hoiw long the indwelling catheter can keep for a patient ?
- 0Jul 21, '10 by mikhyhello all !
i am just wondering how long the indwelling foley catheter can keep in place for a patient ? is there a policy ?
thanks ! i am look forward to your guys reply !
- 1Jul 21, '10 by KiringatIt depends on the policy of your individual facility. In my hospital, patients must be evaluated for the necessity of a catheter every 48 hours. The only reasons for leaving one is:
Urinary tract obstruction
Recent bladder surgery or injury
Accurate I & O
Pelvic fracture/crush injury
End of life/comfort care
If the patient doesn't meet those criteria, the catheter comes OUT!
- 1Jul 21, '10 by ayla2004we have 28 day cathater which we have a similar policy for. We TWOC(trial without cathter ) if the pt fails to pu we monitior for retention. if they fail 2 Twoc they need urology review
we also have 3 month catheter were patient are admiited with them and and these have been initated by urology or neurology
these we change if needed but do not remove.
- 1Jul 21, '10 by MelEpiRNYup, depends on a few things. There are lots of policies available online.
Basically, the risk of infection increases daily with indwelling caths. The patient should be evaluated for necessity every shift. Don't go with what traditionally we thought were good reasons the foley should be in- for years nurses just left foleys in for days for various reasons that aren't good (pt can't walk, patient wants it, I&O monitoring, etc). There are better ways to get I&O (unless the patient is incontinent).
The reasons Kiringat listed are pretty standard.
Now- this also depends on where you are. LTC usually changes them q 30 days. If you're in acute care, and the patient had recent surgery (not urological), that catheter should come out within 2 days. It's one of the 'Core Measures' submitted to CMS/ TJC for repayment. CMS will also no longer reimburse hospitals for any costs associated with Catheter-related infections (you're looking for upwards of $3,000 a patient on average).
Catheter-related infections are becoming a pretty big deal. If that cath can come out, the sooner the better. If the patient is male, I'd look into condom-caths.