From the Guidelines
Foley catheters should not be changed at a fixed routine interval, as there is no evidence to support that this practice reduces the risk of catheter-associated urinary tract infection (CA-UTI) or catheter blockage, as stated in the 2009 international clinical practice guidelines from the Infectious Diseases Society of America 1. When considering the frequency of changing a Foley catheter, several factors should be taken into account, including:
- The individual patient's needs and medical history
- Institutional policies and guidelines
- The type of catheter material used, such as silicone, latex, or rubber
- The presence of symptoms such as discomfort, leakage, or decreased urine output
- The risk of catheter-associated urinary tract infection (CA-UTI) and catheter blockage According to the evidence, routine catheter change at periodic intervals (e.g., monthly) is not evidence-based and may not be necessary for all patients 1. However, for patients who experience repeated early catheter blockage, more frequent changes may be necessary, sometimes as often as every 7-10 days, although this has not been evaluated in clinical trials 1. It is essential to use aseptic technique when changing catheters to minimize infection risk and document the date of insertion to ensure timely replacement. The decision to change a Foley catheter should be based on individual patient needs and clinical judgment, rather than a fixed schedule. Regular monitoring for signs of infection, blockage, or other complications is crucial to ensure the best possible outcomes for patients with indwelling urinary catheters.
From the Research
Frequency of Changing a Foley Catheter
The recommended frequency for changing a Foley (indwelling urinary) catheter varies depending on the patient's condition and the setting.
- According to 2, limited evidence suggests that routine catheter changes every 4 to 6 weeks reduce catheter-associated urinary tract infection (CAUTI) incidence in patients managed by long-term catheterization.
- A study by 3 found that catheters were changed every 2 weeks for burn patients with long-term Foley catheters.
- Another study by 4 found that routine catheter changes every month in asymptomatic individuals with spinal cord injury caused a significant rise in the urinary white blood cell count, without altering the bacterial identity or colony count.
Considerations for Catheter Change
When considering the frequency of catheter change, the following factors should be taken into account:
- Patient's underlying disease and total body surface area burned, as these factors can increase the risk of fungal urinary tract infection 3
- Presence of pyuria and bacteriuria, which are prevalent among individuals with spinal cord injury with indwelling Foley catheters 4
- Importance of staff education, monitoring of catheter use and CAUTI incidence, and careful attention to techniques for catheterization and catheter care 2