Indwelling Urinary Catheter (Foley)
ProceduresThe steps
- Verify the indication — CAUTI prevention starts with 'does this patient still need it?'
- Strict sterile technique; dominant hand stays sterile once gloved
- Female: clean front-to-back, spread labia with non-dominant hand (now contaminated), insert until urine, then 1–2 inches more
- Male: hold penis perpendicular, retract foreskin (replace after!), insert nearly to the hub before inflating
- Inflate balloon with the pre-filled sterile water; gentle traction until it seats
- Secure to thigh (statlock/tape); bag below bladder level, off the floor
🛡 Never skip
NEVER inflate until urine confirms bladder placement — a urethral balloon is an injury Daily necessity review — every catheter-day is CAUTI risk No urine on insertion in a female patient? You're likely in the vagina — leave it as a landmark, get a new sterile kit, insert anterior to it
Common mistakes
- Breaking sterility and 'deciding it was fine' — restart with a new kit; nobody respects the nurse who guessed
- Forgetting to replace the foreskin — paraphimosis is a urologic emergency
- Bag riding above bladder level on transport (retrograde flow)
Source: Lippincott Nursing Procedures, 9th ed.; CDC CAUTI guidelinesReference only — verify against your facility's policy.
