Is there a Physician Order?
Urinary Retention or Bladder outlet obstruction
Accurate urine output measurements in the critically ill patient
Selected surgical procedures
Enter Procedure Type:
Patient requires prolonged immobilization
Assist in healing of open sacral wounds in the incontinent patient
Improve comfort at end of life
Catheter to discontinue order
Is the Foley bag equal or less than half full? (If greater than half full - please Empty)
Orange sticker on tubing nearest the bag?
Initials on the sticker
SCIP - Has this catheter been in place 2 days or longer? (If 2 days please request documentation to continue from physician.)
Securement (Statlock) in place?
Tamper Evident Seal (TES) Intact -if not please explain in text below.
Seal is broken - Please Explain.
No Dependent Loops
Tubbing and bag below bladder
Bag is above floor (not touching floor)?
Education Provided and Documented
Clean port with alcohol when emptying the bag or accessing port for any reason.