Urinary Catheter Orders

Urinary Catheter Orders Policy 

Purpose 

To ensure the proper management and documentation of urinary catheter use in residents, following current CMS guidelines and State Operations Manual (SOM) requirements for long-term care facilities. 

Policy 

Urinary catheters will be managed based on physician orders, ensuring proper catheter size, type, and maintenance procedures are followed to prevent complications and ensure resident comfort. 

Procedure 

I. Diagnosis: 

• Document the diagnosis requiring Foley/urinary catheter: _________________________________ 

II. Catheter Specifications: 

• Catheter Size: 

• Size: #________ Fr 

• Balloon: ______________ cc 

• To straight drainage and/or leg bag as indicated. 

• Catheter Type (if indicated): 

• ☐ Silicone 

• ☐ Silver Tipped 

• ☐ Other: __________________________ 

III. Maintenance: 

• Patency and Care: 

• Check Foley catheter for patency and provide Foley care every shift. 

• Securement: 

• Secure Foley catheter to body/leg to prevent catheter-related injury. 

• Changes: 

• Change Foley catheter when necessary to maintain patency. 

• Change Foley drainage bag when necessary. 

• Irrigation: 

• Irrigate Foley catheter with 60 cc NS using gentle pressure as needed for blockage. 

IV. Documentation: 

• MD Signature: 

• Date: ___________________________ 

• Transcribed By: 

• Date: ___________________________ 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.