MEJIA, Michelle Erika F.

BSN III-B / NCM103

Fluids and Electrolytes


CONTINUOUS BLADDER IRRIGATION

Continuous bladder irrigation is a procedure usually required for two common
reasons. One is that it is done in order to decrease the chances of the formation of
blood clots in the bladder right after certain kinds of surgery. Second is to administer
medication into the bladder in order to ward off an infection or maybe for other
reasons. At times, there is a need for constant monitoring, to be certain that no
complications may happen.

DEFINITION
Continuous bladder irrigation is an ongoing infusion of a sterile solution into the
bladder, generally by utilizing a three-way irrigation closed system that has a triple-
lumen catheter. One lumen is for draining urine; another for inflating the catheter
balloon, and the last one is for carrying the irrigation solution.

PURPOSE
To prevent the formation of blood clot, permit urine free flow of urine and
sustain patency of indwelling catheter (IDC), by the continuous irrigation of the
bladder with the use of normal saline.

EXPECTED OUTCOMES
The urinary catheter stays patent and urine is drained freely through the IDC
Patient comfort is preserved
Reduced or prevented formation of clot in the bladder or the IDC
Reduced risk of urinary tract infection by using aseptic technique in connecting
the bladder irrigation to the IDC

EQUIPMENT
Non sterile gloves
Personal protective equipment (PPE)
0.9% sodium Chloride irrigation bags as per facility policy
Chlorhexidine 0.5% with 70% alcohol wipes
Continuous bladder irrigation set, closed urinary drainage bag with anti-reflux
valve.
3-way catheter
Underpad
IV pole
PROCEDURE RATIONALE
1. Explain the procedure to the patient and provide privacy. This is to
keep patient informed and comfortable
2. Place the patient in a position for easy access to the catheter while preserving his
comfort. This will help save time and effort and keep the patient comfortable.
3. Make sure that the patient has a three-way urinary catheter otherwise, a three-
way catheter has to be inserted. A three-way catheter is needed to allow for
different fluids to pass through the set.
4. Place the irrigation flasks on the IV pole and prime irrigation set, upholding
asepsis of the irrigation set. To prevent infection and other complications.
See to it that only one of the irrigation flask clamps have been opened
when priming the irrigation set or else the fluid can run from one flask to
another. After the irrigation set has been primed, make sure that every
clamp on the irrigation set is closed.
5. Put on goggles and impermeable gown, place underpad beneath the catheter
connection. In order to maintain sterility and keep from contamination.
6. Wash hands and put on non sterile gloves. To decrease the risk of spreading
bacteria and contamination.
7. Swab the IDC irrigation as well as catheter ports with chlorhexidine swabs and let
dry. To prevent contamination.
8. Remove the valve from the irrigation lumen of the catheter with the use of sterile
gauze and discard valve. To initiate irrigation.
9. Attach the irrigation set to the irrigation lumen of the catheter, sustaining a clean
procedure. This is to prevent spread of bacteria and risk of contamination.
10. Remove valve or old drainage bag from the catheter lumen with the use sterile
gauze and put on catheter drainage bag while still maintaining clean procedure.
To prevent the spread of bacteria and risk of contamination.
Make sure that you do not start bladder irrigation until urine is freely
draining.
11. Unclamp the irrigation flask which was used to prime the irrigation set and adjust
the roller clamp to set the rate of administration. To start the procedure and
meet the goals of the procedure.
12. Document procedure done and include urine color, level of hematuria, urine
output, and patients reaction. Documentation is proof that procedure was
done and to record the patients progress.