home foley teaching

disher · Feb 3, 2002

We suggest rinse with warm water, rinse with cold water, fill the bag with 50/50 vinegar and water, soak for 20 minutes drain.

If patient doesn't go home to a hospital bed they can "hang" the bedbag by putting it inside a pillowcase and tucking the top of the pillowcase between the boxspring and mattress.

Home Health Columnist / Guide · Feb 3, 2002

If patient doesn't go home to a hospital bed they can "hang" the bedbag by putting it inside a pillowcase and tucking the top of the pillowcase between the boxspring and mattress.

Disher, in my seventeen years of homecare never thought of that great advice!!

Still shows you can learn something new everyday.

hoolahan, ASN, RN · Feb 3, 2002

That is an excellent idea disher!!

I hope you guys don't mind, but I copied this thread into the home health forum. Not sure if all posts will go to both foums, will test it and see!

hoolahan, ASN, RN · Apr 24, 2002

I am bringing this one up to the top b/c I have a frustration. I am trying to get together a pt handout for cleaning foley supplies like leg and bed bags. But guess what? I can't find any research to support changing bags. All the research I have, including a pt teaching guide from BARD, states to maintain a closed system!

So, why are we teaching people to change bags? I know the obvious answer is b/c the leg bag is more convenient and aesthetically pleasing to the person w a foley who is ambulatory, and the leg bag does not hold enough to make it through the night. What I have read is the correct way to do things is to attach the bed bag to the drain spout of the leg bad in order to "not break the system."

I don't think I've seen any more infections in pt's who open and close the system, in fact, I think I see more infection in the bed bound pt's who keep bed bags on 24/7. And what about the need to irrigate? We teach families to irrigate right? How does one irrigate w/o opening the system?

If anyone has literature, from a reputable source regarding how these supplies should be cleaned, please ley me know. I want to be able to put references at the end of my packet, or at least along with it so nurses will 1) know it is evidence-based, and 2) we will all be teaching pt's consistently.

Thanks

Home Health Columnist / Guide · Apr 28, 2002

Have pamphlet from Bard and willing to mail/fax/e-mail file copy to anyone.

disher · Apr 28, 2002

Hoolahan, Was told by a urologist that every day an indwelling catheter is in place the risk of UTI increases 10%. If someone has an indwelling in for 1 day they have a 10% risk of UTI after 10 days they have a 100% risk of UTI. Given this information, I think efforts to prevent UTI by maintaining a closed system maybe futile. I will check and see if I can locate any evidenced based cleaning information for you. :)

disher · May 1, 2002

Hoolhan, information on cleaning leg/bed bags is available on the American spinal cord injury nurses website http://www.aascin.org Look under- Publications - Nursing Clinical practice Guideline Neurogenic Bladder Management, p29 rinse with cold water and add 15ml bleach to get 1:10 to water concentration. The bleach reccommendation originates from an article in Rehabilitation Nursing, Dille, C.M. & Kirchhoff, K.T. (1993) "Decontamination of vinyl urinary drainage bags with bleach",18 (5), 292-295. Hope this helps with your pamphlet. :)

disher · May 1, 2002

Hoolahan two more website that may be of interest to you. The center for disease control site contains tons of evidence based info. and nursing center.com has fulltext continuing ed articles, search for one tittled Combating UTI (it is pretty good resource). Both sites discuss maintaining a closed system but also advise disinfecting the end of catheter before reconnecting (at my hospital we wipe the catheter an alcohol swab before connecting) the websites are: http://www.cdc.gov/ncidod/hip/GUIDE/uritract.htm

http://www.nursingcenter.com/library/index.asp

hoolahan, ASN, RN · May 2, 2002

Thanks Disher, cdc was one of the first sites I checked, and they really didn't address home care, hence the not opening the system, whihc in the hospital, with all the MRSA, etc, makes perfect sense.

NOw the next tip I need is how the heck do you rinse the bags and tubing out on the bed bag, not too easy to run water and pour vinegar into the tubings. Anyone have any neat little teaching tips for that? Do you tell pt's to try a small funnel, or what? I have taught pt's to soak the legs bags in the vinegar water solution inside a basin. I tell them after you get the bag filled, all the bubbles come out, then pinch off the ends and shake it around to get all the sediment out, if any, then drain, and repeat 2 or three times as needed. Mt pt's have said this works well, but I need a better tip to clean out the leg bags.

I will go check out that other site you recommended first disher, thanks.

I'm back from my surfing, and that spinal cord nurses site has a wonderful clinical practice guide. I never would have thought of looking at a site like that. Thank goodness we can come here, and help each other like this!!! Thanks disher, and NRS Karen, who I reuested a sample of her info she got from Bard. Which is interesting, b/c I have a pt teaching guide from Bard that actually discourages you from opening the system, or even removing the red plastic at the connector site. The stuff I have must be older than what NRSKaren got. Thanks again guys!!

disher · May 2, 2002

Your welcome hoolahan,glad to share info with you. I found the best way to rinse a bedbag or legbag, is with an irrigation syringe (the ones that look like turkey basters). The syringe fits snugly into the top of the tubing and makes a good funnel. You can attach the the syringe and hold it under the tap to run water through it. Or you can mix (bleach and water) or (vinegar and water) in the bottle that comes with the irrigation kit and pour through the funnel into the tubing and bag. Keep the drain tube closed while filling the bag and agitate the bag for about 30 seconds after it is full.

If bleach and water is used drain immediatly after agitating. If vinegar and water is used it can sit in the bag for 30 minutes (some patients let it sit overnight).