Urinary catheters are used by home healthcare patients, like Edward Jones, for a variety of reasons. Urinary catheterization allows access to the bladder for the purpose of draining urine. This access is gained by inserting either a catheter through the urethra into the bladder or a suprapubic catheter through the anterior abdominal wall into the bladder. The practice of urinary catheterization may date back to 300 AD or possibly earlier. The precursor to the modern catheter, made of gum elastic, was introduced in 1779, followed by the first latex catheter in the 1800s. In 1853, Jean François Reybard developed the first indwelling catheter, which utilized an inflated balloon to secure its place in the bladder. Frederick Foley later redesigned this catheter in 1932, and the Foley catheter remains one of the most commonly used devices for management of urinary dysfunction today (Bloom et al., 1994Lawrence & Turner, 2005). As the materials and design of catheters have evolved over time, so too have the care and management involved with catheterization. To ensure the best patient outcomes and minimal complications, the home healthcare practitioner must stay informed about catheter care. This article reviews current options for urinary catheterization and their associated complications and provides approaches to the assessment and management of catheters in patients with urinary dysfunction.

Approximately 4 million Americans undergo urinary catheterization annually, and more than 500,000 of these catheterizations involve indwelling catheters left in place for some period (Warren, 2001). Between 15% and 25% of patients may receive indwelling catheters during hospitalization, and the prevalence of catheter use in residents of long-term care facilities is estimated between 7.5% and 10% (Saint et al., 2000). One study found that of 4,010 individuals receiving home care services, 4.5% used an indwelling catheter (Sorbye et al., 2005). Although the indications for catheterization have been extensively outlined, reports of the inappropriate use of catheters range from 21% to more than 50%