This article delves into the repercussions of delayed Foley catheter removal, shedding light on the health risks associated with nursing malpractices. Health-care-associated infections (HAIs) pose a significant threat, with catheters being a major contributor. The focus is primarily on indwelling urinary catheters, such as the Foley catheter, and the adverse effects observed when not removed promptly.
The study explores the development of bacteriuria and urinary tract infections, emphasizing the urgency of catheter removal to prevent complications. Complications include urethral issues, bladder stones, allergic reactions, genital infections, and immune system stress. The article highlights the role of backflow, bacterial contamination, and inadequate emptying in causing catheter-associated infections (CAUTIs).
With a comprehensive review of the literature, this article aims to underscore the importance of timely Foley catheter removal, urging healthcare practitioners to adopt best practices and hygiene standards. By understanding the implications discussed, healthcare providers can enhance patient care and minimize the risk of catheter-associated complications.
Running head: EFFECTS OF LATE FOLEY REMOVAL BY NURSES 1
Effects of late Foley Removal by Nurses
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EFFECTS OF LATE FOLEY REMOVAL BY NURSES 2
Effects of late Foley Removal by Nurses
Health-care associated infections commonly known as (HAIs) are a common occurrence
in hospitals and are mainly provoked by nursing malpractices associated with negligence of
duties. These infections are very costly to treat besides the fact that the infections have an impact
on mortality. A study by Baim (2005) owed the lax full use of hospital equipment on patients to
be the cause of the health care risks. The tool accounting for 80% of the HAIs are the catheters
used in hospitals for purposes of draining fluids from the body. According to Diggery (2012)
Catheters were designed to assist the body in the drainage of bodily fluids from various parts of
the body due to different body anomalies. The type responsible for the HAIs is the indwelling
urinary catheters, the most common form being the Foley catheter. According to Baim (2005) "a
Foley catheter is a flexible tube passed through the urethra and into the bladder to drain urine."
Catheterization should not be used longer than is necessary as the risks grow for every day it is in
the body. The untimely removal of the Foley catheters has led to patients contracting the various
urinary tract infections among other complications. This article addresses some of the
implications of the late removal of the Foley catheters by nurses.
Bacteriuria and urinary tract infection
The surveillance of Foley catheter use is paramount and when its purpose is served the
device should be extracted carefully making sure to observe hygiene. According to Diggery
(2012) once the Foley catheters are not removed on time, a patient may to experience a sudden
urge to urinate and gets a burning sensation when doing so, fever, pain in the abdominal area or
in the genital area and swelling in the urethral area. These are signs and symptoms that an
infection has occurred and medical attention should be provided immediately to avoid further
spread of the infection-causing germs. A catheter associated infection (CAUTI) is the most
EFFECTS OF LATE FOLEY REMOVAL BY NURSES 3
common effect of the untimely removal of Foley catheters. According to Baim (2005),
indwelling catheters lead to infections due to reasons attributed to backflow of already
contaminated urine into the kidney, bacteria from the bowel movement getting into the catheter
and non-frequent emptying of the urine bag. The UTI usually follows a formation of bio film that
prevents any response from the host immune system. The germs existence in the urine may cause
severe kidney and bladder complications.
Urethral complications- Most of the urethral complications have been attributed to the
lengthy use of Foley catheters. This kind of complication is mostly common in neuropathic
women though it is also found in men. The longer the catheter is dwelling in the body the more
downward pressure it exerts on the sphincter muscles around the bladder and the gut. This is
especially common for the Foley catheters designed with large balloons that exert a lot of
downward pressure on body muscles. The aftermath is loosened muscles that are inefficient in
their function bringing about fistula, abscess and complications like iatrogenic hypospadias (a
preventable injury to the ventral male urethra (Agarwal, Gandhi, Kashyap, Liebman, 2011).
Bladder stones- According to Baim (2005) a prevalence of 55-65% of the bladder stone
cases is attributed to the prolonged use of the indwelt catheters. Bladder stones are hard crystals
of minerals in the blood due to lack of proper disposal of urine and in these case the bladder
stones are attributed to the negligence of nurses to dispose of the filed urine bags. The longer the
Foley catheter is in the body the more chance the bladder stones are likely to develop. As the
Foley catheter continues to dwell in the body the bladder stones develop and may even spread
further into the Kidney and other parts of the body. According to Diggery (2012), a person with
small concentration of bladder stones is more likely to develop full bladder stone disease with
the prolonged use of the indwelt catheter and this may increase chances of the bladder cancer.
EFFECTS OF LATE FOLEY REMOVAL BY NURSES 4
Allergies-the late removal of Foley catheters by nurses can lead to development of
allergic reactions by patients. The latex material forming the catheters may not be body friendly
and the unnecessary prolonged use of the catheter enhance these reactions that can even be life
threatening or lead to lifetime complications.
Genital infections-A study done by Diggery (2012) showed that prolonged use of
indwelt catheters and lack of proper management of the catheters may lead to the development of
genital infections like epididymitis (a medical condition characterized by pain it the male
epididymis) and candidacies (a disease in the female genitals causing abdominal pain)
Stressing of the immune system-CAUTI infections do not respond to immune responses
since the bacteria responsible for the infections form a bio film around the Foley catheter that
hinder the immune response. So long as the catheter remains in the body the immune systems
tries to fight off the bio film and this may lead to overstressing and weakening of the immune
system and may leave a patient with a weaker immune system.
Conclusion & Review
Foley catheters are very essential for the drainage of urine in patients with inability to do
so but should not be allowed to dwell in the body longer than necessary. However, it's paramount
to make sure the use of the catheters is safe and well managed to prevent to development of the
various catheter associated complications which are usually immediately or experienced after a
period of time. If a patient is required to use the catheter for a longer time nurses are advised to
use the advanced version, which are made up of a thin hydrophilic surface coating that makes
application easy and safe. Nurses should also ensure frequent catheterization of patients to avoid
overfilling that increase chances of infected urine getting back into the bladder and spreading
further to the kidney. High standards of hygiene should be maintained to enhance safe removal
EFFECTS OF LATE FOLEY REMOVAL BY NURSES 5
and insertion of the catheters. Hence, the removal of Foley tends to have significant negative
impact prompting the need to have better management before removal to address patient issues.