A Foley catheter is a flexible tube inserted through the urethra into the bladder to drain urine into a collection bag. It is held in place by a small balloon filled with sterile water. Proper cleaning and maintenance prevent the entry of bacteria, which can lead to a Catheter-Associated Urinary Tract Infection (CAUTI). CAUTIs are common healthcare-associated infections, making diligent home care necessary for safety and comfort.
Daily Care of the Catheter Insertion Site
Meticulous hygiene of the meatus, the area where the catheter enters the body, should be performed at least once daily. Hand hygiene is the first and most important step, requiring thorough washing with soap and water before touching the catheter. Supplies needed include mild soap, warm water, and clean washcloths or gauze pads.
To clean the insertion site, gently wash the area around the catheter with the mild soap and water, being careful not to pull on the tubing. For females, clean from front to back; males should clean from the tip of the penis downward. Carefully wipe away any dry or crusty material present around the meatus.
Next, the first few inches of the catheter tubing should be cleaned. Use a fresh washcloth or gauze to clean the tube starting at the insertion point and moving downward, away from the body. This action helps prevent bacteria from migrating up the tubing toward the bladder.
After washing, rinse the area completely to remove all soap residue and gently pat it dry with a clean, soft towel. Secure the catheter to the thigh or abdomen with a securement device or tape, ensuring there is some slack in the tubing to prevent pulling. Securing the catheter prevents unnecessary movement, irritation, or the entry of microorganisms.
Routine Maintenance of the Drainage System
The drainage system, comprising the tubing and the collection bag, requires specific care to maintain a closed, sterile environment. The collection bag must always be positioned below the level of the bladder, even when sleeping, to ensure proper gravity drainage and prevent the backflow of urine. The tubing must be kept free of kinks, loops, or obstruction to allow continuous flow.
The drainage bag should be emptied regularly, typically every four to eight hours, or when it is about one-half to two-thirds full. This prevents the bag’s weight from pulling on the catheter and ensures continuous flow. When emptying the bag, the drain spout must not touch the floor or the toilet bowl to avoid contamination.
Use a separate, clean container to collect the urine, and wash hands before and after the emptying procedure. If a reusable bag is used, clean it when switching between a smaller leg bag for daytime and a larger bag for nighttime. A common cleaning solution is a mixture of one part white vinegar to one part water, which is swished inside the bag and tubing for 15 to 30 minutes to reduce odor and bacterial growth. Drain the bag, rinse thoroughly with cool water, and hang it to air dry with the drain spout open, ensuring the spout does not touch any surface.
Recognizing and Addressing Complications
Being aware of signs that indicate a problem is as important as the daily cleaning routine. A catheter-associated urinary tract infection (CAUTI) is a significant risk, and symptoms can sometimes be subtle. Signs of a potential infection include the presence of blood in the urine, urine that is cloudy, dark, or has a foul odor, and the appearance of gritty sediment or mucus.
Physical symptoms can include fever, chills, pain in the lower abdomen or flank area, or increased muscle spasms in the bladder. In older individuals, new onset of confusion or a general feeling of being unwell may be the only signs of a serious infection. Another complication is catheter blockage, which is indicated by no urine output for several hours despite adequate fluid intake or urine leaking around the catheter.
Immediate contact with a healthcare provider is necessary if a fever above 100°F (37.8°C) or chills develop, or if there is no urine draining into the bag. Similarly, persistent pain, heavy bleeding, or a sudden change in mental status warrants professional medical attention. Do not attempt to flush or remove a blocked or non-draining catheter, as this requires a medical assessment to prevent further injury or complications.