Wipe the connector on the new bag with the second alcohol pad.
8. Connect the clean bag to the catheter and release your finger pinch. Make sure the catheter is tightly connected to the bag to keep it from opening or leaking.
9. Check all connections. Straighten any kinks or twists in the tubing.

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How to take care of your drainage bags

Caring for your leg drainage bag

• Empty the leg bag into the toilet every 2 to 4 hours, as needed. You can do this through the spout at the bottom of the bag. Do not let the bag get completely full.
• Do not lie down for longer than 2 hours while you’re wearing the leg bag. This can keep your urine from draining the way it should.

Caring for your night drainage bag

• Always keep the night bag below the level of your bladder.
• When you go to sleep, hang your night bag off the bed. You can do this by using a small trash can. Place a clean plastic bag inside the trash can. Hang your night bag inside of the trash can.

Cleaning your drainage bags

Clean your leg bag and night bag every day. Follow these instructions.

1. Gather your supplies. You will need:
   • White vinegar.
   • Cool water.
2. Clean your hands with soap and water or an alcohol-based hand sanitizer.
   • If you’re washing your hands with soap and water, wet your hands and apply soap. Rub your hands together well for at least 20 seconds, then rinse. Dry your hands with a paper towel. Use that same towel to turn off the faucet.
   • If you’re using an alcohol-based hand sanitizer, cover your hands with it. Rub them together until they’re dry.
3. Rinse the bag with cool water. Do not use hot water because it can damage the plastic.
4. To help get rid of the smell, fill the bag halfway with a mixture of 1part white vinegar and 3 parts water. Shake the bag and let it sit for 15 minutes.
   • If you cannot get the mixture into the bag, try putting the vinegar and water into a measuring cup with a pour spout. Then use the spout to help pour the mixture into the bag.
5. Rinse the bag with cool water. Hang it up to dry.

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How to prevent Foley catheter infections

Follow these guidelines to prevent getting infections while you have your catheter in place:

• Keep the drainage bag below the level of your bladder.
• Always keep your drainage bag off the floor.
• Keep the catheter secured to your thigh to keep it from moving.
• Do not lie on your catheter or block the flow of urine in the tubing.
• Take a shower every day to keep the catheter clean.
• Wash your hands before and after touching the catheter or bag.

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Common questions about caring for your Foley catheter

Can I place a Foley catheter myself?

No. Your catheter is placed by your healthcare provider.

How long can I wear my Foley catheter before it needs to be changed?

Your catheter should be replaced about once a month, if it stops working, or if you have an infection.

Can I poop when I have a Foley catheter?

Yes. Your catheter will not affect your pooping.

Can I get an erection with a Foley catheter?

Yes. You can get an erection with a catheter in place.

Can I drive with a Foley catheter?

You can drive with a catheter unless your healthcare provider gives you other instructions.

Can I exercise with a Foley catheter?

Ask your healthcare provider if you can exercise while you have a Foley catheter in place.

Can I swim with a Foley catheter?

No. You cannot swim with a catheter in place.

Can I fly on an airplane with a Foley catheter?

Yes. You can fly on an airplane with a catheter.

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When to call your healthcare provider

Call your healthcare provider right away if:

• Your catheter comes out. Do not try to put it back in yourself.
• You have a fever of 101°F (38.3 °C) or higher.
• You’re making less urine than usual.
• You do not have urine draining into your drainage bag.
• Your urine smells bad.
• You have bright red blood or large blood clots in your urine.
• You have abdominal (belly) pain and no urine in your catheter bag.

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Clinical Guidelines (Nursing) : Indwelling urinary catheter

Introduction

Aim 

Definition of Terms

Indications

Preparation 

Catheter size

Procedure for insertion of urinary catheter 

Special precautions

Documentation

Ongoing nursing management

Troubleshooting

Removal of urinary catheter 

Complications

Discharge information

Companion documents

References

Introduction

Insertion of an indwelling urethral catheter (IDC) is an invasive procedure that should only be carried out using aseptic technique, Insertion of an indwelling urethral catheter (IDC) is an invasive procedure that should only be carried using aseptic technique, either by a nurse, or doctor if complications or difficulties with insertion are anticipated. Catheterisation of the urinary tract should only be done when there is a specific and adequate clinical indication, as it carries a risk of infection.


Aim

To ensure the insertion and care of the urinary catheter is carried out in a safe manner that minimises trauma and infection risks.
 

Definition of terms

• Indwelling Urinary Catheter (IDC): A catheter which is inserted into the bladder, via the urethra and remains in situ to drain urine.  
  
• Oliguric: a reduction in urine output.
  
• Paraphimosis: occurs when the foreskin is left in a retracted position. The pain and swelling may make it difficult to return the foreskin to the non-retracted position, this may reduce blood flow to the tip of the penis which if left untreated could lead to necrosis of the glans penis. 

Indications

• To drain the bladder prior to, during, or after surgery
  
• For investigations
• To accurately measure the urine output 
• To relieve retention of urine
  
• To relieve urinary incontinence when no other means is practical
  

Preparation

Preparation of the child and family

• Gain patient/primary care givers consent for procedure
• Families/primary care givers should be given a thorough explanation of
  the procedure. Involve the parents where possible when providing an age
  appropriate explanation of the procedure to the patient.
• Consider the need for a referral to play therapy to assist in explaining
  and preparing the patient for the procedure. Play therapists are also able to
  empower the child to identify distraction techniques, as well as provide
  support and distraction throughout the procedure.
• Nursing staff should discuss and plan procedural pain management with
  the child and family prior to the procedure. This may include non pharmalogical
  (including distraction techniques) and pharmalogical considerations including
  Nitrous Oxide or sedation if necessary. For more information regarding this
  please see the Procedural Pain Management guideline.

Preparation of Environment and Equipment

Ensure the patient’s privacy is maintained throughout the procedure and that they are kept warm. Ensure there is adequate light to perform the procedure.

Prepare the following equipment:

• Dressing trolley
  
• Catheterization pack and drapes
  
• Sterile gloves
  
• Appropriate size catheter (see
  catheter size guideline below)
  
• Sterile Lubricant and/or Xylocaine jelly syringe (plain sterile lubricant for infants)
  
• Sterile water to inflate balloon (normal saline can crystallise and render the balloon porous, causing its deflation and the risk of catheter loss)
  
• 5ml/10ml Syringe
  – as stated on catheter packaging
• Specimen jar
  
• Sterile normal saline
  
• Straps/tape to secure catheter to leg
  
• Drainage bag
• Waterproof sheet

Catheter size

Use an appropriate size catheter depending on the age of the child. Catheters that are too big or small are at risk of urethral trauma or leakage. The rational for IDC insertion should also be considered when selecting catheter, for example a patient requiring an IDC post kidney trauma may require a larger size to provide adequate drainage of potential blood clots. Consider silicone catheter if for long term use. 

Procedure for insertion of urinary catheter 

The need for an IDC should be discussed with the patients’ medical team
prior to insertion. Medical approval for IDC insertion should be ordered and/or
documented.

The following should be completed in line with the RCH Aseptic Technique Procedure. 

Female child

• Perform hand hygiene
  
• Place child in supine position with knees bent and hips flexed
  
• If soiling evident, clean genital area with soap and water first
• Perform hand hygiene
• Open dressing pack (aseptic field) and prepare equipment needed using
  aseptic technique
• Pour sterile normal saline onto tray
• Perform aseptic hand wash and don sterile gloves
• Apply sterile drapes/towel
• Separate labia with one hand and expose urethral opening. In neonates,
  the urethral meatus is immediately above the hymeneal fringes.
• Using swabs held in forceps in the other hand clean the labial folds and
  the urethral opening. Move swab from above the urethral opening down towards
  the rectum. Discard swab after each urethral stroke into waste bag or
  designated waste area.
• Remove catheter wire if a 6Fr catheter is used
• Lubricate catheter
• Insert catheter into the urethral opening, upward at approximately 30
  degree angle until urine begins to flow.
• 
  Inflate the balloon slowly using sterile water to the volume recommended
  on the catheter. Check that child feels no pain. If there is pain, it could
  indicate the catheter is not in the bladder. Deflate the balloon and insert the
  catheter further into the bladder. ALWAYS ensure urine is
  flowing before inflating the balloon. Note that in a child under 6 months a
  balloon is not typically used. In this case be especially mindful that
  strapping is secure.
• Withdraw the catheter slightly until resistance is felt and attach to
  drainage system
• Remove gloves and perform hand hygiene
• Secure the catheter to the thigh with either a catheter securement
  device or tape
• Clean trolley and dispose of used articles into yellow biohazard bag
• Perform hand hygiene 

Male child

• Perform hand hygiene
  
• Place child in supine position
• If soiling evident, clean genital area with soap and water first
• Perform hand hygiene
• Open catheter pack (aseptic field) and prepare equipment needed using
  aseptic technique
• Pour sterile saline onto tray
• Perform aseptic hand wash and don sterile gloves
• Lift the penis and retract the foreskin if non-circumcised. Do not force
  the foreskin back, especially in infants. A sterile gauze swab can be used to
  hold the penis. 
• Using other hand, clean the urethral opening with swabs held in forceps.
  Use a circular motion from the urethral opening to the base of the penis.
   Discard swab into waste bag or designated waste area. 
• For boys older than 3 years insert the Xylocaine gel into the urethra.
  Gently hold the urethra opening closed and wait 2 – 3 minutes to give the gel
  time to work. For infants apply sterile lubricant to catheter before insertion.
  Post urology surgery consider using two syringes of xylocaine gel to increase
  lubrication of the urethra and decrease risk of trauma.
• Remove the wire if using a 6Fr catheter
• Hold the penis with slight upward tension and perpendicular to the
  child’s body. Insert the catheter.
• When the first sphincter is reached (at level of pelvic floor muscles)
  gently bring the penis down to face the child’s toes, apply constant gentle
  pressure. If resistance is felt the following strategies should be considered:
  • Remove the catheter and utilise a 2nd tube of lubricant
  • Increase traction on penis and apply gentle pressure on the catheter
  • Ask the child to take a deep breath
  • Ask the child to cough and bear down e.g. try to pass urine
  • Gently rotate the catheter.

If unable to pass the catheter seek assistance from treating medical team or Urology registrar. DO NOT use force as you may damage the urethra.

• Advance the catheter and gently insert it completely into the urethra
  until the connection portion.
  
• ALWAYS ensure urine is flowing before
  inflating the balloon.
  
• Inflate the balloon slowly using sterile water to the volume recommended
  on the catheter. Check that child feels no pain. If there is pain, it could
  indicate the catheter is not in the bladder. Deflate the balloon and insert the
  catheter further into the bladder. Note that in a child under 6 months a
  balloon is not typically used. In this case be especially mindful that strapping
  is secure.
• Withdraw the catheter slightly till resistance is felt and attach to
  drainage system
• Reposition the foreskin if applicable
• Remove gloves and perform hand hygiene
• Secure the catheter to the thigh with either catheter securement device
  or tape
• Clean trolley and dispose of used articles into yellow biohazard bag
• Perform hand hygiene 

Special precautions

Rapid drainage of large volumes of urine from the bladder may result in hypotension and/or haemorrhage. If concerned clamp catheter if the volume seems excessive. Release clamp after 20 minutes to allow more urine to drain. A medical review of the child should be requested.

For post obstructive diuresis IV replacement of fluid and electrolytes may be required. This should be discussed with the treating medical team.

Documentation

Insertion of the IDC should be documented in the LDA activity. 

• Including catheter type, length and size 
• Amount of water instilled into balloon 
• Document all procedures and cares involving IDC cares

Ongoing nursing management

• Measure urine output as indicated 1 – 4 hourly, assessing the colour and concentration of urine output.        
• Unless otherwise specified by the treating team, normal paediatric urine output is 1-2ml/kg/hr. Report any variation from this to the treating medical team.  
  • Certain drugs will increase diuresis, such as diuretics and ACE inhibitors.
    
  • If oliguric ensure catheter is not blocked (see
    trouble shooting below).
    
  • Record fluid balance. A fluid balance which keeps the urine dilute will lessen the risk of infection. This may not be possible due to the clinical condition of the child.
    
• The IDC insertion site and securement should be assessed at least once a shift, to ensure the IDC is not pulling on the genitals and not twisted. 
  
• IDC drainage bags should be emptied once a shift at a minimum. 
  
• Position drainage bag to prevent backflow of urine or contact with the floor. Gravity is important for drainage and prevention of urine backflow. Ensure the drainage bag is below the level of the bladder, is not kinked or twisted and is secured.

Drainage system

Adherence to a sterile continuously closed method of urinary drainage has been shown to markedly reduce the risk of acquiring a catheter associated infection. Therefore breaches to the closed system should be avoided.

Consider changing the catheter tube and/or bag based on clinical indicators including infection, contamination, obstruction or if system disconnects. If the equipment is damaged or leaks, replace system and/or catheter using aseptic technique and sterile equipment.

Hygiene

• Routine hygiene should be maintained with routine bathing/showering, including daily clean IDC insertion site with warm soapy water and more frequently if build-up of secretions is evident
• Uncircumcised boys should have the foreskin gently eased down over the catheter after cleaning.
• Always check the strapping of the catheter is secure after hygiene is performed.

Infection surveillance

• Consider daily the need for the IDC to remain in situ. Remove as soon as no longer required to reduce risk of Urinary Tract Infection (UTI).
• Cloudy, offensive smelling or unexplained blood stained urine is not normal and needs further investigation.

Specimen collection

• Urine for for urinalysis or culture should be collected fresh from the needleless
  sampling port of catheter tubing (not drainage bag), this should be completed
  in line with the Aseptic Technique Procedure.
  • Clamp below the sampling point.  
  • Scrub sampling point vigorously with 70% alcohol and chlorhexidine (0.5% or 2%) soaked gauze or swabs for at least 15 seconds and allow to air dry 
  • Access port with a 10ml syringe to collect sample
  • Unclamp catheter
• Large volumes e.g. 24hr collection, can be collected from drainage bag.

Troubleshooting

• Catheter not draining/ blocked/patient oliguric
  
• Check catheter/tubing not kinked
  
• Check catheter is still secured to patient leg and that it  hasn’t migrated out of bladder
  
• Assess patient’s hydration status to ensure they are not dehydrated. Consider the need to perform a bladder scan to assess bladder volume. Escalate to medical team if concerned.
  
• The patency of a catheter can be checked via the sampling port or catheter tubing. A blocked catheter should be flushed via the catheter tubing, this is of particular importance in case of blood clots or mucus (for example after a bladder augment).  
  

The following techniques to check for patency and/or flush a catheter should be completed following the Aseptic Technique Procedure. 

Catheter leaking

• Ensure the catheter is still draining and that the urine is not overflowing around a blocked catheter. See above for tips regarding catheters not draining.
• If the catheter is a balloon catheter, make sure the balloon is still inflated. Hold the catheter tubing securely in the same position and empty the balloon to make sure the amount that has been placed initially in the balloon is still present. If not, reinflate the balloon to its initial volume with water. Deflation of the balloon happens easily with a 6Fr catheter.
• Check catheter size is correct for age/size of the child. Use of a balloon catheter in neonates should only be with consultation with the treating medical team.
• Consider the need to remove and reinsert a new catheter in consultation with the treating medical team.  

Removal of urinary catheter 

Equipment required for removal:

• Standard precaution PPE
• 5ml/10ml Syringe – as stated on catheter packaging
• Waterproof sheet
• Kidney dish / receiving container

Procedure:

• Explain procedure to child and family and gain consent.
• Check amount of water used to inflate IDC balloon.
• Gather equipment required for removal
• Ensure patient privacy and have patient in supine position. 
• Place waterproof sheet and/or kidney dish between patient legs.
• Perform hand hygiene & don gloves.
• Deflate balloon completely and remove any straps/tapes
• Gently withdraw catheter on exhale if possible, with rotation movements if necessary.
  • Bear in mind that once inflated, the balloon won’t deflate to its total initial flat state and the balloon portion of the catheter will remain larger than the catheter itself.
    • If resistance felt and catheter cannot be easily removed do not force, leave catheter in situ and consult medical team. 
    • Consider cutting the catheter at the balloon inflation point to ensure the balloon is deflated. 
    • Once removed inspect catheter for intactness. Report if not intact.
• Perform hand hygiene.
• Document catheter removal in the LDA activity.
• Observe for urine output post catheter removal.
• If the patient has not passed urine 6 – 8hours post catheter removal
  assess the patient’s hydration status and consider the need to perform a
  bladder scan. Discuss findings with the treating medical team. 

Complications 

• Inability to catheterise: ensure appropriate catheter size has been
  selected based on the age/size of the child. Ensure adequate procedural pain relief
  and distraction is in place during the procedure.
  • Escalate to the treating medical team and consider the need for a
    referral to the urology team.  
  • In young girls, the urethra can be difficult to localise and the
    catheter can go directly in the vagina. In this case, leave the first catheter
    in the vagina and use another one to place immediately above, which will be
    more likely to go in the urethra.
• Urethral injury may occur from trauma sustained during insertion or
  balloon inflation in incorrect position: it is very important to ensure the
  catheter is in the bladder before inflating the balloon, this can be confirmed
  by visualising the stream of urine prior to balloon inflation.
• Haemorrhage
• False passage (catheter pushed through urethral wall): The risk of false
  passage is actually higher when using a smaller catheters, ensure catheter size
  utilised is appropriate for child’s age and size.
• Urethral strictures following damage to urethra. This may be a long term
  problem
• Infection
  • To minimise risk of infection insertion of IDC’s must be performed using surgical aseptic technique with single use sterile gloves.  
  • Regular hygiene should be maintained whilst IDC is in situ. 
  • Where possible avoid disconnecting the IDC circuit to minimise risk of contamination
  • Monitor for and report signs of infection including fever, offensive smelling urine, unexplained blood or cloudy urine.
• Psychological trauma
• Paraphimosis due to failure to return foreskin to normal position following catheter insertion:
  • To minimise risk, remember to replace the foreskin to normal position in non-circumcised patients and check at catheter care or nappy change that the foreskin is in place.

Discharge information

• Some children will be discharged from the hospital with their IDC
  insitu. It is important to teach the families how to care for the catheter, how to
  perform hygiene, how to monitor the output and how to troubleshoot. Refer to  Kids Health
  Info Fact Sheet: Indwelling urinary catheter


Companion documents

Other RCH IDC resources available:

• Kids Health Info Fact Sheet: Indwelling urinary catheter

• RCH Teaching and supporting clean
  intermittent catheterisation for parents and children

References

• Anderson, C. , & Herring, R. (2019). Pediatric Nursing Interventions and Skills. In M. Hockenberry, D. Wilson, & C. Rodgers (Eds.), Wong’s Nursing Care of Infants and Children (pp. 701-704) St. Louis, Missouri: Elsevier.
• Australia and New Zealand Urological Nurses Society, (2014). Catheterisation Clinical Guidelines
• Australian Guidelines for the Prevention and
  Control of Infection in Healthcare (2019) pages 137-140
  https://www.nhmrc.gov.au/guidelines-publications/cd33
• Fasugba, O., Koerner, J., Mitchell, B. G., & Gardner, A. (2017). Systematic review and meta-analysis of the effectiveness of antiseptic agents for meatal cleaning in the prevention of catheter-associated urinary tract infections. Journal of Hospital Infection, 95(3), 233-242.
• Galiczewski, J. M. (2017). An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: direct observation of catheter insertion procedure. Intensive Critical Care Nursing. 40:26–34. Intensive & Critical Care Nursing, 41, 2. https://doi.org/10.1016/j.iccn.2017.04.002
• Gould, C., Umscheid,C., Agarwal,R., Kuntz,G., Pegues, D., & the Healthcare Infection Control Practices Advisory Committee (HICPAC). (2009) Guideline for prevention of catheter associated urinary tract infections (2009) Updated: June 6, 2019. https://www.cdc.gov/infectioncontrol/pdf/guidelines/cauti-guidelines-H.pdf
• Government of Western Australia Department of Health (2015). Indwelling Catheter: Blockage. Clinical Guideline, Women’s and Newborn Health Service, King Edward Memorial Hospital.
• Government of Western Australia Department of Health. Urethral Catheterisation Neonatal Guideline. (2019).
• Holroyd, S. (2019). Indwelling catheterisation: evidence-based practice. Journal of Community Nursing, 33(5), 40-46.
• NHS Southern Health, Urinary Catheter Care Guidelines (2020)
• Pradhan, S. K., & Das, K. (2017). Urinary Bladder Catheterization. Practical Procedures in Pediatric Nephrology, 4.
• Royal College of Nursing Catheter Care RCN Guidance for Healthcare Professionals (2019)
• Rowe, J. (2020). Urinary catheter management. Starship Hospital New Zealand.

Evidence table

Indwelling urinary catheter insertion and management evidence table

Please remember to
read the disclaimer.

The
development of this nursing guideline was coordinated by Liam Cunningham, RN, Day Medical Unit, and approved by the Nursing Clinical Effectiveness Committee. Updated September 2020.  

American journalist James Foley’s family confirmed his death. /ITAR-TASS/. Relatives of American journalist James Foley, who was executed by Islamic State (IS) militants, confirmed the fact of his death. The corresponding statement was distributed on August 20 by his family.

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Islamic State militants posted online footage of the execution of an American journalist Foley.

On behalf of her entire family, she asked “the kidnappers to spare the lives of the remaining hostages.” “Like Jim, they are not guilty of anything. They do not control the policy of the US government in Iraq, Syria or any other part of the world,” she added.

Representatives of the American administration, in turn, reported that the video that appeared on the Internet, most likely, really captured Foley’s execution. They also added that US President Barack Obama is scheduled to issue a special statement on the matter on Wednesday.

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The Islamic State, an extremist group operating in Iraq and Syria, released a video titled “Message to America” ​​on Tuesday evening. It shows footage of the execution of American journalist James Foley, who went missing in northwestern Syria on November 22, 2012. The video also shows Time magazine journalist Steven Sotloff, who went missing in Libya in August 2013. “The life of this American citizen, Obama, depends on your next decision,” IS militants said in a statement.

The authenticity of the video is being verified by US intelligence agencies. “The intelligence community is working to determine its authenticity as soon as possible,” White House National Security Council spokeswoman Caitlin Hayden said Tuesday. “If (the tape) is genuine, we are appalled by the brutal murder of an innocent American journalist and offer our deepest condolences to his family. and friends.”

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Obama said he ordered the bombing of militants in Iraq in the interests of US national security

On August 8, US President Barack Obama authorized airstrikes against Islamists in Iraq to protect US personnel and to aid Iraqi and Kurdish forces. Since then, US aircraft have carried out about 70 strikes against Islamic State positions in Iraq.

A day earlier, ISIS threatened to attack the Americans “anywhere” at its discretion if the US does not stop airstrikes on the group’s positions in Iraq. “We will drown you in blood,” the media quoted the extremists’ laconic message in English.

10 years of Iraqi sovereignty: from America’s ambitions to terrorist victories

Journalists killed in hot spots

Journalists killed in the line of duty are traditionally published by organizations such as Reporters Without Borders and the Committee to Protect Journalists.

According to the Committee to Protect Journalists, at least 1,070 journalists have been killed since 1992, when NGOs began compiling lists of dead journalists on a regular basis. The most tragic year was 2012: according to the International Press Institute, 133 journalists were killed last year.

According to Reporters Without Borders, 43 journalists have been on the death toll lists in this incomplete year. In recent years, the most dangerous countries for press workers have been Iraq, Afghanistan, Libya, Syria, and now Ukraine, where four of our colleagues were killed this year.

Since 1992, 165 journalists have been killed in Iraq, according to statistics from the Committee to Protect Journalists. In Syria, 66 journalists were killed during the same period, in Afghanistan – 26, in Libya – 8.

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The family of the executed Foley was forbidden to collect ransom money

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Maxim Makarychev

Michael Foley, the younger brother of American journalist James Foley executed by Islamic State militants, said that his family faced resistance and even threats from government officials. US structures during the campaign to free the hostage.

US policy does not allow government negotiations with terrorist organizations and the payment of ransoms for Americans kidnapped by them. Foley Jr. said the US administration hampered efforts by the journalist’s family to privately raise funds for his release.

“They got in our way,” Foley Jr. told Fox News journalist Megan Kelly in an exclusive interview about the US government’s role in saving his older brother.

The problem arose after the family of the journalist being held hostage launched their own campaign to raise funds for his ransom and subsequent release.

“I was threatened by the State Department when collecting a ransom for my brother,” said Michael Foley, making it clear that the US administration resisted this. “We were smart enough to let this information go by, but they slowed our work. We lost a lot of time.”

Photojournalist James Foley was abducted by militants in northern Syria in 2012 and held captive for 21 months before being executed by a terrorist group.

On August 19, a video of IS fighters was uploaded to YouTube under the title “Message to America”. Foley, a seasoned war journalist who worked for Boston’s GlobalPost, was filmed at an undisclosed location kneeling in the desert wearing an orange shirt and trousers, similar to those worn by Guantanamo Bay prisoners. After reading a statement condemning the US government and its air strikes in the region, Foley’s execution was carried out by militants.

The killer, who spoke with a British accent, threatened to kill American journalist Stephen Saltoff, who was also abducted in Syria. On September 2, Islamists released a video of Saltoff’s execution, which worked for Time magazine, as well as the Christian Science Monitor and other media outlets.

In the days following Foley’s execution, the White House claimed that a special force had been sent to Syria a month earlier on a secret mission to rescue the hostages, including Foley, but the operation to search for them was unsuccessful.

“Since his capture, we have been using every means at our disposal to try to bring him home to his family and to gather any information we could get about his whereabouts, his condition and the threats he faces.” ,” Caitlin Hayden, spokeswoman for the National Security Council, said last month.

The mother of the slain journalist, Diana Foley, said she learned of her son’s death from a journalist who was crying on the phone while reporting the tragic news.