Foley
Indications
Acute urinary retention
Chronic urinary incontinence (as last resort)
Need for accurate output measurement (critically ill)
Perioperative use for surgical procedures
Healing of sacral/perineal wounds in incontinent patients
Comfort care for terminal patients
Bladder irrigation (after prostate surgery)
Contraindications
Urethral trauma or injury (pelvic fracture – check for blood at meatus)
Allergy to catheter materials (latex or iodine – use silicone or
alternative)
Catheter Sizes (French Gauge)
Children: 8-10 Fr
Adult females: 14-16 Fr
Adult males: 16-18 Fr
Post-op or clots: 20-24 Fr (larger for irrigation)
Supplies Needed
Sterile Foley catheter kit (includes:
o Catheter
o Lubricant
o Sterile gloves
o Antiseptic solution (povidone-iodine or CHG)
o Syringe with sterile water (usually 10 mL)
o Drainage bag with tubing
o Waterproof drape
o Collection tray
Additional sterile gloves (optional)
Extra lubricant or catheter if needed
Securement device (leg strap or StatLock)
Infection Control / Aseptic Technique
Perform hand hygiene before and after procedure
Use sterile technique throughout insertion
Maintain closed drainage system
Secure catheter to prevent movement and trauma
Keep drainage bag below bladder level at all times
Empty bag when 2/3 full or every 8 hours
Clean perineal area and catheter regularly (per facility policy)
Patient Preparation
Explain the procedure and obtain informed consent
Position patient:
o Females: supine, knees flexed, hips externally rotated
o Males: supine with legs extended and slightly apart
Provide privacy (curtain, drape)
Assess for allergies (iodine, latex)
Steps for Insertion
1. Perform hand hygiene and don gloves
2. Position patient and expose perineal area
3. Place waterproof pad under patient
4. Drape patient for privacy and remove gloves
5. Open catheter kit using sterile technique
6. Don sterile gloves
7. Place sterile drape under patient
8. Prepare all items on sterile field:
o Open antiseptic
o Attach syringe to balloon port
o Open lubricant
o Lubricate catheter tip
9. Cleanse urinary meatus:
o Female: front to back, separate labia, use new swab per stroke
o Male: circular motion from meatus outward, retract foreskin if
needed
10. Insert catheter:
o Female: advance 2-3 inches until urine flows, then 1-2 more
inches
o Male: advance 6-8 inches until urine flows, then to bifurcation
11. Inflate balloon with sterile water (verify balloon inflates
correctly)
12. Gently pull back until resistance is felt
13. Secure catheter to thigh (prevent tension/trauma)
14. Connect to drainage bag
15. Dispose of equipment, remove gloves, perform hand hygiene
16. Document procedure
Documentation
Date/time
Type and size of catheter
Amount of water used to inflate balloon
Characteristics of urine (color, clarity, odor)
Urine output
Patient tolerance
Any complications
Teaching provided
Nursing Considerations & Ongoing Care
Monitor for signs of infection: fever, cloudy/foul-smelling urine, pain
Assess urine output and patency of catheter
Encourage fluid intake unless contraindicated
Avoid kinks in tubing
Keep bag below bladder, off the floor
Empty bag with clean container, without contaminating outlet
Provide catheter care per facility policy (typically every shift)
Complications
Catheter-associated urinary tract infection (CAUTI)
Urethral trauma or irritation
Blockage or leakage
Bladder spasms
Latex allergy reaction
Hematuria
ATI
Do not test balloon before insertion (can distort shape)
Secure tubing to thigh or abdomen (per male/female)
Clean perineal area daily and after BM
Promptly remove catheter when no longer needed
Use bladder scanner before insertion if retention is suspected
Do not forcibly insert against resistance
"CATHETER"
C: Consent & Comfort
A: Aseptic technique
T: Tube selection & size
H: Hand hygiene
E: Educate patient
T: Tuck & secure
E: Evaluate urine output
R: Record all findings
