Skin Integrity Preserved Using a Nurse-Constructed Silicone Adhesive Foley Catheter Securement Device: A Pilot Study

Cathleen T. Van Houten, St. John Fisher College


Background: Both critical care and wound care nurses frequently note skin breakdown when providing care for patients in the intensive care unit (ICU). Anasarca can be a temporary effect of multiple fluid boluses. Skin becomes fragile and thin, and is more prone to skin tears, blistering, and pressure ulcers. Skin breakdown from the use of adhesive-backed catheter securement devices also is a potential untoward outcome. Despite lack of evidence regarding whether catheter securement is beneficial in preventing catheter-associated urinary tract infections (CAUTI), nurses do agree that securement helps prevent the unplanned removal of a Foley catheter.

Objective: The purpose of this catheter anchor trial (C.A.T.) was to determine whether a nurse-constructed catheter securement device could maintain Foley catheter placement without causing skin breakdown on the thigh beneath the securement device.

Methods: A pilot study using a convenience sample (n=29) of patients in the surgical intensive care unit (SICU) who had a urethral Foley catheter and thigh edema were enrolled from October 2012 through March 2013. The SICU nurses were instructed on the inclusion/exclusion criteria, process for enrollment, and a checklist to be completed at the end of each 12-hour shift. Each subject was outfitted with a standard acrylic adhesive catheter securement device on one thigh and the nurse-constructed device on the contralateral thigh.

Results: Data was analyzed. Results indicated that the use of the nurse-constructed catheter device resulted in no incidents of skin breakdown. Further research is warranted.