URINARY CATHETERIZATION
Introduction
Urinary catheterization is a procedure where a flexible tube called the catheter is used to collect the urine and drain the bladder. Urinary catheterization is also called Foleys catheterization.
What is prevalence of Urinary catheter use?
A study revealed that catheters were more prevalent in males. It also mentioned that catheters are most prevalent in patients aged over 70 . The highest prevalence was in critical care, where over 70% of patients have a catheter in situ. Most of them are discharged home with urinary catheters in situ.[1] It is revealed that long-term indwelling urinary catheter contributes to associated morbidity and mortality.
When is Urinary Catheterization Used?
A urinary catheter is recommended when an individual is:
- Unable to urinate
- Unable to control the urge to urination or
- When experiencing leaky urine or urinary incontinence.
Purpose of Urinary Catheterization
Therapeutic purpose
- To relieve urinary retention or urinary incontinence
- To Instill medications directly into the bladder
- To drain the urine from the bladder, e.g. during delivery or during anaesthesia, before, during or after surgery.
- Bladder irrigations
Diagnostic purpose
- To accurately measure urine output
- To collect urine for culture
- To determine the causes of genitourinary infections
Types Of Urinary Cathter
- Intermittent catheters: Catheter that is temporarily inserted to empty the bladder
- Indwelling catheters: Catheters that remain in place for many days or weeks, these are held in position by an inflated balloon in the bladder.
Main Risk factor for indwelling cathter
The urinary infections are caused by an indwelling catheter as they allow the entry of bacteria into the urinary tract, these infections are called Catheter-Associated Urinary Tract Infections (CAUTI).
A study conducted by the Performance Improvement Department of one home healthcare agency (HHA) identified an increase in the rate of catheter-associated urinary tract infections (CAUTI) in 2009. It was revealed that it was the most common infection among long-term care residents.[2]
Role of Nurse during Process
It is essential for skilled nurses to put the Foley urinary catheter using aseptic and hygienic measures as the risk of acquiring infection is very high.
The nurse will clean the catheter and check for any
- Leakage, swelling or bleeding around the urethra or catheter.
- Presence of any particular door, stones, sediments, etc in the urine collected in the urinary bag.
- Minimal or no drainage of urine collected in the urine bag even after the taking sufficient fluid.
The nurse will record the urine output, document the changes, and inform the physician if any signs of infection are noted.
