Jump to content

Removing Foley’s on intubated patients

Critical   (613 Views 5 Comments)
by righteousjenn righteousjenn (Member) Member Nurse

righteousjenn specializes in CVICU.

9,350 Profile Views; 708 Posts

So I work in CVICU.. within the last year our ID team has really been pushing for removal of Foley catheters on intubated patients. I am struggling to see the rationale behind this because most of the patients we do get who they are pushing this on are really sick. I have removed them on supervisor request only to have to reinsert my next shift due to urinary retention post removal (my guess is because they are sedated and it really does take active participation to void the first time).

How does your hospital manage these patients? Are other facilities doing this as well? And where is the evidence showing that this is ultimately better for them at this stage of their ICU stay? I’ve tried looking it up but have found nothing. 

I do realize the risk of infection, as with any invasive device, however, or CAUTI numbers have been 0 thus far in our unit (prior to them recently pushing this on us) 

my unit is small... our ICU is about 3x the size and most of my removals/reinsertions happen when I float to their unit. 

 

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

117 Posts; 1,707 Profile Views

I'm not sure why one has to do with the other.    Intubation isn't related to urinary issues.    While the need for an indwelling cathter indeed should be revisited from time to time, I'm not sure why intubation is even a trigger let alone an indication for removal.

Share this post


Link to post
Share on other sites

missk729 has 1 years experience as a BSN, RN and specializes in Medicine ICU.

4 Posts; 206 Profile Views

Hello, nurse from Texas here! I am a Medicine ICU RN, and on my unit we generally try to assess the need for foleys in all of our patients. Most of the reasoning is to decrease risk of CAUTI's in our patients.  I've had one male patient who did have a condom catheter once his renal status improved. Other than that time, most intubated patients I have cared for had Foleys in place.

Share this post


Link to post
Share on other sites

Wolfbiologist specializes in None yet.

7 Posts; 210 Profile Views

As a male with the  experience of a mere 10 day foley, these things are horrid. The bladder spasms almost ended me. Pain from a spasm caused me to faint, fall, and smack my head on a concrete floor. That sucked.

Then when a nurse finally removed the wretched thing, I was unable to speak... let alone breathe... due to the pain of removal.

Kill me before you try to insert one of those damn things again. Otherwise, I will fight you to the the death if you try to shove one of those things in me.

Share this post


Link to post
Share on other sites

amoLucia specializes in LTC.

5,183 Posts; 45,875 Profile Views

Why intubated pts? I ask just like you.

Are they intubated AND unresponsive??? I guess they'd not complain about being turned & managed for incont care. So, on the other hand, being intubated BUT responsive pts could resist turning and be more restless.

Wouldn't I&O be expected of ICU level of care pts? We all know that output accuracy is almost impossible without a fc.

Incont increases the risk of skin issues, so wouldn't this be counterintuitive???

Oh, hush my mouth!!! Why should the higher-upperers make sense? 🤯

Maybe your physician staff could be an ally?

 

Share this post


Link to post
Share on other sites
×