Bladder irrigation with a 2-way Foley

[dudette10, MSN, RN]

I have looked at the Bard site, searched the internet, and asked two more experienced nurses at work. I've not been able to get a clear answer.

With someone diagnosed with hematuria but WITHOUT CBI ordered, the patient is often catheterized with a 2-way Foley. However, manual bladder irrigation is often ordered. The standard manual irrigation on a 2-way requires breaking the catheter seal that connects it to the drainage bag system, irrigating with a 60 ml piston syringe, then reattaching the system. Even with pristine aseptic technique, this method seems less than ideal and runs the risk of introducing bacteria into what is supposed to be a closed system.

Has anyone ever heard of using the sampling port for bladder irrigation? Can anyone think of any reason why this would not be better solution to reduce risk of infection during manual bladder irrigation on a 2-way Foley?

[icuRNmaggie, BSN, RN]

The large clots need to be removed manually with a Toomey syringe with the catheter opening open to air.

I dont think the large clots would be removed with gravity drainage and I can picture the sampling port clogging up when using a leur lock 60cc syringe and that not being an efficient way to clear the clots.

You should invent a new CBI catheter with a closed system irrigation port that pulls from the bag, a backflow valve, a temp probe, a stopcock for bladder pressures and that monitors urine output and charts it. You will be rich!