Performing Intermittent Closed Catheter Irrigation

Goal: The patient exhibits the free flow of urine through the catheter.

1. Confirm the order for catheter irrigation in the medical record.

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 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. Put on gloves. Empty the catheter drainage bag and measure the amount of urine, noting the amount and characteristics of the urine. Remove gloves.

8. Assist patient to comfortable position and expose access port on catheter setup. Place waterproof pad under catheter and aspiration port. Remove catheter from device or tape anchoring catheter to the patient.

9. Open supplies, using aseptic technique. Pour sterile solution into sterile basin. Aspirate the prescribed amount of irrigant (usually 30 to 60 mL) into sterile syringe. Put on gloves.

10. Cleanse the access port on catheter with antimicrobial swab.

11. Clamp or fold catheter tubing below the access port.

12. Attach the syringe to the access port on the catheter using a twisting motion. Gently instill solution into catheter.

13. Remove syringe from access port. Unclamp or unfold tubing and allow irrigant and urine to flow into the drainage bag. Repeat procedure, as necessary.

14. Remove gloves. Secure catheter tubing to the patient’s inner thigh or lower abdomen (if a male patient) with anchoring device or tape. Leave some slack in the catheter for leg movement.

15. Assist the patient to a comfortable position. Cover the patient with bed linens. Place the bed in the lowest position.

16. Secure drainage bag below the level of the bladder. Check that drainage tubing is not kinked and that movement of side rails does not interfere with catheter or drainage bag.

17. Remove equipment and discard syringe in appropriate receptacle. Remove gloves and additional PPE, if used. Perform hand hygiene.

18. Assess patient’s response to the procedure and the quality and amount of drainage after the irrigation.