MrBrown says ...

Foley or multiple straight caths - an infection is going to occur. This is partly due to the disability of the patient and her inability to even perform personal hygiene.

Patients with central lines (such as Qunton caths etc) for dialysis are going to suffer an infection before their permanent access matures enough for regular use. Change deressings with clean technique and use sterile products, it is still going to happen.

A foley long term is a sure infection as the bacteria have a path in place continuously into the bladder.

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Thanks for the reply.  My question though was, which one creates more possibility for the infection.  As far as inability of the pt to perform personal hygiene, well, someone else will do it for her, either nurses or aides.  You know how that goes.   Are you saying that the rate of infection occurring is about the same?    The way I see it, whether long term or short term, bacteria should get into the bladder; it doesn't take long. 

So... why Foleys are even in use?  They are pretty common in the hospitals.   I have worked in a hospital for almost ten years, haven't seen a pt w/Foley develop UTI.   In some nursing homes, if a pt has, say, MRSA in urine, he/she'll get a Foley, and that way, he/she's contained, and can move around instead of staying in his/her room only for the contact isolation.  I've seen it, and it apparently worked, in terms that MRSA was gone, as well as the Foley.  Oh, I guess, it depends on the facility. 

Everybody tends to forget that this is an invasive procedure, and doing it so many times a day q day just adds to it.  If this was done to you, considering that you can voice your feeling of discomfort, that would be a different story.  But this patient is nonverbal;  her legs are contracted, and no doubt hurt when you have to hold them apart so that the cath can be inserted, leave alone the discomfort of inserting it every so often.   Level of comfort/discomfort should be considered, too. 

For example, when I had my C-section 20-some years ago, I had wound infection afterwards.  The dressing had to be changed three times a day, every day.  So, every time a tape over the wound has to be removed, and a new tape goes on over a new dressing.  You would say that there is nothing wrong with this procedure (not sure if it was sterile, but let's assume it was).  Yet I let them know in no uncertain terms that it was uncomfortable, at which point montgomery straps were applied, which was much more comfortable.  Again, neither method would increase the possibility of a new infection, but the difference is in the patient's level of comfort.