Managing indwelling urethral catheters.

An indwelling urethral (Foley) catheter is a closed sterile system that is inserted through the urethra to allow for bladder drainage. In the 1930's Frederick Foley designed a rubber tube with a separate lumen used to inflate a balloon which holds the catheter in place in the bladder. Historically, indwelling catheters primarily have been used in chronic, medically compromised elderly patients. As the number of elderly patients continues to increase, particularly in such settings as home care, the use of indwelling catheters is increasing. Nurses caring for patients with urinary incontinence, neurogenic bladder, and/or urinary retention manage these catheters. However, most nurses will agree that managing this type of system poses multiple medical and nursing care problems. In fact, Foley catheters are associated with several complications and side effects that increase patient morbidity and mortality. This article reviews current strategies for providing good catheter management as well as steps for retraining the patient following catheter removal.