Foley catheters, otherwise known as urinary catheters, are important pieces of medical equipment that can be crucial in helping patients who are suffering from urinary problems like painful or difficult urination, incontinence, urethral blockages, or patients undergoing surgery or post-surgery.

However, in order to keep a Foley catheter clean and functioning as intended, it needs to be flushed or irrigated on a regular basis. The flushing procedure is relatively straightforward, but still needs to be carried out with a lot of care and attention. In this guide, we’ll explain why flushing is important and look at how to flush a Foley catheter.

Why Flush a Foley Catheter?

Before we look at a step-by-step method of how to flush a Foley catheter, it’s important for medical students and practitioners to understand why flushing is so important. So, why is it necessary to flush a Foley catheter? Well, the main purpose of flushing a catheter is to clean it and get rid of any debris or blockages inside the tubing.

Not only that, but the catheter flushing procedure also helps to wash and cleanse the bladder itself, getting rid of any debris and preventing any build-ups of mucus inside the bladder. This is very important, as catheter tubes are narrow and can easily become blocked, which may lead to pain and discomfort for the patient.

Mucous plugs and blood clots can form in the bladder and enter the catheter tubing, leading to these kinds of blockages. In some cases, this may lead to not only abdominal pain or discomfort, but even more serious symptoms like distention, bladder spasms, and so on. Flushing is therefore a crucial part of general catheter usage and maintenance.

When Should a Foley Catheter Be Flushed?

In general, it may be recommended to flush a catheter at least once a day, or a patient may even require multiple flushings per day as a preventative measure in order to ensure that the catheter is clear, and the bladder is as clean as possible. However, you may also decide to only flush the catheter if a problem is detected, like a blockage or pain in the patient’s abdomen. 

Here are some situations when a flushing may be needed:

• The catheter has stopped draining urine at the usual rate 
• The catheter has gone a full hour without draining any urine 
• The patient experiences abdominal pain or discomfort 
• The urine draining from the catheter is cloudy or has a strong odor 
• The patient has abdominal distention 
• Urine is bypassing the catheter 
• The patient feels a strong need to urinate

In any of these situations, there could be some kind of blockage or problem with the catheter. Flushing it will help to get rid of any debris or blockages and should get it running smoothly once more, as well as alleviating any pains or other symptoms that the patient may be experiencing.

What Equipment Is Needed for a Foley Catheter Irrigation?

For a Foley catheter flushing or irrigation, you will need the following pieces of equipment: 

• A bladder syringe with an appropriate catheter tip to connect to the catheter tubing 
• Some saline solution at room temperature 
• Alcohol or medical wipes for cleaning the catheter tubing
• A tray to store the syringe and other items prior to use
• A pan to collect any fluids or urine that escape from the catheter during the flushing procedure
• Medical gloves 

How to Flush or Irrigate a Foley Catheter

Next, let’s look at the full process of how to flush or irrigate a Foley catheter in a simple step-by-step way.

Step 1. Wash Your Hands with Soap and Water

As with many medical procedures, the very first thing to do is wash your hands well with soap and warm water. Wash for at least 15 seconds and build up some foam and lather between your fingers as you wash to get rid of any dirt and microbes. If soap and water are not available, alcohol sanitizer may be used as an alternative. You can also put on a pair of medical gloves at this stage.

Step 2. Prepare the Supplies

Next, you’ll need to prepare the various supplies and pieces of equipment that you’ll need to carry out the flushing procedure. Often, medical institutions make use of Foley catheter irrigation kits, which contain all you need for the procedure, including some sterile gloves, a sterile catheter tipped syringe, some saline solution, and so on. Open one of these kits or gather each of the items separately. 

Step 3. Speak with the Patient

At this stage, if the patient is awake and able to communicate, this is a good moment to speak with them about the procedure, especially if it’s the first time they’re having their catheter flushed. You can let them know what the process entails, as well as asking if they’re experiencing any difficulties with the catheter or any symptoms like abdominal pain.

Step 4. Fill the Syringe

Next, you need to fill the catheter syringe with saline solution, if this has not already been done. Typically, you’ll use a fresh catheter tip syringe from a packet, and simply insert the tip into the bottle of saline solution. Use the plunger to draw out the correct amount of saline for your syringe, and take care to keep your fingers around the outside of the bottle, keeping them away from the top to reduce the risk of contamination. You can then set the syringe aside with a cover on a clean tray while you proceed to the next step. Make sure to tap the syringe first to remove any air bubbles.

Step 5. Clean Your Hands Again and Apply Some Fresh Gloves

Next, for extra safety, it’s best to remove your existing pair of medical gloves, wash your hands one more time, and apply a fresh pair of gloves. This is because you may have touched certain items, like the saline solution bottle, which may not be entirely sterile. This may not always be necessary if you managed to maintain sterility for all of the previous steps, but is a useful extra precaution in most cases.

Step 6. Prepare the Patient and Pan

The next step is to get the patient ready for the flushing procedure. Ideally, the patient should be lying flat on their back, with the knees raised and legs apart. It may also help for them to sit up slightly, but this is not always necessary. Position a pan and potentially some towels between the patient’s legs, ready to collect any urine or fluids that drain out of the catheter during the procedure.

Step 7. Clean the Catheter Tubing

Use an alcohol wipe or medical wipe to clean the connection site around the catheter and drainage tubing. Rub the wipe around the area for at least 15 seconds, and leave it a moment to dry. You can then proceed to disconnect the drainage tubing from the catheter. Place the end of the catheter tubing in the pan so that any fluids can drain into the pan. As for the drainage tubing and bag, this may either be disposed of or set aside, depending on whether you plan to replace it or reuse it.

Step 8. Drain Urine Using Empty Syringe

This step may be considered optional, but is standard practice in many hospitals. It involves using an empty catheter syringe to draw out any excess urine or fluid from the catheter. To do this, place the syringe into the opening of the catheter tubing and plug the plunger back slowly to drain out any fluid.

Step 9. Flush with the Saline Solution

Next, you can actually flush the catheter. To do this, simply take your saline syringe and connect it to the opening of the catheter tubing. Push the plunger down to force the fluid into the catheter tubing, but stop if you feel any kind of resistance. Once done, pull the plunger back to draw as much of the fluid out as possible.

Step 10. Clean the Tubing Again and Reattach the Drainage Tubing

Once the catheter has been flushed, you can remove and dispose of the syringe and then use another alcohol wipe to clean the tubing once more. After that, you can either reconnect the drainage tubing and bag or add a new bag.

Step 11. Check that Urine is Flowing

The final step of the procedure is simply to visually inspect the catheter and drainage bag to see that urine is now flowing. This may not happen immediately, but drainage should start quite quickly after a flushing procedure. As long as urine is flowing correctly, the catheter is working as intended.

FAQ

Is Flushing a Catheter the Same Thing as Irrigating It?

Yes, the terms flushing and irrigating are used interchangeably in most medical settings and mean the same thing in this case. 

What Type of Irrigation Fluid Is Used for Flushing Foley Catheters?

When flushing a Foley catheter, standard saline solution used. This is comprised of a mixture of sodium chloride (salt) and water with a ratio of 9 grams of salt per liter of water.

How Should the Patient Be Placed During a Foley Catheter Irrigation?

Ideally, the patient should be in the supine position (lying flat on their back), and it helps if they can bend their knees to raise the legs slightly, with the legs separated a little to provide easier access to the catheter.

How Should You Document a Foley Catheter Irrigation?

This will depend on the policies in your practice or clinic. In general, it’s helpful to note down the date and time of each flushing so that an accurate record of irrigation can be kept and monitored.

How Often Do You Change a Foley Irrigation Kit?

In general, a fresh or sterile irrigation kit should be used for each flushing. This is to reduce the risk of infection. The same syringe may be used multiple times, but will need to undergo sterilization in between uses.