“Practical Issues for Urinary Catheter Management,” by Vivian Williams for OPENPediatrics

Clinical Pearls: Practical Issues For Urinary
Catheter Management, by Inpatient Nurse Practitioner Vivian Williams. Health care workers in all health care settings
should always adhere to the latest World Health Organization guidelines on hand hygiene and
barrier precautions before and after contact with the patient, bodily fluids, or patient
surroundings. For more information, please watch our video
entitled Hand Hygiene. Introduction. Hi, my name is Vivien Williams, and I am the
Inpatient Nurse Practitioner for the Department of Urology at Boston Children’s Hospital.
Today we will be discussing clinical pearls: how to manage issues related to the Foley
catheter. A Foley catheter system is comprised of two
components, the urinary or Foley catheter, which is inserted here within the urethra,
as well as the urinary drainage bag. This is typically connected to the side of the
bed. Securing the Urinary Catheter. The catheter should be attached to the thigh
or the abdomen in order to decrease meatal necrosis, trauma, or skin breakdown. The site
of securement should be rotated to prevent skin breakdown. You should change the site
every three days. Always apply a layer of protection underneath
the catheter in order to prevent skin breakdown. Here we’ll be using a 2×2 gauze underneath
the tubing. We will then secure it with tape or tegaderm as such. If available, a catheter securing device can
also be used to attach the Foley catheter to the patient. Collection Bag. You must keep the collection bag below the
level of the bladder. It is especially important during transfers to be cognizant of where
the bag is. One of the most important pieces of assessing
a catheter is to be sure there are no kinks within the tubing. You must also be sure that
within the environment there is nothing occluding the tubing itself. The bag itself must be
emptied every three to six hours or when it is approximately one half to three quarters
full. Never allow this spigot and the non-sterile
collection chamber to come into contact. You also want to assess whether there is an airlock
within the bag. In order to do this, you must open up the bag and allow air to flow within
the bag. Separate the front and back part from the bag and see if this allows the urine
to drain. Be sure to close the bag afterwards. Troubleshooting Problems with Urinary Catheters. What if there is tension on the urinary catheter? Prior to securing the catheter, you always
want to be sure that the catheter is not on too much tension, as such, within the urethra.
There should be a gentle loop of catheter, which is secured in place, which does not
tug or pull upon the urethra. Tension can cause bladder spasm. If a patient is having
consistent bladder spasm, you could consider starting the patient on an antispasmotic.
If there is tension, the catheter should be re-secured. What if there is decreased urine output? You always want to assess that there is urine
within the catheter. If there is no urine and the patient says that they feel full,
it is critical that you assess that there are no kinks or occlusions within the catheter
tubing. And then you could consider flushing the catheter at the port site with normal
saline. Keep in mind this is a sterile technique. Thank you for watching Clinical Pearls, Care
of the Patient with Issues with the Foley Catheter. Please help us improve the content by providing
us with some feedback.

15 thoughts on ““Practical Issues for Urinary Catheter Management,” by Vivian Williams for OPENPediatrics

  1. Not sure that wearing jewellery on the finger of the left hand (wedding ring?) is good hygiene practice. Is it?

  2. The most important subject was ignored: how to properly insert the catheter without causing harm. I have been hospitalized 3 times where the nurse used a rapid, "quick insertion" method which always causes internal harm and bleeding. There is a sphincter muscle just outside the bladder which needs time to adjust to the catheter's insertion. Ramming it home causes damage, immense pain and bleeding. In my 10 years wearing a catheter, I have only met one nurse who knew how to insert properly.

  3. You forgot to.mention that the patient usually screams with agony as this is inserted / removed…Time medics found another way….

  4. My grand father felt a lot of pain on some days after getting his urinating bag and after watching this vedio i figured that doctors didn't stick the tube with his leg with a gauze.
    I putted the gauze and it released the strain on his urethra.He is feeling well for now…
    Seriously how careless a doctor can be.

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