Foley Balloon Test

[OR male nurse]

In school we were taught to pre-inflate the balloon on the Foley to make sure there weren't any pin holes. In reality, the urologists don't want you to pre-inflate because they say it makes the ribs on the balloon stick out which could cause irritation to the urethra when you do insert the Foley. I've put in hundreds of Foley catheters on my patients and never had any problems until yesterday when one of the general surgeons was watching me and had a huge pissy fit because I didn't pre-inflate the balloon ? I responded that the urologists say otherwise and he wasn't impressed with my answer.

Just wondering how many of you out there either inflate or don't when putting in the Foley. I've never had a balloon not work in my hundreds of times of putting one in and figure that if there is a hole, you'll find out when you pull back on the catheter and it comes back out because it's not inflated. I feel it's pretty much a non-issue but now they are making a big deal out of this where I work.

[muffin7]

I have never had a problem with a balloon, but like you said, you would see it is defective when you anchor it in the bladder. If it was an emergency trauma case you may want to inflate to check before inserting. In all other cases I would tend to go with the advice of a Urologist over a Gen Surgeon when it come to foleys. You could also have the Urologist speak to the Surgeon and let their egos duke it out.

[Heogog53]

Was always taught to pre-inflate foleys- and the urologists I work with do the same. All the residents and attendings pre-inflate foleys. The urologists say better to know if there's a hole in the foley before you try putting the thing in, because you might not get a second chance with some patients' urinary tract issues.

[beanal]

It depends on the patient as to whether or not I check the balloon. Most patients I do check the ballon but I don't for patients with a hx of BPH as it is hard enough to try to get the foley inserted with an enlarged prostate. I don't want to take the chance of the balloon not returning to its original pre inflated state as this would make it even harder to insert.

BTW our urologist never want the ballon to be tested.

[Rose_Queen, BSN, MSN, RN]

We have had our policy changed to state that we are not to preinflate the balloon. This is both what the manufacturer recommends and what our urologists prefer. Even when the policy stated to check, none of the urologists would. The manufacturer states they test balloons during manufacture.

[OrthoRN09]

Two of the facilities I did clinicals at had policies not to pre-inflate foley balloons. I don't know about where I work now because we have urology techs that do all the foleys.

[SandraCVRN]

We had a ballon yesterday that did not inflate. Good thing we checked.

[leadesign]

When I was in school we were not taught to pre-inflate. Ten years later, the hospital I worked at wanted the balloons pre-inflated. Ten years later AORN standards said there was no need to pre-inflate because you could weaken the balloon and have you ever had one that failed?

[OR male nurse]

Wow.. this discussion is still going on and on

[babyshark]

firstly, it is imperative for any nurse to be aware of his hospital policy regarding foley insertion and uti prevention protocol. this would not only aid in your ability to respond intelligently to the surgeon who is breathing down your neck and/or insisting you are mistaken, but for continuity of care. most operating rooms base their policies on current aorn standards, and those are the policies that you as a hospital employee must adhere to---whether the surgeon (a mere visitor in your OR) agrees or not.

also, research this topic for yourself, and develop a standard practice that you would be able to stand behind at a deposition. if there is a chance that your hospital is unclear on its foley insertion policy you would be able to say with confidence what your standard practice involves when your hospital hangs you out to dry. i would not recommend altering that practice from patient to patient or depending on who the surgeon is.

medicare reimbursement is a hot topic in hospitals across the country and many of them are trying every way possible to decrease their patient length of stay since the new reimbursement clause does not allow for nosocomial infections---including uti.

learn the policy and stick to it. if there isn't one, gather the necessary troops to get one implemented. and until that happens, develop your evidence based practice and do not stray from it.

[momforever1]

If you go to the Bard website, they will tell you NOT to preinflate the balloon as it is quality checked during manufacturing. In 25 years, 15 floors, 10 OR I have never prechecked balloons and never had a problem. I have to go with the manufacturer on that one

[ashifer22]

That is correct about Bard manufacturer advising NOT to pre-inflate balloons. When they are inflated that creates tons of little cracks that is a medium for bacteria and going from a dirty to clean area it is a risk for infection.