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.

Cont

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

purpose

To prevent the formation ofblood 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.

indication

contraindication
Bleeding Bladder distension Bladder cramp

Types of solution
Eighty-nine persons with bacteriuria were randomized to irrigate their bladders twice daily for 8 weeks with 30 mL of (a)sterile saline, (b)acetic acid, (c)neomycin-polymyxin solution. Urinalysis, cultures, and antimicrobial susceptibility tests were performed at baseline and weeks 2, 4, and 8 to determine the extent to which each of the solutions affected numbers and types of bacteria, urinary pH, urinary leukocytes, and generation of antimicrobial-resistant organisms.

Prepare the equipment

3way catheter 0.9% sodium Chloride irrigation bags as per facility policy Continuous bladder irrigation set and closed urinary drainage bag with anti-reflux valve. Chlorhexidine 0.5% with 70% alcohol wipes Non sterile gloves Personal protective equipment (PPE) Underpad (blue) inkchopad IV pole

Test And Prepare Your Equipment Before inserting the catheter, ensure that the balloon inflates and deflates easily. Use only water - not normal saline - to inflate the balloon as normal saline can precipitate, making the balloon difficult to deflate when the patient is ready for catheter removal. Final steps in preparation include attaching the catheter to the collecting tubing, opening the sterile package of viscous lidocaine or topical lubricant, and pouring the betadine solution onto the cotton balls, which will be used in the next step.

Preparation of the patient

Explain

the procedure to the patient. This is to keep patient informed and understands and allay anxiety. Positioning In both males and females, the patient should be positioned supine (lying flat). Females should be placed in the frog-leg position so you can more easily access the urethral meatus. 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.

Procedure

Put on goggles and impermeable gown, place under pad beneath the catheter connection. In order to maintain sterility and keep from contamination.

Wash hands and put on non sterile gloves. To decrease the risk of spreading bacteria and contamination.

Swab the IDC irrigation as well as catheter ports with chlorhexidine swabs and let dry. To prevent contamination.

Remove the valve from the irrigation lumen of the catheter with the use of sterile gauze and discard

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.

Unclamp the irrigation flask which was used to prime the irrigation set and adjust the roller clamp to set therateof administration. To start the procedure and meet the goals of the procedure. 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.

Suprapubic bladder irrigation

PROCEDURE DONE IN THE OPERATION BY DOCTOR Prepare equipment such as : 1 bottle of Normal Saline irrigation solution 1 prepackaged irrigation kit 1 catheter plug

Asuprapubiccatheteris a flexible rubber or plastic tube that is placed directly into the bladder. Thesuprapubiccatheteris surgically implanted via an abdominal incision and is used as a urinary drainage method. Since the placement of thesuprapubiccatheteris a surgical procedure, it must be performed by a physician.

Procedure to follow :

1. Wash your hands well before and after the procedure. 2. Sit on the edge of a bed or large chair. Place a clean towel over your thighs and under connection site of suprapubic catheter. 3. Pour saline solution into the collection container. Draw 15 to 20 ml of solution into the syringe. 4. Remove plug from the end of the catheter. Make sure this is done without pulling on the catheter.

Cont
5. Open the alcohol swab wrapper. Remove the alcohol swab and use it to clean the area of the catheter that had been covered by the plug. 6. Insert the tip of the syringe into the suprapubic catheter. Then gently insert the solution into the catheter. 7. Remove the syringe and let the solution flow into the drainage container. Do NOT let the end of the catheter touch the drainage container. Do not draw up any of the solution after it has drained into the container. 8. After all the solution has drained, wipe the end of the catheter with the unused alcohol swab. Wait a few seconds to let the alcohol evaporate then cover with a clean plug.

Continuous bladder irrigation

Two types : Closed CBI Open CBI

Closed Bladder Irrigation : provides intermittent or continuous irrigation of the catheter without disrupting the sterile connection between the catheter and the drainage system . Intervention : Limits UTI risk Set - up : involves continuous infusion of sterile solution into the bladder Via : triple lumen catheter Application : following genitourinary surgery preventing urinary tract occlusionby clots do not disconnect a urinary catheter and drainage system unless the catheter is being irrigated using intermittent open technique use normal saline antiseptic technique

Before procedure

check patient record to determinepurpose for bladder irrigation check physiciansorders to determine: type and amount of irrigant frequency of irrigation: rate and if continuous or intermittent.

assessment

Colour of urine Presence of mucus, clots or sediment Palpate the bladder For CBI assess ongoing urinary output For CBI assess amount ofirrigant inputting note amt remainingin bag to be imputed Assess forabdominal pain or spasms Assess for sensation of bladder fullness Assess for urinary bypass Assess for signs and symptoms of UTI

complication

If output is less than input, catheter may be obstructed by clots or mucous or tubing kinked If urinary output has stopped and catheter patency cannot be re-established through manual irrigation stop CBI and notify physician

Three way bladder irrigation

Three-Way Urinary Catheter Continuous bladder irrigation shall be done via a three-way

EQUIPMENT: Three-way Catheter set-up Irrigation fluid and/or medications

Urinary Drainage bag IV tubing Catheter Plug urinary catheter.

A 3-way catheter is a style of catheter that ends in three separate prongs instead of a single or double tube. It is used to treat bladder infections and other conditions which require a doctor to introduce something into the bladder as well as drain it. Since 3-way cathether are a style of Foley catheters which won't slip out, they are sometimes known as Foley catheters or 3-way Foley catheters.

WHEN PERFORMING ContinuousBladderIrrigation(CBI), the3waycatheteris threaded up the patient's urethra and into thebladder. After the balloon is inflated, anirrigationbag full of saline is attached to one of the narrower tubes and hung on an intravenous, or IV, pole. This allows gravity to push the saline though thecatheter. The saline flows through thecatheter, into thebladderand out again through the other two tubes. The wider center tube allows for blood clots and other matter to pass through thecatheterwithout plugging up the overall flow.