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Safety Matters: Foley catheters

When patients are admitted to the hospital, their diagnosis may require the insertion of a Foley catheter, a flexible tube that is passed through the urethra and into the bladder.

“The tube has two separated channels, or lumens, running down its length, with one lumen open at both ends to allow urine to drain into the collection bag,” said Lisa Moore, director of infection prevention and risk management at Baptist Memorial Hospital-Memphis. “The other lumen has a valve on the outside end and connects to a balloon at the tip; the balloon is inflated with sterile water to anchor the catheter in place.”

These devices were named after the designer, Frederic Foley, a surgeon from Boston who practiced in the 1930s. Catheters are used by patients who are having problems such as urinary incontinence (leaking urine or being unable to control when you urinate); urinary retention (being unable to empty your bladder when you need to); surgery on the prostate, urinary tract or genitals; or other medical conditions such as multiple sclerosis, spinal cord injury or dementia. They are also used to accurately measure urine output in critically ill patients; for some surgical procedures; to assist in healing open, sacral or perineal wounds in incontinent patients; in patients who require prolonged immobilization; or to improve comfort for end-of-life care.

While there are several types of catheters, the three main types are indwelling, external and intermittent catheters. Health care providers will most often use the least invasive catheter to avoid the potential for catheter associated urinary tract infections, said Moore.

At Baptist, written guidelines for catheter use, insertion, maintenance and discontinuation can be found in the “Patent Care Policy and Procedure Manual.” While proper steps are necessary for the insertion of Foley catheters under sterile procedures, these devices must also be removed utilizing correct procedures.

Moore reported that complications from Foley catheters can be very serious. Possible complications include allergy or sensitivity to latex, bladder stones, blood infections, blood in the urine, kidney damage (usually only with long-term, indwelling catheter use), urethral injury, and urinary tract or kidney infections. Catheter associated urinary tract infections are the most common and are easily prevented by adhering to the indications for use and removing necessary catheters as soon as possible, advised Moore.

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