University of Colorado Health-Central, Unit-Based Guideline: Perioperative Services

University of Colorado Hospital Guideline for

Bladder Scan Use in Post Anesthesia Care Units
Related Policies and Procedures:
Insertion, Removal and Care of an Indellin! "oley Catheter
Pediatric Post #nesthesia Care
Post #nesthesia Care
University of Colorado Hospital Guideline: $oidin! #l!orithm for Preventin! Postoperative
Urinary Retention %P&UR'
Approved By: Perianesthesia Guidelines (as) "orce

Owner: Perianesthesia *uality Improvement Committee
Subitted by: Raelyn +icholson, R+, BS+, PCC+
!ate updated"reviewed: ,-./-0/.1
Perioperative Guideline #as$ %orce review date: ,-./-0/.1
Purpose:
Guidelines for the use of the 2ladder scanner on patients in the post anesthesia care settin!s3
Sources:
Baldini, G3, Ba!ry, H3, #pri)ian, #3, 4 Carli, "3 %0//5'3 Postoperative urinary retention: anesthetic
and perioperative considerations3 Anesthesiology, 110%6', ..75-..683 %9&: .'
"eliciano, (3, ;ontero, <3, ;cCarthy, ;3, 4 Priester, ;3 %0//='3 # retrospective, descriptive,
e>ploratory study evaluatin! incidence of postoperative urinary retention after spinal anesthesia
and its effect on P#CU dischar!e3 Journal of PeriAnesthesia Nursing, 07%,', 751-1//3 doi:
./3./.,-?3?opan30//=3/53//, %9&: ,'
Hansen, B3S3, Soreide, :3, @arland, #3;3, 4 +ilsen, &3B3 %0/..'3 Ris) factors of post-operative
urinary retention in hospitalised patients3 Acta Anaesthesiologica Scandinavica, 55, 616-61=3 doi:
./3....-?3.755-,68,30/..3/01.,3> %9&: 1'
$erathon3 %0//='3 BVI 900 !ser"s #uic$ %eference3 Bothell, @#3 %9&: ='
@arner, #3<3, Phillips, S3, Ris)e, A3, Hau2ert, ;3, 4 9ash, +3 %0///'3 Postoperative 2ladder
distension: ;easurement ith 2ladder ultrasono!raphy3 Journal of PeriAnesthesia Nursing, 15%.',
0/-063 %9&: 8'
!efinitions:
P#CU- post anesthesia care unit
Bladder Scan- %Bladder $olume Instruments' B$I 51// 2y $erathon
#IP- #nshutB Inpatient Pavilion
#&P- #nshutB &utpatient Pavilion
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Guideline:
A& 'nitial Assessent
.3 :ach patient receivin! anesthetic a!ents should 2e evaluated for 2ladder
distention as part of their nursin! assessment3
03 Patients ith orders ritten to void 2efore dischar!e need to 2e encoura!ed to
void3
73 (he re!istered nurse may use palpation of the 2ladder, patientsC ur!e to void,
and inta)e-output of intravenous fluids !iven under the care of anesthesia to
help assess 2ladder volume status3
13 # 2ladder scan ultrasound should 2e o2tained if a patient is not a2le to void 1-
, hours from removal of "oley catheter, strai!ht catheteriBation, or post sur!ery3
63 # 2ladder scan ultrasound should 2e o2tained to assess for residual urine if a
patient has any discomfort or ur!e to void ith ina2ility to void or voids less
than .6/ml3
B3 Use of Bladder Scan
.3 (he primary nurse should chec) out the 2ladder scan from the clean utility room
2y usin! the loc) system in place3 Complete the si!n out sheet posted a2ove the
scanner3
03 Bladder scan may only 2e 2orroed 2y the #&P P#CU staff3 (he #IP
P#CU staff ill o2tain the scanner for the #&P staff in the same format as
stated a2ove3
73 &nce the scanner is 2rou!ht to the patientCs 2edside, the nurse ill poer on the
scanner 2y pressin! the on-off 2utton3
13 (he scannin! mode should no 2e selected, hich includes: female, male-non
uterus female, or child %less than ,/l2s'3
63 Place the patient in lyin! position, prefera2ly as flat as possi2le3
,3 #pply ultrasound !el to the end of the pro2e3
83 ;a)e contact 2eteen the patient and the pro2e a2out 7 fin!ers a2ove pu2ic
2one and aim up toard the 2ladder3
=3 Press and release the tri!!er hile still maintainin! contact ith the patient3
53 $erify the scan 2y visualiBin! all = arros on pro2e screen and 2y ensurin! a
yello, round shape surrounded 2y hite on the scan screen3
./3 If the scan is not adeDuate, re-aim the pro2e and ta)e another scan until verified3
..3 +otify the sur!ical physician if a 2ladder volume !reater than 1//ml is
recorded3 &2tain an order to strai!ht catheteriBe or place an indellin! catheter3
.03 If less than 1//ml 2ladder volume is o2tained, then continue to encoura!e the
patient to void 2y usin! techniDues to stimulate 2ladder refle> %cold ater to
a2domen, stro)e inner thi!h, run ater, flush toilet'3 Continue to assess the
patient and repeat the 2ladder scan in 0 hours if the patient has not voided3
.73 Replace the 2ladder scan to its position in the clean utility3 ;a)e sure to loc)
up the eDuipment and complete the si!n out sheet hen finished3
.13 :ducate the patient and family that the patient should void independently ithin
, hours of catheteriBation3 (he patient should notify medical staff if he or she is
una2le to void hether at home or in the hospital3
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C& !ocuentation
Eocument the folloin! on the appropriate patient chart in :pic Eoc "losheets:
.3 Bladder assessment
03 Bladder scan volume %ml'
73 #mount of voided urine %if applica2le'
13 Clinician communication
63 +ursin! interventions
,3 Patient-"amily :ducation
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