Administering a Continuous Closed Bladder Irrigation

Goal: The patient exhibits free-flowing urine through the catheter.

1. Confirm the order for catheter irrigation in the medical record. Calculate the drip rate via gravity infusion for the prescribed infusion rate.

2. Bring necessary equipment to the bedside.

3. Perform hand hygiene and put on PPE, if indicated.

4. Identify the patient.

5. Close curtains around the bed and close the door to the room, if possible. Discuss the procedure with patient.

6. Adjust bed to comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009).

7. Empty the catheter drainage bag and measure the amount of urine, noting the amount and characteristics of the urine.

8. Assist patient to comfortable position and expose the irrigation port on the catheter setup. Place waterproof pad under the catheter and aspiration port.

9. Prepare sterile irrigation bag for use as directed by manufacturer. Clearly label the solution as ‘Bladder Irrigant.’ Include the date and time on the label. Hang bag on IV pole 2.5 to 3 feet above the level of the patient’s bladder. Secure tubing clamp and insert sterile tubing with drip chamber to container using aseptic technique. Release clamp and remove protective cover on end of tubing without contaminating it. Allow solution to flush tubing and remove air. Clamp tubing and replace end cover.

10. Put on gloves. Cleanse the irrigation port on the catheter with an alcohol swab. Using aseptic technique, attach irrigation tubing to irrigation port of three-way
indwelling catheter.

11. Check the drainage tubing to make sure clamp, if present, is open.

12. Release clamp on irrigation tubing and regulate flow at determined drip rate, according to the ordered rate. If the bladder irrigation is to be done with a medicated solution, use an electronic infusion device to regulate the flow.

13. Remove gloves. Assist the patient to a comfortable position. Cover the patient with bed linens. Place the bed in the lowest position.

14. Assess patient’s response to the procedure, and quality and amount of drainage.

15. Remove equipment. Remove gloves and additional PPE, if used. Perform hand hygiene.

16. As irrigation fluid container nears empty, clamp the administration tubing. Do not allow drip chamber to empty. Disconnect empty bag and attach a new full irrigation solution bag.

17. Put on gloves and empty drainage collection bag as each new container is hung and recorded.