ON
BLADDER IRRIGATION
MSc Nursing
Bladder irrigation can be defined as a process of flushing out or washing out the
urinary bladder.
OR
Bladder irrigation is a technique used to flush blood clots or debris from the
bladder by pushing water solution into the bladder and immediately draining.
PURPOSE
EXPECTED OUTCOMES
•The urinary catheter remains patent and urine is able to drain freely via the
indwelling catheter (IDC)
•The patient’s risk of Urinary Tract Infection is minimised, through use of aseptic
technique when connecting bladder irrigation to IDC
EQUIPMENT FOR WARD BASED CONTINUOUS BLADDER
IRRIGATION
•3way catheter
•Continuous bladder irrigation set and closed urinary drainage bag with anti-
reflux valve.
•Alcohol wipes
METHODS
1. OPEN METHOD
Open irrigation means that the closed drainage system must be opened to the
environment in order to do the bladder irrigation.
Every time the catheter is disconnected from the drainage tubing to do the
procedure, there is a great risk of introducing bacterial contamination into the
urinary bladder. There are also increased chances of introducing air.
2. CLOSE METHOD
GENERAL INSTRUCTIONS
Irrigation is carried out until the return flow is clear. The color of the drainage
should be checked and recorded.
ARTICLES
a) Disposable gloves
b) Mackintosh
c) Three way retention catheter
d) Sterile drainage tubing and bag in place
e) Sterile antiseptic swab
f) Sterile receptacle
g) Sterile irrigation solution warmed or at room temperature.
h) Normal saline
i) Distilled water
j) Solution as prescribed by physician
k) Infusion tubing
l) IV Stand
m) Kidney tray
n) Paper bag
PROCEDURE
1) Check the physicians order for amount and strength of irrigating fluid and
reason for irrigation.
2) Preparatory phase :
a) Explain the procedure and purpose to the client to reduce anxiety.
b) Provide privacy and drape the client.
c) Empty, measure and record the amount and appearance of urine present in
the urinary bag.
4) Irrigate bladder
a) Intermittent irrigation
Instill the prescribed amount of irrigant. If specific amount is not ordered,
fill up to 150ml of irrigant.
Clamp the irrigant tubing to prevent further filling of irrigant.
If physician has ordered the irrigant to remain in the bladder for a measured
length of time, clamp the drainage tube and wait for the prescribed length
of time.
Open the drainage tube (the clamp) and monitor the drainage bag.
b) Continuous bladder irrigation
Adjust the clamp on the irrigation tube to allow the prescribed rate of
irrigation to flow into the catheter and bladder.
Monitor the color, clarity, debris and volume as it flows back into the
drainage bag.
5) Tape the catheter securely on the thigh to prevent catheter from dislodging.
7) Discard all used disposable articles, clean and replace reusable articles.
Prevention of infection
a) Practice strict aseptic techniques. Everything that touches the urinary tract
should be sterile namely the fluids, catheter, tubing’s and other equipments.
b) Practice thorough hand washing before and after the procedure.
c) Cleaning the catheter that is lying outside the urethra reduces the chances of
urinary tract infection.
d) Increase the fluid intake.
e) Every patient and his relatives should be taught about the catheter care.
One way to avoid this is establishing a bladder training program. The catheter is
clamped for increasing lengths of time and then released at specific specified
intervals to allow the drainage of urine. By this way the bladder is alternatively
stretched and allowed to be empty thus restoring its normal function.
Clot formation
The patient develops urinary tract infection as a result of technique during the
procedure.