A Foley catheter is a thin, flexible tube inserted through the urethra into the bladder to continuously drain urine. It is always connected to a collection device. The leg bag serves as a smaller, more discreet reservoir worn on the leg, allowing for mobility and concealment under clothing during the day. Properly attaching this bag to the catheter tubing is a necessary procedure to maintain the closed drainage system and prevent infection.
Preparing the Supplies and Area
The process begins by observing infection control practices, starting with hand hygiene. Wash your hands thoroughly with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer. This action reduces the risk of introducing bacteria into the urinary tract system, which can lead to a urinary tract infection (UTI).
Next, collect all the necessary supplies. These include the new, clean leg bag, a pair of clean, non-sterile gloves, antiseptic wipes (typically alcohol prep pads), and a clean towel or pad to place under the connection site. A waste receptacle should be positioned nearby for immediate disposal of used items. Having everything within easy reach minimizes the time the system is open and exposed to the environment.
Position the person comfortably, ensuring easy access to the end of the Foley catheter tubing, which is usually secured to the thigh. Place a clean, absorbent towel or pad beneath the connection point. This towel will catch any residual urine drops when the old bag is disconnected, keeping the area clean and dry.
Step-by-Step Connection Procedure
Once the area is prepared, put on the clean, non-sterile gloves to maintain cleanliness throughout the procedure. Before disconnecting the existing drainage bag, pinch and hold the soft rubber catheter tubing close to the connection site. Pinching the tubing stops the flow of urine, preventing leakage and minimizing contamination when the system is opened.
With the tubing pinched, gently disconnect the old drainage bag by twisting and pulling the connector apart from the catheter tubing. Immediately place the old bag aside on the absorbent towel, ensuring the exposed connector tip does not touch any surface. The next step involves cleaning the exposed tip of the Foley catheter tubing and the connector on the new leg bag.
Use a fresh antiseptic wipe, such as an alcohol prep pad, to thoroughly clean the end of the catheter tubing. Next, take the new leg bag and remove the protective cap from its connector. Using a separate, new antiseptic wipe, clean the tip of the leg bag connector, being careful not to touch the cleaned surfaces.
To complete the connection, firmly insert the cleaned connector tip of the new leg bag into the end of the catheter tubing. Use a slight twisting motion as you push the connector in until the fit is snug and secure. A tight connection prevents accidental disconnection, which would break the closed system, prevent leakage, and reduce the risk of infection.
Securing the Bag and Final Checks
Immediately after the connection is secured, the drainage system must be checked for proper function and secured to the leg. The first check involves verifying the drainage valve, or outlet tap, on the bottom of the new leg bag is fully closed before releasing the pinch on the catheter tubing. An open valve will result in urine immediately draining onto the leg or floor, compromising hygiene.
Next, attach the leg bag to the leg using the provided straps, which are typically made of elastic or Velcro. The bag should be secured with two straps, placed around the thigh and/or the calf, depending on the bag’s design. The straps must be snug enough to prevent the bag from slipping down the leg but not so tight that they impede circulation or cause discomfort.
Ensure the catheter tubing has a small amount of slack or a gentle curve, avoiding any sharp bends or kinks. Kinked tubing will obstruct the flow of urine, causing it to back up and potentially leading to discomfort or pressure on the bladder. The bag must be positioned to remain below the level of the bladder at all times, utilizing gravity for continuous drainage.
Finally, observe the connection site for a few moments to confirm there are no leaks and that urine is flowing freely into the new bag. The tubing should not pull on the catheter, which is anchored internally, as this can cause irritation or injury to the urethra. Once all checks are complete, dispose of the gloves and any used materials in the waste receptacle and perform a final hand wash.