What are the home care instructions for a patient with a Foley catheter?

Home Care Instructions for Foley Catheter Management

Hand Hygiene and Infection Prevention

Clean technique with thorough handwashing before and after any catheter care is the cornerstone of home Foley catheter management. 1

• Wash hands with soap and water for at least 20 seconds before touching the catheter, drainage bag, or insertion site 1
• Alcohol-based hand sanitizer (gel or foam) is an acceptable substitute when soap and water are unavailable 1
• Clean gloves are not required for family members performing catheter care at home, though they may be worn if preferred 1
• Always wash hands again after completing any catheter care procedure 1

Daily Catheter and Insertion Site Care

Keep the catheter insertion site clean and dry using only soap and water—avoid antiseptics, ointments, and petroleum-based products for routine daily care. 1

• Wash the area where the catheter enters the body once daily with mild soap and water, cleaning away from the urethral opening 1
• Rinse thoroughly and pat dry with a clean towel 1
• Do not apply antibiotic creams, ointments, or petroleum jelly to the insertion site, as these do not reduce infection risk and may cause harm 2, 3
• Inspect the insertion site daily for redness, swelling, drainage, or encrustation 1

Securing the Catheter

Secure the catheter to your thigh (for men) or lower abdomen (for women) using a catheter strap or medical tape to prevent accidental pulling and urethral trauma. 4

• Position the catheter without tension or pulling on the urethra 4
• For men: secure to the upper thigh with slight slack to allow leg movement 4
• For women: secure to the lower abdomen or upper thigh 4
• Avoid taping directly to skin if possible; use a commercial catheter securement device when available 4
• Check the securement daily and reposition if the catheter has shifted 4

Drainage Bag Management

Maintain a closed drainage system at all times and keep the collection bag below bladder level to prevent backflow of urine into the bladder. 1, 5, 2

Positioning and Handling

• Never raise the drainage bag above the level of your bladder—this allows bacteria-laden urine to flow backward 5, 2
• Keep the drainage tubing free of kinks and loops that could obstruct urine flow 6
• Ensure the tubing does not touch the floor 2
• Empty the bag when it is one-half to two-thirds full, or at least every 8 hours 7

Emptying Technique

• Wash hands before and after emptying the bag 1
• Use a clean container dedicated solely to catheter drainage—never reuse this container for other purposes 2
• Open the drainage spout and allow urine to flow into the container without letting the spout touch the container or any surface 1
• Close the spout securely after emptying 1
• Discard the urine in the toilet and clean the collection container with soap and water 8

Cleaning Drainage Bags

Clean reusable drainage bags daily with a 1:10 diluted bleach solution (1 part household bleach to 10 parts tap water) to reduce bacterial counts and extend bag life. 8, 3

• After emptying the bag, fill it with the diluted bleach solution through the drainage port 8
• Allow the solution to remain in the bag for at least 15–30 minutes 8
• Drain the bleach solution completely and rinse the bag thoroughly with tap water 8
• Hang the bag to air dry when not in use 8
• Replace drainage bags according to manufacturer instructions or when they become discolored, cracked, or malodorous (typically every 4–7 days for leg bags, monthly for overnight bags) 8, 3

Showering and Bathing

Showering is permitted if you protect the catheter and connection site with an impermeable cover; do not submerge the catheter under water in a bathtub. 1

• Cover the catheter-drainage bag connection with a waterproof barrier (plastic wrap secured with tape) before showering 1
• Avoid directing the shower spray directly at the catheter insertion site 1
• Never take a bath or sit in a tub of water with a catheter in place 1
• Pat the catheter and surrounding area dry after showering 1

Fluid Intake and Urine Monitoring

Drink 6–8 glasses (approximately 1.5–2 liters) of water daily unless your doctor has restricted your fluid intake. 2, 7

• Adequate hydration maintains good urine flow and helps prevent catheter blockage 2, 7
• Monitor your urine for color, clarity, and amount 1, 7
• Normal urine should be pale yellow to amber and relatively clear 7

Recognizing Complications and When to Seek Help

Contact your healthcare provider immediately if you develop fever ≥100.4°F (38°C), new suprapubic or flank pain, rigors, blood in urine, or if the catheter stops draining. 2, 7

Signs of Infection Requiring Medical Attention

• Fever of 100.4°F (38°C) or higher 2
• New pain in the lower abdomen, back, or flank 2
• Shaking chills or feeling very ill 2
• Confusion or altered mental status (especially in elderly patients) 2
• Foul-smelling or cloudy urine with symptoms (note: cloudy urine alone without symptoms is common and does not require treatment) 2, 7

Mechanical Problems Requiring Immediate Attention

• No urine draining for 4–6 hours despite adequate fluid intake 6, 7
• Catheter accidentally pulled out or partially dislodged 4
• Visible blood in urine (more than slight pink tinge) 7
• Leaking around the catheter 6, 7
• Catheter appears blocked or encrusted 6, 3

What NOT to Do

Do not irrigate the catheter, apply antiseptic solutions to the insertion site, or take antibiotics for cloudy urine alone without symptoms. 2, 7, 3

• Do not routinely irrigate or flush the catheter—this does not prevent infection and may introduce bacteria 2, 7
• Do not use povidone-iodine, hydrogen peroxide, or other antiseptics for daily cleaning of the insertion site 2, 3
• Do not disconnect the catheter from the drainage bag unless absolutely necessary 1, 5
• Do not take cranberry tablets or supplements—these have not been proven effective for catheter users and may be costly without benefit 2
• Do not request or take antibiotics for asymptomatic bacteriuria (bacteria in urine without symptoms)—this is universal with long-term catheters and treating it increases antibiotic resistance without preventing infection 2, 7, 3

Catheter Replacement Schedule

Catheters should be changed at regular intervals based on material type and individual encrustation patterns, typically every 2–4 weeks for latex and 4–12 weeks for silicone catheters. 6, 3

• Silicone catheters resist encrustation better than latex and can remain in place longer 3
• Some patients who form encrustations rapidly may require catheter changes as frequently as every 5 days to prevent blockage 6
• Your healthcare provider will determine your specific replacement schedule based on your history of blockages and catheter tolerance 6, 3
• If you develop a symptomatic urinary tract infection, the catheter should be replaced before starting antibiotics 2

Supplies to Keep at Home

• Spare catheter of the correct size (keep at least one extra) 1
• Catheter securement device or medical tape 4
• Drainage bags (both leg bag for daytime and larger overnight bag) 8
• Household bleach for cleaning bags 8
• Clean container for emptying drainage bag 2
• Mild soap for daily hygiene 1
• Disposable gloves (optional for family caregivers) 1