Hospital acquired infections (
Hospital acquired infections (HAI) is preventable andconsidered “never events”
Indwelling foley catheterization should be the final meansof providing the patient protection of dressings or skin lesions.Strict aseptic technique is mandatory.
1. Indicate at least 7 criteria for short-term indwellingfoley catheter.
2. List at least 5 complications of long-term use ofindwelling foley catheter and briefly describe or definethem.
3. List at least 4 nursing interventions in maintainingthe catheter.
Answer:
1. Indications for Short-term indwelling catheterization
- Post surgery and in critically ill patients to monitor urinaryoutput.
- Prevention of urethral obstruction from blood clots withcontinuous or intermittent bladder irrigations
- Instillation of medication into the bladder.
- Surgical procedures involving pelvic or abdominal surgeryrepair of the bladder, urethra, and surrounding structures.
- Urinary obstruction (e.g. enlarged prostate), acute urinaryretention.
- Decompression of the bladder.
- Measure residual urine.
- Management of patients with spinal cord injury, neuromusculardegeneration, or incompetent bladders.
2. Complications of long term Foley’s catheter;
Urinary tract infections – It is very commonfor patients to get UTIs from catheters. Some infections can bevery deadly.
Cystitis – Cystitis is inflammation of thebladder and is most frequently caused by bacteria in the bladderdue to a urinary tract infection, but can also be caused by certaindrugs, radiation therapy, chemotherapy and long-term use of aurinary catheter.
Urethral Injury – Urethral injury due to traumais a common complication associated with Foley catheters especiallyif the catheter is inserted forcefully or roughly.
Blood Infection – Blood infection, or sepsis,is a rare complication of bladder catheterization and is typicallyonly found in patients requiring long-term catheterization.
- Narrowing of the urethra (this complicationusually occurs in long term insertion due to scar tissue formationby the insertion of the catheter.
3.Nursing management
- Make sure that urine is flowing out of the catheter into theurine collection bag. Make sure that the catheter tubing does notget twisted or kinked.
- Keep the urine collection bag below the level of thebladder.
- Make sure that the urine collection bag does not drag and pullon the catheter.
- It is okay to shower with a catheter and urine collection bagin place, unless the doctor says not to.
- Check for inflammation or signs of infection in the area aroundthe catheter. Signs of infection include pus or irritated, swollen,red, or tender skin.
- Clean the area around the catheter twice a day with water. Drywith a clean towel afterward.
- Do not apply powder or lotion to the skin around thecatheter.
- Do not tug or pull on the catheter.
- A person should not have sexual intercourse while wearing acatheter.
- At night it may be helpful to hang the urine collection bag onthe side of the bed.
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