Question

Hospital acquired infections (HAI) is preventable and considered "never events"

Indwelling foley catheterization should be the final means of providing the patient protection of dressings or skin lesions. Strict aseptic technique is mandatory.

1. Indicate at least 7 criteria for short-term indwelling foley catheter.

2. List at least 5 complications of long-term use of indwelling foley catheter and briefly describe or define them.

3. List at least 4 nursing interventions in maintaining the catheter.

Answer 1

1. Indications for Short-term indwelling catheterization

• Post surgery and in critically ill patients to monitor urinary output.
• Prevention of urethral obstruction from blood clots with continuous or intermittent bladder irrigations
• Instillation of medication into the bladder.
• Surgical procedures involving pelvic or abdominal surgery repair of the bladder, urethra, and surrounding structures.
• Urinary obstruction (e.g. enlarged prostate), acute urinary retention.
• Decompression of the bladder.
• Measure residual urine.
• Management of patients with spinal cord injury, neuromuscular degeneration, or incompetent bladders.

2. Complications of long term Foley's catheter;

Urinary tract infections - It is very common for patients to get UTIs from catheters. Some infections can be very deadly.

Cystitis - Cystitis is inflammation of the bladder and is most frequently caused by bacteria in the bladder due to a urinary tract infection, but can also be caused by certain drugs, radiation therapy, chemotherapy and long-term use of a urinary catheter.

Urethral Injury - Urethral injury due to trauma is a common complication associated with Foley catheters especially if the catheter is inserted forcefully or roughly.

Blood Infection - Blood infection, or sepsis, is a rare complication of bladder catheterization and is typically only found in patients requiring long-term catheterization.

• Narrowing of the urethra (this complication usually occurs in long term insertion due to scar tissue formation by the insertion of the catheter.

3.Nursing management

• Make sure that urine is flowing out of the catheter into the urine collection bag. Make sure that the catheter tubing does not get twisted or kinked.
• Keep the urine collection bag below the level of the bladder.
• Make sure that the urine collection bag does not drag and pull on the catheter.
• It is okay to shower with a catheter and urine collection bag in place, unless the doctor says not to.
• Check for inflammation or signs of infection in the area around the catheter. Signs of infection include pus or irritated, swollen, red, or tender skin.
• Clean the area around the catheter twice a day with water. Dry with a clean towel afterward.
• Do not apply powder or lotion to the skin around the catheter.
• Do not tug or pull on the catheter.
• A person should not have sexual intercourse while wearing a catheter.
• At night it may be helpful to hang the urine collection bag on the side of the bed.