A Foley catheter is a flexible tube inserted through the urethra into the bladder, allowing urine to drain into an external collection bag. This indwelling device provides a continuous drainage pathway for individuals unable to empty their bladder naturally. The presence of the catheter creates a direct route for bacteria to enter the urinary system, significantly increasing the risk of a Catheter-Associated Urinary Tract Infection (CAUTI). Proper, consistent cleaning of both the catheter and the drainage system is necessary to minimize this infection risk and maintain comfort.
Essential Supplies and Setup
Before beginning any cleaning procedure, gathering the necessary materials ensures the process is efficient and sanitary. You will need mild, unscented liquid soap, warm water, and clean washcloths or gauze pads. A separate, clean container for rinsing water is helpful if you are not near a sink or shower. Hand hygiene is the first step, requiring a thorough washing of hands with soap and water for at least 20 seconds, or using an alcohol-based hand sanitizer. Once your hands are clean, put on non-sterile gloves, which provide an additional layer of protection. Having a catheter securement device, such as a leg strap, is helpful to prevent accidental pulling on the tubing. This preparation ensures all necessary items are within easy reach, allowing the cleaning to proceed smoothly.
Daily Cleaning Procedures for the Catheter and Area
Cleaning the catheter and the meatus (the insertion site) should be performed at least twice a day, typically morning and evening. Secure the catheter to your leg or abdomen to prevent tugging during the cleaning process. This securing step helps maintain the integrity of the connection and prevents irritation to the urethral opening. Start by gently washing the entire genital and perineal area with mild soap and warm water.
For women, the cleaning motion should be from front to back to prevent transferring bacteria toward the urethra. Men should thoroughly clean around the tip of the penis, and if uncircumcised, the foreskin must be gently retracted to clean the exposed surface before being returned to its normal position. Focus on the catheter tubing, starting where it exits the body. Hold the catheter gently at the meatus with one hand and, using a soapy washcloth, wipe the tubing away from the body. Clean the first two inches of the tubing closest to the body, as this area is the most likely entry point for external bacteria.
After cleaning the area and the catheter tube, rinse thoroughly with clean water to remove all soap residue, which could cause skin irritation. Pat the entire area dry with a clean towel, taking care not to rub the skin. Wash your hands again after completing the routine.
Cleaning and Maintenance of the Drainage System
Managing the drainage system involves routinely emptying the collection bag and performing periodic cleaning of the bag itself. The drainage bag must always be kept below the level of the bladder; this prevents the backflow of urine, which can introduce bacteria and cause infection. The bag should never rest on the floor.
Routine emptying is necessary when the bag is approximately half to two-thirds full, or at least every eight hours, to prevent the weight of the fluid from pulling on the catheter. When emptying, the drain spout should be held over a toilet or a measuring container. Prevent the spout from touching the inside rim of the receptacle. After the bag is empty, the spout should be wiped with an alcohol wipe or clean tissue before being closed and secured back in its holder.
Cleaning the Drainage Bag
To clean the drainage bag, a common at-home method involves using a diluted solution of white vinegar and water, typically mixed in a ratio of one part vinegar to three parts water. A mixture of one tablespoon of bleach to half a cup of water is another option to disinfect the bag. After emptying the bag and rinsing it with cool tap water, pour the cleaning solution into the bag. Shake it gently to coat the inside, and let it soak for about 15 to 30 minutes. Drain the solution, rinse the bag again with cool water to remove all traces of the cleaning agent, and then hang it up to air-dry with the spout open and pointed down.
Recognizing Signs of Infection and When to Seek Help
Despite meticulous cleaning, the risk of a CAUTI remains, and recognizing the early signs of infection is necessary for timely treatment. Indicators include a change in the urine, such as it becoming cloudy, dark, or having a strong, foul odor. The presence of blood in the urine (hematuria) is another symptom.
Physical discomfort is also a sign, including pain or tenderness in the lower abdomen or the flank area just below the ribs. Systemic symptoms like a fever above 100.4°F (38°C), chills, or body aches suggest the infection may be spreading. In older adults, a sudden onset of confusion or a change in mental status may be the only apparent sign of a urinary infection.
Contact a healthcare provider immediately if you notice any of these signs. Immediate medical attention is required for an absence of urine draining into the bag for several hours, even with adequate fluid intake, or the catheter leaking urine around the insertion site. Any symptom that causes significant concern or is not improving within 48 hours should prompt a call to your medical team.