[Learning Points]
- Learn catheter self-care techniques, including cleaning methods and techniques for securing the catheter to ensure hygiene and reduce the risk of infection.
- Know the dos and don’ts of a urinary catheter, including not twisting, pulling, or compressing it to ensure proper function, and avoiding touching the floor to prevent backflow of urine and infection.
- Learn to observe the color, volume and shape of urine, and empty urine bags regularly to maintain good urine excretion, maintain adequate water intake, and choose foods that help make urine acidic.
- Know the warning signs to return to the hospital for treatment.
Introduction
The foley catheter drainage is very important, your attentive care and cleanliness allows the catheter to maintain patency, and also greatly reduce the chance of infection.
The location that foley catheter can be inserted
- Insert through urethra
Foley catheter is inserted through your urethra, connect with drainage bag, and secured to your leg.
- Insert through cystostomy
Cystostomy is a passage from bladder to abdomen. It is located between the navel and suprapubic. Foley catheter is inserted through your cystostomy, connect with drainage bag, and secured to your body.
Who need foley’s catheter
- Prostatic hypertrophy may cause urinary retention.
- Diabetic cystopathy may cause urination difficulty.
- Patient who has spinal cord or brain injury, which may affect voiding function.
- Insert foley catheter temporary after surgery to solve urinating problems, and replace or remove, depending on doctor's orders.
- Stones, tumors, or inflammation may cause urethra stricture so you are unable to urinate.
- People who need to closely record urine output
How to care for your foley catheter at home
- If you are able to yourself for:
- Prepare: towel, medical tape
- Steps:
- Using water, clean your catheter every day when you shower.
- Dry the area with towel.
- Use medical tape to secure the catheter tube to your leg again so you do not pull or move the catheter.
- If you can not get out of bed, and you need some help:
- Prepare: towel, basin, pad, medical tape
- Steps:
- Wash your hand
- Place a pad under your hip.
- If you are female, wash the perineum with warm water and soap, then dry this area with towel.
- If you are male, wash the balanus with warm water and soap, then dry this area with towel.
- Use medical tape to secure the catheter tube to your leg again so you do not pull or move the catheter.
- Remove the pad.
- Wash your hand
Note: If you are female, you must separate the labia, or if you are male, you must pull the foreskin to clean up, and remember to reset the foreskin after cleaning.
- If foley catheter is inserted through your cystostomy:
- Prepare: 10% aqua beta-iodine, sterile normal saline, 3x3 inches of Y- type gauze, 3x3 inches of general gauze, sterile cotton swabs, medical tape
- Steps:
- Wash your hand
- Use sterile cotton swabs moistened with 10% aqua beta-iodine to disinfect the skin surrounding cystostomy about 5 centimeters, and wait for 2 minutes.
- Use sterile cotton swabs moistened with normal saline to clean up the beta-iodine.
- Use the Y- type gauze and general gauze to cover cystostomy, and secure them with medical tape.
- Use medical tape to secure the catheter tube to your body again so you do not pull or move the catheter.
- Wash your hand
Precautions- Keeping the drainage bag below the level of your waist can helps stop urine from moving back up the tubing and into your bladder to prevent infection.
- Your foley catheter should always be attached to other equipment to form a closed drainage system. Don’t disconnect any part of the closed system unless it is necessary such as when changing the bag. Always close the drainage spigot after emptying urine out of the drainage bag.
- Do not loop or kink the tubing so urine can flow out. And don’t pull the tubing to prevent hurt to your urethra caused by hematuria.
- Drinking at least 2000cc or more liquid a day, in order to avoid infection and urinary tract obstruction. Grapes, watermelon, asparagus, citrus will help urine become acidic to reduce urinary tract infections opportunities.
- Empty the drainage bag when it is ½ to ⅔ full. Always wash your hands before and after you touch the catheter, tubing, or drainage bag and keep drainage spigot clean. Don’t let the drainage bag touch or lie on the floor.
- The silicone catheter should be change every month. If you are in the following situation: your catheter comes out; the closed drainage system has accidentally come open or apart; urine leaks from or around the catheter, tubing, or drainage bag; there is less urine than usual or no urine draining into the bag; then contact your home care nurse or go to the clinic or even hospital to replace with a new one.
- Always change a new drainage bag with the foley catheter. If you see a layer of crystal inside, obstructing the tubing, you must replace the bag.
- Do not wipe back and forth when cleaning the perineum.
- Change the fixed position of the foley catheter every day.
When do you need to return to the emergency department for treatment?
- You have a fever, chills, or have pain in your waist, lower abdomen.
- You feel burning in the urethra, or increased pus discharge from your urethra. You have a cloudy urine, hematuria, pyuria.
- If your catheter is obstructed, and urine couldn’t flow out, and you feel bladder fullness.
- Cystostomy have pus discharge.
Conclusion
Keeping the foley catheter unobstructed can avoid inflammation of the urinary tract and reduce the incidence of infection. If you have a sudden fever, urethral pain or bloody urine, you should seek medical attention immediately.
References
- Chuang, P.Y., Chen, C.C., Huang, Y.F., Liu, Y.C. (2021). Improvement of the accuracy of indwelling urinary catheter care in foreign caregivers. Tzu Chi Nursing Journal, 20(50), 86-99. https://doi.org /10.6974/TCNJ
- Chen, S.T., Cheng, C.H., Fan, L.K. (2019). A project for improving the completion rate of bundle care on catheter-associated urinary tract infection. National Taiwan University Hospital Nursing Journal, 15(1), 218-232. https://doi.org/10.6740/ NTUHJN.201901_15(1).0019
- McCleskey, S. G., Shek, L., Grein, J., Gotanda, H., Anderson, L., Shekelle, P. G., Keeler, E., Morton, S., & Nuckols, T. K. (2022). Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: A systematic review. BMJ Quality & Safety, 31(4), 308–321. https://doi.org/10.1136/bmjqs-2021-013839