condom catheters

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Give me your best tips for getting condom caths to stay put. I work in home health and have a patient that had a foley, but kept pulling it out. The physician said ok to try a condom cath, but after putting it on this morning, the caregiver called to say it already came off.

I made sure the member was dry (difficult because he urinates frequently), and used skin prep before applying the catheter. He has advanced Parkinson's plus dementia and is very active in his bed, so this is going to be a challenge---but I really want to try because he hates the foley so much. When the caregiver told him I was removing the foley this morning, he looked at me and said "God bless you!"

Specializes in Med-Surg.
I have never found a way to make a condom catheter work. We have switched to Reliafit external catheters now, but I haven't had to use one yet.

The problem with that brand is how dang expensive they are. They fell off constantly on my unit. They were also a huge pain to apply also to get that "flower" on right.

For both the reliafit and regular condom catheters, they seem to be a huge hit and miss. It depends on the patient and a list off variables as to if they will work or not. Patients mental status, mobility/activity level, moisture in general, and member size/shape, ect...

We try to use them just for those who are not very mobile + incontinent and who need accurate output recorded (but don't really need a foley either). It just depends.

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Specializes in Oncology.
The problem with that brand is how dang expensive they are. They fell off constantly on my unit. They were also a huge pain to apply also to get that "flower" on right.

For both the reliafit and regular condom catheters, they seem to be a huge hit and miss. It depends on the patient and a list off variables as to if they will work or not. Patients mental status, mobility/activity level, moisture in general, and member size/shape, ect...

We try to use them just for those who are not very mobile + incontinent and who need accurate output recorded (but don't really need a foley either). It just depends.

Ah, I've been wondering how reliable they are. The rep brought in all of this pretty data proving they don't cause UTI's, and I'm thinking, "Well THAT'S not what I'm worried about here." I asked how well they stay on and he danced around the question.

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Fyi, UAP (home health aides) can put condom catheters on. So, tell your staff that. They do come off rather easily, but a nurse need not apply those.

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The problem with that brand is how dang expensive they are. They fell off constantly on my unit. They were also a huge pain to apply also to get that "flower" on right.

For both the reliafit and regular condom catheters, they seem to be a huge hit and miss. It depends on the patient and a list off variables as to if they will work or not. Patients mental status, mobility/activity level, moisture in general, and member size/shape, ect...

We try to use them just for those who are not very mobile + incontinent and who need accurate output recorded (but don't really need a foley either). It just depends.

I maintain that strict I/O without a Foley is a joke. If you they cared that much about I/O, then they should have ordered a Foley.

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Specializes in hospice.
I maintain that strict I/O without a Foley is a joke. If you they cared that much about I/O, then they should have ordered a Foley.

I worked a tele unit where everyone was on strict I&O, but lots of people didn't have foleys. I will never forget those poor little old ladies on Lasix having to get up to the commode ten times a night, and pouring from the bucket into graduate to measure before flushing. At least the guys could use urinals.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

As has been pointed out previously, a confused patient who pulls his indwelling foley out is not likely to leave a condom catheter alone either.

You can try a skin prep which helps it to "stick" to the skin of the member somewhat, however, you DO NOT want to promote any shearing or tearing injuries to that skin.

Why does this fellow require a catheter? Why is the team focusing on a POC that is irritating, agitating, and annoying the patient?

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I worked a tele unit where everyone was on strict I&O, but lots of people didn't have foleys. I will never forget those poor little old ladies on Lasix having to get up to the commode ten times a night, and pouring from the bucket into graduate to measure before flushing. At least the guys could use urinals.

That's correct, and one incontinent episode and it's all shot to hell anyway - hence why strict I/O without a Foley is a joke.

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Once, when I was an aide in the hospital, I had an adult (youngish) pt who needed a condom catheter. Our regular ones wouldn't stay on, so I *ahem* had to go find a smaller size.

He was a jerk, and when he rudely called me a name and asked why it took so long to get my supplies. I took great enjoyment in informing him, in front of his visitors, that he required a child-sized catheter and that I had to walk over to the pediatrics wing to find one.

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The critical thinking needed to start with the physician that ordered the condom cath.

Then the nursie that only wants to follow the doctor's order.

In this case.. I am advocating for the PATIENT that does not want anything placed in or on his member.

There are many other options to prevent a "mess".

Care to expound on "Thanks for playing"?

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Specializes in LTC.
The critical thinking needed to start with the physician that ordered the condom cath.

Then the nursie that only wants to follow the doctor's order.

In this case.. I am advocating for the PATIENT that does not want anything placed in or on his member.

There are many other options to prevent a "mess".

Care to expound on "Thanks for playing"?

I agree, if pt doesn't want anything on his member, he isn't going to keep anything on his member. I know briefs are not the best option, but could be a better option than this poor man pulling the catheters out (or off) and having urine on his skin anyhow. I think a suprapubic would be a good option here.

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As has been pointed out previously, a confused patient who pulls his indwelling foley out is not likely to leave a condom catheter alone either.

You can try a skin prep which helps it to "stick" to the skin of the member somewhat, however, you DO NOT want to promote any shearing or tearing injuries to that skin.

Why does this fellow require a catheter? Why is the team focusing on a POC that is irritating, agitating, and annoying the patient?

Bingo! Strict I &O is easy for a physician to order. To carry it out should not require a problem for the patient or the nurse. The doctor needs to be informed of that. Only an hemodynamically unstable patient ... or one with newly diagnosed renal disease requires "strict" I & O.

Let's advocate for patient comfort.

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Specializes in NICU, PICU, Transport, L&D, Hospice.
Bingo! Strict I &O is easy for a physician to order. To carry it out should not require a problem for the patient or the nurse. The doctor needs to be informed of that. Only an hemodynamically unstable patient ... or one with newly diagnosed renal disease requires "strict" I & O.

Let's advocate for patient comfort.

In fact, it would seem from the OP that no one is advocating for the patient in this situation.

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