Flowsheet for Continuous Bladder Irrigation

We have a page that has three columns 1st is total in, 2nd is total out then third column is true urine which is just the first two colums subtracted from each other. Simple but effective and pretty self explanatory...It is a separate sheet from our regular I/O and is strictly for CBI so as not to confuse everything else...it is also documented hourly so that there is less confusion in totals at the end of the shift...

I think a lot of the confusion comes at the end of the shift when we are getting totals. Somehow it always seems to get messed up trying to figure out what the last shift did and how that effects our totals. Just didn't know if there was an easier way.

We have 2 blank columns on our I&O sheets we use for that purpose.

column 1. date and time

column 2. irrigation solution name

column 3. amount of irrigation solution hung

column 4. amount of output/color

column 5. total output for shift (subtract amount in from amount out)

Remember output should be at least 300 cc for an 8 hour shift and color of output should be going from a bright red to clear or almost clear in about 24 or so hours. There may be clots or sediment in output at first but if irrigation is running at a proper rate, this should clear up in a few hours. Many patients c/o discomfort and bladder spasms in first 24 hours, so pain med is approiate and also antispasmotic if ordered. If not call doctor, he will probably give order for Ditropan or something like that.

I do not mean to lecture you on proper patient care but I saw a patient really suffering because doctor was not clear with orders and nurse was not very experienced. Remember a negative output may indicate more severe problem and needs reported quickly.

Hope this helps.

Hello, I am too looking for a good CBI worksheet with clear directions. I have a mad night last shift with pt. getting blood along with CBI and having 6 other patients to boot. Our sheet has 4 columns, one for volume up, volume in, foley contents and amt of urine output. It is very confusing when you hang a new bag in keeping up with what is actual urine ouput. Also, I did find out that if you have to irrigate, that using the straight lumen on the 3way will facilitate breaking a clot, I tried using the curved one and had no luck. Any input (no pun intended) would be greatly appreciated.

WE just make our own columns on our I&O sheets. Not the most professional looking thing you've ever seen, but it works and has that "we care for you" look to it since it looks handmade :) Of course I guess it could also look like "we are too cheap to have pre-made sheets."

Thanks for this. I had my first one of these just yesterday and I was very confused on the charting. The key is to note each hour I & O and subtract the difference. Not complicated (now!)

Are there links to any sample flowsheets, showing the CBI in, volume out, and true urine?

Could you please post a link to a sample flowsheet?

Thanks so much

We just grab a sheet of paper and write down the Ins and Outs. How do you all handle a large difference in the two? Sometimes it is hard to figure out how much is left in a 3000ml bag of NS irrigation and figuring out how much one shift should claim versus the next shift. It should all even out in the 24hr fluid balance but sometimes it doesn't. WE recently had a pt who had -350 for a 24 hour period and then a couple days later had a fluid balance of +6000. His BMP looked HORRIBLE and if he truly had 8000 true urine output (yikes) then why does is labs look so bad?

So, any tricks on recording the I&O on CBI?

Please help. I'm recently back working in nursing and am in search of a good flows

We just make a sheet: date/time fluid was hung and total amt in bottle (2000 for us). Nurses empty cbi foleys on our unit and when we empty we write out the amt on the sheet in the second Column. We keep listing the output in the second column until the bag is empty, once that is done we add up output, subtract input, and you have total urine out! Then we cross off that chart and start a new one with the new bag. If we change shifts I just explain what I have been doing and the next shift will continue and enter the amounts once the bag is finished. Since its hard to try and determine how much is in the bag, I feel that this is the better option. It will all add up in 24 hr output. We also have computer charting and interventions for cbi where we enter everything at the end of each bottle. HTH