Flushing a Foley catheter

[beckakc]

Did something change along the way?... to flush a Foley, you need to maintain sterile aseptic technique... right? Most of the residents I work with in ltc have orders to flush prn obstruction. I personally would rather change the catheter rather than push that yuck back into the bladder but I had an orientie that wanted to flush for decreased output. Now we don't have sterile syringes in house. I told her we could micky mouse the procedure with iv flushes because there sterile but we would need 6 of them and you put youself at risk from flashback fluid because they don't fit. I strongly recommended to wait until I could speak to the higher ups about obtaining sterile irrigation syringes. My peers recommended enteral syringes... Not sterile... And come to find out that's what we have been using for years. Ugh. Policy and procedure manual plainly stated to use sterile syringe. Director of nursing told me she was going to have the policy changed. Am I crazy or is this place insane?

[AgentBeast, BSN, RN]

Pretty much insane, but most nursing homes are and couldn't care less about evidence based best practices or patient safety. The only thing they care about is the almighty dollar. Flushing an indwelling urinary catheter is an aseptic procedure. Catheters should be flushed with 30-60cc of sterile water from a sterile 30-60cc syringe. Water and not normal saline because water will lyse any clots or cellular debris clogging up the catheter.

[amoLucia]

To OP - enteral feedings need NOT always be sterile. Used to be just regular meals could be blender-ized, thinned with fluid (ie tap water) and then just gravity-bolus or pump-infused. Do you NOT have any of those big 50cc or 60cc luer lock syringes in the house? And the bulb syringes that come with the solution canister - I believe they're sterile.

To AgentBeast - You have a pretty much skewed view of NHs. There are some decent facilities out there - I have worked for several. You do a serious injustice to that part of the industry that struggles to provide good care. Please, don't brush all of us with one fell swoop. Yes, cost containment is a major concern. But good facilities will provide for what is needed when they so need.