Indwelling Urinary Catheters and Home Care Management: Part 1
Presented by Lisa A. Gorski
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As many as 11% of home care patients in the US have indwelling urinary catheters, more commonly referred to as Foley catheters. These catheters are associated with significant urethral, bladder, and kidney morbidity yet are necessary for home care patients who have conditions such as chronic urinary retention or urinary incontinence that cannot be managed with a less invasive method. To reduce the risk for catheter-related complications, home care nurses must possess sound decision-making relative to appropriate indications for placement, understand catheter types/sizes and features, and attend to aseptic technique during insertion. This course provides the home care nurse with essential information regarding indications for indwelling urinary catheters, types and characteristics of catheters, advantages and disadvantages of various catheter drainage systems, and best practices relative to catheter insertion and replacement. Patient case scenarios are incorporated throughout this course.
Meet your instructor
Lisa A. Gorski
Lisa A. Gorski has worked for 40 years as a clinical nurse specialist (CNS) and educator for Wheaton Franciscan Home Health & Hospice, now part of Ascension at Home, in Milwaukee, Wisconsin. As a CNS, she has played a key role in the home infusion therapy program, contributing to clinician education, policy and procedure…
Chapters & learning objectives
1. Overview: Indwelling Urinary Catheters
Indwelling urinary catheters allow for continuous, passive urine drainage from the bladder. Such catheters may be placed for short-term or long-term (generally greater than 30 days) needs. Most commonly, long-term catheters are placed via the urethra, but in some cases, catheters are placed through the abdominal wall (suprapubic catheters). In this section, indications for appropriate catheter use are explored. Reimbursement for catheter care under Medicare is also described.
2. The Catheter System: Catheter Types and Sizes
The catheter system includes the catheter, the drainage system, and securement devices. This section focuses on the types and sizes of catheters. Catheters are made of different materials and come in different sizes and lengths, offering advantages and disadvantages depending upon individual needs. Catheter selection is illustrated in the context of a patient case example.
3. The Catheter System: Catheter Securement and Drainage System
Catheter securement is an important intervention to reduce risks associated with catheter traction or pulling, which can cause damage to the urinary meatus, urethra, or urinary stoma. Drainage systems include large (overnight) drainage bags, leg bags, catheter valves, and “belly” bags.
4. Catheter Placement and Replacement
Key aspects of catheter placement and routine replacement are explained in this section. The topic of catheter replacement is explored in the context of available evidence to guide practice.
