Help! EBP on not inflating foley balloon prior to insertion

[highlandlass1592]

Hi All. Been hearing for a while now that new EBP is stating NOT to check the foley balloon before it's inserted as there have been patient injuries due to the balloons not being fully deflated before insertion. Problem is, I haven't been able to find such documentation. Anyone got any links/information I can use? Thanks in advance.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

My question is if you don't check the ballon then you have a balloon inflate improperly due to a defect and you have that catheter balloon lopesided and its sitting on the bladder wall causing irritation/damage which is the lesser evil?

Check the balloon on a catheter. They're ALL lopsided, very non irritating.

[Airidis]

I love that you've given me a name and date to go by but that research is at least 8 years old, surely there is something more relevant.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

I am a nursing student. Last week, we performed insertion of a Foley catheter on a manikin. Prior to inserting, I inflated the balloon to test it and it was fine, so I thought. I insert the Catheter;however,upon removaal, I was unable to extract it andd had to take the peineal area apart to get it out. Then, someone else tried their Foley and had no problems. So, I am wondering, does this actually in the field? I believe that could cause trauma to the patient.If you do find some information,let me know. I'm interested.

If you can't get the foley out for any reason, it's no onger your problem. Let the doc deal with it.

[CCRNCCU2008]

bard manufacturer (which is who we use) says not to pretest as they test 100% of foleys per quailty controls.

[shiccy]

Bard may test foley's in the factory, but latex and rubber are fickle things. They change very quickly with levels of moisture and temperature. If your supplies are on a cold truck for a long time, there's a chance the rubber/silicon can warp or even crack (for the person that had said they have 3 foleys/year that rupture. I guess what my thought process is I've never seen a difference with foley's pre and post inflation after testing.

Something that has to be said, as well, is that if your hospital policy states to NOT test the foley, then DON'T. This is something that can change after you are out of school. If your hospital does NOT have a policy on whether or not to test the balloon before insertion, and you learned to do it in school then at least by Ohio law you SHOULD test it as it's officially the authority on whether or not to do something if your hospital policy doesn't exist.

IF your hospital doesn't have that policy in place, then you can advocate to get it INTO policy.

This being said, I've not put a TON of foleys in (they're usually done in ER/already done from day shift for the new admits), but the few dozen I've done I've never had one that wasn't intact.

[klone, MSN, RN]

I put foleys in probably 1-2 times per shift, every shift, for the past six years. I've never had one where the balloon leaked.

For those of you who are having problems with balloon leakage, you might want to investigate a different brand of catheter? That seems excessive to be having that problem 2-3 times/year.

[SandraCVRN]

Never had one leak, but have had them not deflate....

[dishes, BSN, RN]

Something that has to be said, as well, is that if your hospital policy states to NOT test the foley, then DON'T. This is something that can change after you are out of school. If your hospital does NOT have a policy on whether or not to test the balloon before insertion, and you learned to do it in school then at least by Ohio law you SHOULD test it as it's officially the authority on whether or not to do something if your hospital policy doesn't exist.

This is incorrect, a nurse is responsible for staying current with practice and knowing the risks and benefits of any procedure they are perfoming. Pretesting is not recommended by the manufacturers and urologists because it increases the risk of urethral trauma. Urethral trauma can lead to urethral scarring and strictures that require surgical intervention.

dishes

[NoviceRN10]

How would you not notice that a catheter balloon hasn't been totally deflated before you try and insert it? I was taught to test it and don't see any reason not to continue to do so.

[rkitty198, BSN, RN]

According to BARD the manufaturer of our Foley devices, they do not need a test inflation before inserting. I dont think it would cause problems, but it isnt necessary.

[klone, MSN, RN]

How would you not notice that a catheter balloon hasn't been totally deflated before you try and insert it? I was taught to test it and don't see any reason not to continue to do so.

When it's been inflated and deflated, it causes puckering and ridges around the deflated balloon portion of the catheter. That is what can cause internal damage as it's being inserted.

[merlee]

Hi, everyone! Well, I was at my urologist's, today, and I asked her about this subject. Her answer was that the only time they test the balloons was before placement during prostate surgery.

Otherwise, there is concern about those bumps or wrinkles that may occur if the balloon does not deflate properly after testing.

So, 'no' to the testing!