UNIVERSITY OF SAINT LOUIS TUGUEGARAO CITY

COLLEGE OF HEALTH AND ALLIED SCIENCES Name: __________________________ Course/Year:_____________________ Date:_________________________ Set/Group#:___________________

ADMINISTERING A CONTINOUS BLADDER IRRIGATION Instruction: Please put a check ( ) mark on the appropriate column using the scale: 3- Procedure is done excellently (E) 1- the student needs more practice (NP) 2- Procedure was satisfactorily done (S) 0-the student failed to perform the skills/procedure (ND) PROCEDURE POINT EARNED 1. Verify the Doctors order for continuous irrigation. 2. Determine the type of sterile solution, the amount and strength to be used, and the rate. 3.Assemble equipment and supplies: Clean gloves (two pairs) Sterile irrigating solution (at room temperature or warmed to body temperature), usually 200 ml bags Sterile tubing with drip chamber and clamp for connection to irrigating solution IV pole Three way Foley catheter in place in patients bladder Foley drainage set up (tubing and collection bag) Bath blanket Antiseptic swabs 4. Label the irrigation solution clearly with the words Bladder Irrigation and include any information about added medications. Stamp with date, time, and initials. 5. Introduce yourself and verify clients identity. Explain the procedure and the purpose to the patient. 6. Perform hand hygiene, and other necessary infection control measures. 7. Provide privacy by closing curtains or door and draping the patient with bath blanket. 8. Put on gloves. 9. Prepare the sterile irrigation bag for use as directed by manufacturer. Secure clamp and attach sterile tubing with drip chamber to container. Hang bag on IV pole 2.5 to 3 feet above level of patients bladder. Release clamp and remove protective cover on end of tubing without contaminating it. Allow solution to flush E 3 S 2 NP 1 ND Comments 0

tubing and remove air. Reclamp the tubing. 10. Using sterile technique, cleanse the port with antiseptic swabs and attach irrigation tubing to the irrigation port of the three way Foley catheter. If a closed system is used, tubing may already be connected to irrigation port on the catheter. 11. Release the clamp on the irrigation tubing and regulate flow according to physicians order. 12. As irrigation is completed, clamp tubing. Do not allow dip chamber to empty. Disconnect empty bag and attach full irrigation bag. Continue as ordered by physician. 13. Assess patients response to procedure and the quality and amount of drainage. Document on patients chart. 14. Record amount of irigant used on intake- output record. Don gloves and empty the drainage bag, and measure the contents. Subtract the mount of irrigation solution instilled from the total volume of drainage to obtain the volume of urine output. 15. Document the procedure and results in the client record. Note any abnormal constituents such as blood clots, pus or mucus shreds. 16. Perform hand hygiene. TOTAL SCORE

Remarks: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

_____________________________________________ Printed Name & Signature of Clinical Instructor