What is a Foley catheter and how is it used. How is a Foley catheter inserted. What are the potential complications of using a Foley catheter. How to properly care for a Foley catheter at home. When to seek medical attention for Foley catheter issues.

Understanding the Foley Catheter: Purpose and Function

A Foley catheter is a critical medical device used for urinary drainage. This sterile tube is inserted into the bladder to collect and remove urine when a patient is unable to urinate independently. But how exactly does it work?

The Foley catheter features a small balloon at its tip, which is inflated with a sterile solution after insertion. This balloon serves a crucial purpose: it anchors the catheter securely within the bladder, preventing accidental dislodgement. The open end of the catheter is then connected to a drainage bag, creating a closed system for urine collection.

Are there different types of Foley catheters? Indeed, Foley catheters come in various sizes and materials to suit different patient needs. Some are made of latex, while others are silicone-based for patients with latex allergies. The size of the catheter is measured in French units, with typical sizes ranging from 12 to 30 French for adults.

The Foley Catheter Insertion Procedure: What to Expect

The insertion of a Foley catheter is a sterile procedure typically performed by a healthcare professional. Here’s a step-by-step breakdown of what occurs during the insertion:

1. The patient’s genital area is thoroughly cleaned with an antiseptic solution to minimize the risk of infection.
2. The healthcare provider inserts the lubricated catheter through the urethra and into the bladder.
3. Once urine begins to flow into the tubing, confirming correct placement, the balloon at the catheter’s tip is inflated.
4. The catheter is gently pulled back to ensure the balloon is securely positioned against the bladder neck.
5. Finally, the open end of the catheter is connected to a sterile drainage bag.

Is the insertion procedure painful? While some patients may experience discomfort or a burning sensation during insertion, the procedure is generally not considered painful. Healthcare providers often use a lubricating gel to ease the insertion process and minimize discomfort.

Essential Care Guidelines for Foley Catheters

Proper care of a Foley catheter is crucial to prevent complications such as infections or catheter-related injuries. Here are some essential care guidelines:

• Hand hygiene: Always wash hands thoroughly before and after handling the catheter or drainage system.
• Genital hygiene: Clean the genital area twice daily and after each bowel movement.
• Secure the catheter: Use medical tape or a leg strap to prevent tugging or movement of the catheter.
• Maintain a closed system: Keep the catheter connected to the drainage bag at all times, unless changing the bag.
• Position the drainage bag: Always keep the bag below waist level to prevent backflow of urine.
• Regular emptying: Empty the drainage bag every 3-6 hours or when it’s â…” full.
• Bag cleaning and changing: Follow healthcare provider instructions on cleaning and changing the drainage bag.

How often should the catheter itself be changed? The frequency of catheter changes depends on individual circumstances and healthcare provider recommendations. Typically, long-term indwelling catheters are changed every 2-4 weeks, but this can vary based on factors such as the type of catheter material and the patient’s specific needs.

Recognizing and Addressing Common Foley Catheter Issues

While Foley catheters are generally safe when properly managed, certain issues may arise. It’s important to recognize these problems and know how to address them:

No Urine Drainage

If no urine is draining into the bag, check for:

• Kinks in the tubing
• Blockages from tape or straps securing the catheter
• Proper positioning of the drainage bag below waist level

Urine Leakage

If urine is leaking from or around the catheter, tubing, or drainage bag:

• Check if the closed drainage system has accidentally opened
• Clean the catheter and tubing ends with an alcohol pad and reconnect if necessary

Can these issues be prevented? Many common catheter problems can be avoided through proper care and regular monitoring. Staying vigilant about hygiene, maintaining the closed system, and following healthcare provider instructions are key to preventing complications.

Potential Complications and Risks of Foley Catheters

While Foley catheters are invaluable medical tools, they do carry some risks. Understanding these potential complications can help patients and caregivers stay alert to warning signs:

• Urinary tract infections (UTIs): The most common complication, often resulting from bacteria entering the urinary system.
• Bladder spasms: Involuntary contractions of the bladder, which can cause discomfort and leakage around the catheter.
• Urethral injury: Improper insertion or prolonged use can lead to damage of the urethra.
• Bladder stones: Long-term catheter use may increase the risk of bladder stone formation.
• Catheter encrustation: Mineral deposits can build up on the catheter, potentially blocking urine flow.

How can these complications be minimized? Strict adherence to hygiene protocols, regular catheter changes, and proper catheter care can significantly reduce the risk of these complications. Additionally, using the smallest appropriate catheter size and removing the catheter as soon as it’s no longer needed can help prevent issues.

When to Seek Immediate Medical Attention

While minor issues with Foley catheters can often be managed at home, certain situations require prompt medical attention. Patients or caregivers should seek immediate care if:

• The catheter comes out unexpectedly
• There’s sudden appearance of sand-like material in the tubing or drainage bag
• No urine is draining despite troubleshooting measures
• The patient experiences pain in the hip, back, pelvis, or lower abdomen
• The patient becomes confused or unable to think clearly

Why is immediate attention necessary in these cases? These situations could indicate serious complications such as catheter dislodgement, urinary tract obstruction, or systemic infection, which require professional medical intervention to prevent further health risks.

Long-term Management and Quality of Life with a Foley Catheter

Living with a long-term Foley catheter requires adjustment, but many patients successfully incorporate catheter care into their daily routines. Here are some tips for maintaining quality of life:

• Establish a care routine: Set regular times for catheter care and drainage bag emptying.
• Stay hydrated: Adequate fluid intake helps prevent urinary tract infections and catheter blockages.
• Maintain mobility: With proper securing, most patients can remain active with a Foley catheter.
• Consider clothing adaptations: Loose-fitting clothes can help conceal the catheter and drainage bag.
• Join support groups: Connecting with others who use long-term catheters can provide valuable emotional support and practical tips.

How can patients maintain intimacy with a Foley catheter? Intimacy is still possible with a Foley catheter. Open communication with partners, exploring alternative forms of intimacy, and consulting healthcare providers for specific advice can help maintain a fulfilling relationship.

Living with a Foley catheter may present challenges, but with proper care, education, and support, many patients successfully manage their catheters while maintaining a good quality of life. Regular communication with healthcare providers and staying informed about catheter care best practices are essential for long-term success and well-being.

Foley Catheter Placement and Care

Medically reviewed by Drugs.com. Last updated on Jun 6, 2023.

• Care notes
• Aftercare
• Ambulatory
• Discharge
• Español

What is a Foley catheter?

A Foley catheter is a sterile tube that is inserted into your bladder to drain urine. It is also called an indwelling urinary catheter. The tip of the catheter has a small balloon filled with solution that holds the catheter in your bladder.

How is a Foley catheter placed?

Your genital area will be cleaned to prevent infection. The catheter will be inserted into your urethra. When urine begins to flow into the tubing, the balloon is filled to keep the catheter in place. Then, the open end will be attached to a drainage bag.

How do I care for my catheter and drainage bag?

You can reduce your risk for infection and injury by caring for your catheter and drainage bag properly.

• Wash your hands often. Wash before and after you touch your catheter, tubing, or drainage bag. Use soap and water. Wear clean disposable gloves when you care for your catheter or disconnect the drainage bag. Wash your hands before you prepare or eat food.
  
• Clean your genital area 2 times every day. Clean your catheter area and anal opening after every bowel movement.
  • For men: Use a soapy cloth to clean the tip of your penis. Start where the catheter enters. Wipe backward making sure to pull back the foreskin. Then use a cloth with clear water in the same direction to clean away the soap.
  • For women: Use a soapy cloth to clean the area that the catheter enters your body. Make sure to separate your labia and wipe toward the anus. Then use a cloth with clear water and wipe in the same direction.
• Secure the catheter tube so you do not pull or move the catheter. This helps prevent pain and bladder spasms. Healthcare providers will show you how to use medical tape or a strap to secure the catheter tube to your body.
• Keep a closed drainage system. Your catheter should always be attached to the drainage bag to form a closed system. Do not disconnect any part of the closed system unless you need to change the bag.
• Keep the drainage bag below the level of your waist. This helps stop urine from moving back up the tubing and into your bladder. Do not loop or kink the tubing. This can cause urine to back up and collect in your bladder. Do not let the drainage bag touch or lie on the floor.
• Empty the drainage bag when needed. The weight of a full drainage bag can be painful. Empty the drainage bag every 3 to 6 hours or when it is ⅔ full.
• Clean and change the drainage bag as directed. Ask your healthcare provider how often you should change the drainage bag and what cleaning solution to use. Wear disposable gloves when you change the bag. Do not allow the end of the catheter or tubing to touch anything. Clean the ends with an alcohol pad before you reconnect them.

What can I do if problems develop?

• No urine is draining into the bag:
  • Check for kinks in the tubing and straighten them out.
  • Check the tape or strap used to secure the catheter tube to your skin. Make sure it is not blocking the tube.
  • Make sure you are not sitting or lying on the tubing.
  • Make sure the urine bag is hanging below the level of your waist.
• Urine leaks from or around the catheter, tubing, or drainage bag: Check if the closed drainage system has accidently come open or apart. Clean the catheter and tubing ends with a new alcohol pad and reconnect them.

When should I seek immediate care?

• Your catheter comes out.
• You suddenly have material that looks like sand in the tubing or drainage bag.
• No urine is draining into the bag and you have checked the system.
• You have pain in your hip, back, pelvis, or lower abdomen.
• You are confused or cannot think clearly.

When should I call my doctor?

• You have a fever.
• You have bladder spasms for more than 1 day after the catheter is placed.
• You see blood in the tubing or drainage bag.
• You have a rash or itching where the catheter tube is secured to your skin.
• Urine leaks from or around the catheter, tubing, or drainage bag.
• The closed drainage system has accidently come open or apart.
• You see a layer of crystals inside the tubing.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright Merative 2023 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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.  

How to insert a Foley catheter?

Foley catheter is a type of urinal that differs in the form of a retaining inflatable balloon. The equipment was named in memory of the American urologist Frederick Foley and is actively used:

• for the removal of urinary fluid;
• drug withdrawal;
• in X-ray studies;
• in obstetrics;
• in traumatology.

Widespread in medicine due to increased sterility, and large lateral holes provide strong drainage. The device is considered safe for insertion into the bladder due to the high patency through the urethra – suitable for a short or long period.

Indications for catheter insertion

Bladder drainage is a common procedure in urological clinics. The process is presented in the form of introducing a special tube – a catheter – into the bladder. It is used for diagnostic or prophylactic purposes. The use of a Foley catheter to drain the urethra is recommended by doctors if the following symptoms appear:

• urinary retention;
• kidney problems;
• inflammation inside the bladder;
• diagnosis of the amount of residual urine;
• administration of drugs into the urethra;
• operations using anesthesia or standard anesthesia.

If you have at least one of the above symptoms, you should contact your doctor for advice to provide timely assistance to the body!

Types of Foley catheters

When buying a Foley catheter, you should pay attention to the material from which it is made. Depending on the components of the urinal, short-term or long-term drainage will be carried out in the absence of the ability to empty the bladder on its own. Foley catheters are divided into two main types, divided by size into men’s, women’s and children’s.

1. Latex catheters

When using a latex Foley catheter for more than 30 days, inflammatory or allergic processes are formed. Latex devices with a hydrophilic coating are less traumatic and, upon contact with the water surface, become smooth and slippery – this makes it possible to drain the urethra painlessly.

Main parameters of latex catheters:

• high strength;
• high level of elasticity;
• anti-deformation.

2. Silicone catheters

Despite the large number of advantages, the main disadvantage is the high cost due to the difficulties in production. Silicone catheters have the following characteristics:

• human biocompatible component – silicone;
• high temperature resistance;
• is intended for long-term catheterization, up to 12 weeks;
• does not cause allergies due to the biological compatibility of silicone with humans;
• absence of saline encrustations (formation of blockages) in the catheter;
• slow growth of bacteria due to silicone material.

The forerunner of silicone catheters is considered to be silver-plated, made of silicone with a layer of silver.

Detailed Instructions for Foley Catheter Insertion

Attention! Only a physician should insert the catheter for safety and ease of insertion. Detailed instructions are given below and are suitable for inserting the catheter into the urethra for both men and women:

1. Thoroughly clean the vulva, then insert the disposable catheter into the bladder.
2. Next, attach the special funnel to the connecting tube of the equipment.
3. Make sure the catheter is secure and fill the balloon with the recommended amount of sterile water.
4. Drugs can be administered using an additional port in a 3-way Foley catheter.
5. Check the flow of urinary fluid into the balloon.
6. Do not pinch or twist the outside of the device.
7. If overfilled, remove fluid and install new bottle.

Detailed Instructions for Foley Catheter Removal

To remove a Foley catheter, patients are advised to go to the hospital to see their doctor. Removal of drainage from the bladder requires the use of local anesthesia and the insertion of a cystoscope. Inside the urinary canal, the free end of the tube is captured by a special tool – a maniple, after which the Foley catheter is removed from the human body. The operation is performed manually inside a sterile cabinet.

Complications after a catheter that require a doctor’s consultation

If the following symptoms appear after the catheter is removed, the patient should immediately contact the doctor to eliminate the problem:

• bloody discharge in the urine;
• bleeding from the vulva;
• burning in the intimate area;
• fever;
• onset of fever;
• specific smell of urine.

How often should a Foley catheter be changed?

• Silicone catheter can be used up to 30 days;
• Latex catheter used up to 7 days;
• Silver plated is an obsolete type of catheter and is used up to 3 months.

How to care for the catheter?

With proper use of the Foley catheter, cleansing is not required and occurs naturally. To enhance the cleansing properties, patients are given cranberry juice, berries and herbal decoctions in the diet. Flushing required after:

• appearance of salts on the walls;
• turbidity of the urinary fluid;
• clogging of the lumen of the urine output tube.

The fluid is drained every 3-4 hours – this is how long it takes to completely fill the balloon. Urinary fluid is drained from a reusable urinal and washed with antiseptics for subsequent use, and a disposable one is disposed of and replaced with a new sterile balloon.

How do I clean my catheter at home?

For rinsing, use a solution of “Dioxydin” in proportions of 1:40 with water or tablets “Furacillin” 0.1 milligram per 100 milliliters of water. You can rinse with a ready-made remedy from a pharmacy, which the doctor will prescribe for the patient.

Instructions for proper cleaning of the catheter:

1. Wash your hands and remove the syringe, draw up the solution.
2. Disconnect the urinal, treat the ends of the tube with antiseptic solutions.
3. Insert the syringe and slowly dispense the solution.
4. First pour 20-30 milliliters of solution, after draining, repeat the previous steps three times.
5. Attach the urinal back to the balloon.

Consult a doctor to clean the catheter yourself.

How do I shower with a catheter?

• you can take a standard shower with a night bag;
• it is not recommended to take a shower with the device attached to the leg in order to avoid complications;
• It is strictly forbidden to take a bath with a urinal installed, wait until the Foley catheter is removed, otherwise you risk infection.

Conclusion

Foley catheter is an effective medical device for the treatment of diseases of the urethra and drainage of urinary fluid. Modern catheters do not cause discomfort, are easy to maintain and are sterile. An additional advantage is a wide range of models in terms of size and service life, which greatly simplifies the work for patients or medical professionals.

In the Medprofi store you can buy a Foley catheter for yourself or your family. If you have any questions or need help with the choice, our consultants will be happy to help

The materials posted on this page are for informational purposes and are intended for educational purposes. Determining the diagnosis and method of treatment remains the prerogative of your doctor.

The materials posted on this page are for informational purposes and are intended for educational purposes. Determining the diagnosis and method of treatment remains the prerogative of your doctor.

Foley catheters | Urology

Foley catheters | Urology

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Republic of Kazakhstan,
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Urological catheters

Foley catheters

Additional information

Foley Catheter 2 Way Latex Child (270mm)

Foley catheter 2 way Latex Standard (400 mm)

Foley Catheter 2 Way Latex Female (260 mm)

Foley catheter 3 way Latex Standard (400 mm)

Foley catheter Silicone (400 mm)

Description

Foley catheters have a very wide range of applications:

Induction of labor by dilating the cervix. Problems with urination caused by trauma, treatment or diseases of the urinary system. Preparation for the operation. Diagnosis of infectious and other urological diseases. The use of Foley catheters for urinary retention is very effective: the outflow of urine begins already at the time of installation. Catheters of this type are most often recommended for patients who need long-term catheterization.

A distinctive feature of the Foley catheter is two or three independent entrances, which can be used for bladder lavage, hemostasis, instillations.

Classic two-way Foley catheter has one common channel and two passages: one serves to drain urine, and through the second one fills the balloon to fix the catheter in the bladder. Such a system allows maintaining sterility and minimizing the development of side effects.

In a three-way catheter, there is a 3rd channel for the introduction of medicines into the bladder cavity, unlike the previous one. It is a more modern and multifunctional model and has a wider range of applications.