Who Needs a Long-Term Urinary Catheter?
Long-term urinary catheterisation (more than 28 days) is required for: elderly male patients with benign prostatic hyperplasia (BPH) who are not surgical candidates; patients with spinal cord injury or neurogenic bladder; post-surgical patients with urological complications; palliative care patients where catheterisation provides comfort; patients with urinary retention secondary to pelvic malignancy; and post-stroke or dementia patients who cannot manage continence. The catheter is typically a 14–18 Fr two-way Foley with a 10mL balloon, changed every 4–6 weeks.
Catheter Care Routines That Prevent Infection
Daily catheter care at home to prevent CAUTI: Meatal hygiene — clean the urethral opening and catheter tube with soap and water twice daily; Hand hygiene — caregivers must wash hands before and after handling the catheter or bag; Bag position — keep the drainage bag always below bladder level (never on the floor); Closed system — never disconnect the catheter from the drainage bag unnecessarily; Avoid kinks — check the catheter and tubing regularly for kinks blocking drainage; Hydration — encourage the patient to drink 1.5–2 litres of water daily to flush the bladder. The immidit nurse will audit these practices at each visit and correct any gaps.
Monthly Catheter Change — What the Nurse Does
A monthly catheter change visit takes approximately 20–30 minutes. The nurse prepares a sterile field, deflates the balloon of the existing catheter, withdraws it gently, inspects the perineum for skin breakdown or infection signs, lubricates and inserts the new catheter using aseptic technique, inflates the balloon, confirms drainage, and connects a fresh drainage bag. All materials (catheter, bag, lubricating jelly, sterile gloves, antiseptic drape) are brought by the nurse in sealed packaging. A urine sample may be collected if infection is suspected.