Straight cath or foley cath for labor patients??

melmarie23, MSN, RN · Jan 15, 2012

we straight cath prn

eden · Jan 15, 2012

We don't use them unless mom is unable to void for whatever reason. As long as they are able to ambulate with an epidural ( we have guildlines for ambulation with epidurals) they can go to the bathroom and more often then not they can void.

If they can't get up or can get up but don't have the sensation to void we straight cath unless mom requests a foley so she can rest without interruption but our first choice is always a straight cath.

somedayCNM, CNM · Jan 15, 2012

It depends on how far along the mom is and how fast we expect her to dilate. If she's a prime, 3cm, and just got an epidural, she gets a foley. If she's a multip, approaching transition when she gets her epidural and we can guess that she only has an hour or two before she's complete, we'll straight cath her.

BTW, eden, I love that you can walk your patients with epidurals. Gravity is a good friend that we lose once the patient gets an epidural.

RNLaborNurse4U · Jan 15, 2012

Our epidurals are too dense to walk the mom to the bathroom to void. They get intermittent straight caths, prn for distension. The evidence shows that foley placement leads to increased risk of UTI/infections in the postpartum period, which intermittent straight caths do not lead to an increased risk for UTI.

MomBabyUnitRN · Jan 15, 2012

We straight cath as needed...

shortstuff31117 · Jan 16, 2012

The evidence shows that foley placement leads to increased risk of UTI/infections in the postpartum period, which intermittent straight caths do not lead to an increased risk for UTI.

Does anyone have the links to this evidence??

somedayCNM, CNM · Jan 16, 2012

I would also love to find research on intermittent straight cath vs foley. Someone at my childbirth educator's workshop mentioned research that straight cathing causes fewer UTIs and the older nurses in our group were in total disbelief.

allnurses Guide · Jan 16, 2012

Straight cath. None of our docs would tolerate a foley.

Actually, the nurses are in agreement.

beachyfe · Jan 17, 2012

It depends on how far along the mom is and how fast we expect her to dilate. If she's a prime, 3cm, and just got an epidural, she gets a foley. If she's a multip, approaching transition when she gets her epidural and we can guess that she only has an hour or two before she's complete, we'll straight cath her.

That's my experience too. If a mom has an epidural for a long time, then repeated straight caths can introduce as much or more infection than just one insertion of a Foley.

shortstuff31117 · Jan 17, 2012

What is a long time for you guys?? Our docs practice active management, it's a rare pt. that isn't delivered within 12hrs of being admitted, usually way sooner than that.

Lately our docs have been having us take down the foley bulb, which usually results in the foley being pushed out at delivery. Then often they want another foley put in. Seems to defeat the purpose, and doesn't seem cost effective either!

allnurses Guide · Jan 17, 2012

What is a long time for you guys?? Our docs practice active management, it's a rare pt. that isn't delivered within 12hrs of being admitted, usually way sooner than that.
Lately our docs have been having us take down the foley bulb, which usually results in the foley being pushed out at delivery. Then often they want another foley put in. Seems to defeat the purpose, and doesn't seem cost effective either!

Interesting. Our moms are able to get up shortly after delivery and go to the bathroom themselves. Of course we help them ambulate but they are able to ambulate.

Maybe our dosing of the epidurals is less . . . the CRNA comes in to redose when the pain control starts to wear off. It isn't constant.

I cannot remember a time when we used a foley - except of course in a cesarean.