How to Change a. Foley catheter. Patient Education Rehabilitation Nursing. Step-by-step instructions for the caregiver
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1 Patient Education How to Change a Foley Catheter Step-by-step instructions for the caregiver This handout gives step-bystep instructions for changing a Foley catheter, which is a tube in your bladder to drain your urine. A catheter is often used by people with medical conditions that prevent normal urination. A Foley catheter is changed on a regular basis to prevent infections. Your doctor will let you know how often this should be done. This handout should follow teaching received in the hospital. If you have not been shown how to change a catheter, please contact the Rehabilitation Clinic or your doctor. To change a Foley catheter, follow these steps: 1. Wash hands with soap and water. 2. Gather equipment (see checklist). Equipment Checklist Insertion tray: Foley catheter Sterile gloves 10 cc syringe to remove old catheter Syringe with saline New drainage bag Drapes Clean gloves Drain tray Towel Forceps Soap Cotton balls Washcloth Lubricant Flashlight (optional) Disinfectant Insertion tray and Foley catheter.
2 Page 2 3. Position person on his or her back. Remove clothes below the waist. Spread legs slightly. Be sure you have enough light. 4. To remove the old catheter: a) Put on clean gloves (different than the sterile gloves included in the insertion tray). b) Plug the 10 cc syringe into the inflation port and pull back on the plunger until all fluid from the balloon is sucked into the syringe (most times about 3 to 10 cc). Foley catheter equipment. Pulling on the plunger to remove fluid from the balloon. c) Gently pull on the Foley catheter to remove it. If the catheter doesn t come out easily, stop and repeat step 4b. If you are still unable to remove it, call your doctor s office, clinic, or visiting nurse right away. d) Empty the urine in the toilet, then discard the drainage bag, catheter, and syringe in the garbage.
3 Page 3 5. Use a washcloth to wash the area where the catheter enters the body. Use soap and water. Dry well with a towel. (This is a good time to find the urethra the opening into the bladder in females.) Remove and discard gloves. 6. Wash your hands again. Place sterile insertion tray next to person. 7. Open the sterile insertion tray. 8. Remove top drape and place under buttocks (females) or under penis (males) to make a sterile area. 9. Open the outside package and carefully drop the Foley catheter wrapped in plastic wrap into the sterile area. 10. Put on sterile gloves. 11. Prepare your tray by opening the disinfectant and pouring it over the cotton balls. 12. Open lubricant and squeeze into the drain tray. 13. Unwrap the Foley catheter from the plastic and place it in the drainage tray. 14. Remove the rubber tip from the sterile syringe. Optional: Test the balloon on the Foley catheter by plugging the pre-filled syringe into the inflation port and pushing the plunger, causing the balloon to inflate. Pull all the fluid back into the syringe. Testing the balloon on a Foley catheter.
4 Page 4 Females: 15. With your non-dominant hand (the one you do not write with), spread labia to see the urethra (opening to the bladder). Note that this hand is no longer sterile. 16. With your dominant hand (the one you write with), use forceps and one cotton ball at a time to clean the area. Wipe from top to bottom (front to back), one side at a time. Use a new ball to wipe in the center over the urethra. 17. Pick up the Foley catheter with your still-sterile dominant hand (the one you write with), 2 to 3 inches from the tip. Roll the tip of the catheter in the lubricant. 18. Put the drainage port end of the catheter in the insertion tray. Then, slowly and steadily, insert the tip of the catheter into the urethra, until urine starts coming out through the drainage port (about 1½ to 3 inches). Insert another 1 to 2 inches. If urine doesn t come out right away, wait a few minutes until a few drops come out. Drainage tray for for changing Foley catheter. 19. Inflate the balloon by plugging the pre-filled syringe into the inflation port. 20. Push the plunger (use 5 to 7 cc), causing the balloon to inflate. 21. Remove the syringe by twisting off. 22. Pull back gently on the catheter to make sure the balloon is inflated. At this time, you can hook the catheter to the drainage bag. Never force the catheter into the bladder. Ask the person to breathe slowly and deeply to make the catheter easier to insert. If unable to insert, call your doctor s office, clinic, or visiting nurse. 23. Pour urine in the toilet. Discard used equipment in the garbage. Wash hands again.
5 Page 5 Insertion site and leg bag assembly for Foley catheter for females.
6 Page 6 Males: 15. With your non-dominant hand (the one you do not write with), pick up penis. If the person has foreskin, pull it back until you can see the opening into the bladder (urethra). Note that this hand is no longer sterile. 16. With your dominant hand (the one you write with), use forceps and one cotton ball at a time to clean the area. Start at the urethra and wipe in a circular motion, one time around. Repeat cleaning process with remaining cotton balls. Use last cotton ball to wipe across the opening of the urethra. 17. Pick up the Foley catheter with your still-sterile dominant hand, 2 to 3 inches from the tip. Roll the tip of the catheter in the lubricant. 18. Put the drainage port end of the catheter in the insertion tray. Then, holding the penis upwards, slowly and steadily insert the tip of the catheter into the urethra, until urine starts coming out through the drainage port (8 to 12 inches). Insert another 1 to 2 inches. If urine doesn t come out right away, wait a few minutes until a few drops come out. Drainage tray for changing Foley catheter. 19. Inflate the balloon by plugging the pre-filled syringe into the inflation port. 20. Push the plunger (5 to 7 cc), causing the balloon to inflate. 21. Remove the syringe by twisting off. 22. Pull back gently on the catheter to make sure the balloon is inflated. At this time, you can hook the catheter to the drainage bag.
7 Page 7 Never force the catheter into the bladder. Ask the person to breathe slowly and deeply to make the catheter easier to insert. If still unable to insert, call your doctor s office, clinic, or visiting nurse. 23. Pour urine in the toilet. Discard used equipment. Wash hands again. Insertion site and leg bag assembly for Foley catheter for males.
8 Questions? Call Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC Clinic staff are also available to help at any time. Rehabilitation Clinic Notes Box N.E. Pacific St. Seattle, WA University of Washington Medical Center 11/2005 Reprints: Health Online
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