Policy Manual sample

MDT Home Health Care Agency, Inc. 17 BLADDER IRRIGATION PURPOSE: Irrigation is performed in accordance with a specific physician's order specifying solution amount and frequency to establish the patency of a urethral catheter, to treat a bladder infection and to treat a bladder inflammation. Routine irrigations are not recommended because of increased risk of bacterial introduction into the urinary tract. Assessment at the time of irrigation should include: 1. The integrity of the collection system 2. The patient's intake and output 3. The patient's hydration status 4. The blood pressure/vital signs RESPONSIBLE PERSONNEL: RN, LPN EOUIPMENT: Sterile catheter tip syringe and/or bladder irrigation kit, prescribed irrigation solution and disposable gloves. SPECIAL CONSIDERATIONS: The presence of clots, sediment or mucous may plug tubing. Gentle rotation of the catheter while massaging the suprapubic area may loosen plugs. Instruct the patient to inhale deeply, hold the respiration and exhale, or instruct the patient to turn from side to side. Avoid strong aspiration. Strong suction with the syringe may traumatize the bladder wall. PROCEDURE: 1. Explain procedure to patient. 2. Wash hands. Put on gloves. 3. Discard urine currently in drainage bag. 4. Assist the patient to a dorsal recumbent position. Screen for privacy. 5. Keep patient’s chest and abdomen covered through out procedure. 6. Open irrigation tray using aseptic technique. 7 Spread absorbent towelette as indicated: Male - over upper thighs Female - under buttocks 8 Pour the prescribed solution into receptacle. 9. Wipe the connection of the drainage tubing and catheter with an alcohol prep. 10. Disconnect the drainage tubing from the Foley and drain urine. Keep the end of the catheter sterile. Cap or position drainage tube to maintain sterility. 11. Draw up prescribed amount of solution into syringe. Attach the end of the syringe to the catheter. Inject the irrigant slowly and gently. 12. Remove the syringe. Allow gravitational return of irrigant. Repeat procedure if indicated. a) For bladder irrigation : Continue until all ordered solution is used or until return is clear. b) For instillation : Continue until catheter is patent and draining. 13. Leave catheter clamped for bladder instillation. 14. Wipe open end of drainage tube with an antiseptic wipe. Attach to Foley catheter. 15. Make the patient comfortable. Arrange tubing. Measure the amount of return.