hoiw long the indwelling catheter can keep for a patient ?

[mikhy]

hello 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 !

[Kiringat]

It 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

Neurogenic bladder

Recent bladder surgery or injury

Accurate I & O

Bladder irrigation

Epidural catheter

Pelvic fracture/crush injury

End of life/comfort care

If the patient doesn't meet those criteria, the catheter comes OUT!

[BackfromRetirement]

For the reasons mentioned above by kirinqat a catheter can remain for up to 30 days with an order, then must be changed.

[NeoPediRN]

If a patient had a need for a longterm Foley, it needed to be changed every 30 days.

[ayla2004, ASN, RN]

we 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.

[loriangel14, RN]

How often a long term catheter was changed would depend on your facilities policy. Where I work they are changed after 6 weeks.

[Finallydidit]

LTC we change Q30/days or PRN

[caliotter3]

Have seen orders in home health requiring change every 60 or 90 days or PRN.

[MelEpiRN]

Yup, 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.