What are the guidelines for care of a patient with an indwelling catheter?

Your urinary catheter is a thin, flexible tube placed in your bladder to drain your urine (pee). It’s held inside your bladder by a balloon filled with water. The parts of the catheter outside your body are shown in Figure 1.

Figure 1. The parts of your Foley catheter

Catheter Care

To take care of your catheter, you’ll need to do the following:

• Clean your catheter.
• Change your drainage bags.
• Wash your drainage bags every day.
• Drink 1 to 2 glasses of liquids every 2 hours while you’re awake.

You may see some blood or urine around where the catheter enters your body. This may happen when you’re walking or having a bowel movement (pooping). This is normal, as long as there’s urine draining into the drainage bag. If you don’t have urine draining into the drainage bag, call your healthcare provider.

Showering

• You can shower while you have your catheter in place. Don’t take a bath until your catheter is removed. This is because taking a bath while you have your catheter puts you at risk for infections.
• Make sure you always shower with your night bag. Don’t shower with your leg bag. You may find it easier to shower in the morning.

Cleaning Your Catheter

You can clean your catheter while you’re in the shower.

1. Gather your supplies. You’ll need:
   • Mild soap, such as Dove®
   • Water
   • 1 Cath-Secure®

2. Wash your hands well with soap and warm water or use an alcohol-based hand sanitizer.

   • If you’re washing your hands with soap and water, wet your hands, apply soap, rub them together well for at least 20 seconds, then rinse. Dry your hands with a paper towel and use that same towel to turn off the faucet.

   • If you’re using an alcohol-based hand sanitizer, be sure to cover your hands with it, rubbing them together until they’re dry.

3. Using mild soap and water, clean your genital area.
   • If you have a penis, pull back your foreskin, if needed. Clean the area, including your penis.
   • If you have a vagina, separate your labia. Clean the area from front to back.
4. Clean your urethra (urinary opening), which is where the catheter enters your body.
5. Clean the catheter from where it enters your body and then down, away from your body. Hold the catheter at the point it enters your body so that you don’t put tension on it.
6. Rinse the area well and dry it gently.
7. If you removed your old Cath-Secure, use the new Cath-Secure to attach the catheter to your leg to keep it from moving.

Changing Your Drainage Bag

This video demonstrates how to change your urinary (Foley) catheter drainage bag.

You’ll change your drainage bag 2 times a day:

• In the morning after you shower, change the night bag to the leg bag.
• At night before you go to bed, change the leg bag to the night bag.

1. Gather your supplies. You’ll need:
   • A clean washcloth (not one already used for bathing) or a 4”x 4” piece of gauze
   • Night or leg drainage bag (whichever one you are switching to)
   • 2 alcohol pads

2. Wash your hands well with soap and warm water or use an alcohol-based hand sanitizer.

   • If you’re washing your hands with soap and water, wet your hands, apply soap, rub them together well for at least 20 seconds, then rinse. Dry your hands with a paper towel and use that same towel to turn off the faucet.

   • If you’re using an alcohol-based hand sanitizer, be sure to cover your hands with it, rubbing them together until they’re dry.

3. Empty the urine from the drainage bag into the toilet. Make sure the spout of the drainage bag never touches the side of the toilet or any emptying container.
4. Place the clean cloth or gauze under the connector to catch any leakage.
5. Pinch off the catheter with your fingers and disconnect the used bag.
6. Wipe the end of the catheter with an alcohol pad.
7. Wipe the connector on the new bag with the second alcohol pad.
8. Connect the clean bag to the catheter and release your finger pinch.
9. Check all connections. Straighten any kinks or twists in the tubing.

You may also find it helpful to watch the video below that shows you how to change your drainage bags.

Caring for Your Drainage Bags

Caring for your leg bag

• The tubing from your leg bag should fit down to your calf with your leg slightly bent. If you have extra tubing, you may need to cut it. Your nurse will show you how to do this.
• Always wear the leg bag below your knee. This will help it drain.
• Place the leg bag on your calf using the Velcro® straps your nurse gave you. Use a leg strap to secure the tubing to your thigh.
• If the straps leave a mark on your leg, they are too tight. Loosen them. Leaving the straps too tight can decrease your blood flow and cause blood clots.
• Empty the leg bag into the toilet every 2 to 4 hours, as needed. You can do this through the spout at the bottom. Don’t let the bag become completely full.
• Don’t lie down for longer than 2 hours while you’re wearing the leg bag.

Caring for your night bag

• Always keep the night bag below the level of your bladder.
• To hang your night bag while you sleep, place a clean plastic bag inside of a wastebasket. Hang the night bag on the inside of the wastebasket.

Cleaning the drainage bags

1. Gather your supplies. You’ll need:
   • White vinegar
   • Cool water

2. Wash your hands well with soap and warm water or use an alcohol-based hand sanitizer.

   • If you’re washing your hands with soap and water, wet your hands, apply soap, rub them together well for at least 20 seconds, then rinse. Dry your hands with a paper towel and use that same towel to turn off the faucet.

   • If you’re using an alcohol-based hand sanitizer, be sure to cover your hands with it, rubbing them together until they’re dry.

3. Rinse the bag with cool water. Don’t use hot water because it can damage the plastic equipment.
4. To help reduce the smell, fill the bag halfway with a mixture of 1 part white vinegar and 3 parts water. Shake the bag and let it sit for 15 minutes.
5. Rinse the bag with cool water. Hang it up to dry.

Preventing Infections

Follow these guidelines to prevent getting infections while you have your catheter in place:

• Keep the drainage bag below the level of your bladder.
• Keep your drainage bag off the floor at all times.
• Keep the catheter secured to your thigh to keep it from moving.
• Don’t lie on your catheter or block the flow of urine in the tubing.
• Shower daily to keep the catheter clean.
• Wash your hands before and after touching the catheter or bag.

When to Call Your Healthcare Provider

Call your healthcare provider right away if:

• Your catheter comes out. Don’t try to replace it yourself.
• You have a fever of 101°F (38.3 °C) or higher.
• You’re making less urine than usual.
• You don’t have urine draining into your drainage bag.
• Your urine smells bad.
• You have bright red blood or large blood clots in your urine.
• You have abdominal (belly) pain and no urine in your catheter bag.

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If you have any questions, contact a member of your care team directly. If you're a patient at MSK and you need to reach a provider after 5 p.m., during the weekend, or on a holiday, call 212-639-2000.

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