Cleaning Catheter Leg Bags?!

[jocelynlpn, LPN]

In my facility, long term care residents with catheters are highly advised against having leg drainage bags. There is one resident however, that is an exception. Him and his family are aware of the risks that come with leg bags. He is to have his leg bag on during the day, and at night nursing staff switch him to a regular drainage bag.

My manager recently posted a memo regarding the cleansing of leg bags. Cleaning out leg bags?! This is something I have never heard of, let alone learned in nursing school (graduated one year ago)

Here is what our manager expects us to do every evening while doing this resident's HS care (I just typed out what she wrote in the memo for you):

- Aseptic technique must be used with reconnecting, disconnecting and storing leg bags

- Disinfect connection with a 70% alcohol swab before disconnecting/reconnecting

- Drain the urine from the bag and rinse the tubing and bag with tap water until clear (REALLY? tap water? like in the sink that he washes his face?!)

- With a catheter tip syringe, clean the tubing and bag with soapy water and rinse with tap water until clear

-With a catheter tip syringe instill 1 part vinegar to 2 parts water

- The leg bag tubing must be fulled with the selected disinfectant to be properly disinfected.

- Allow to soak for 30 minutes

- Empty the collection system and allow the tubing and bag to air dry

- Cover the ends aseptically with gauze pad and store in a clean dry place

I want to hear what all you other nurses think about this. If you work in a facility where leg bags are used, do you clean them too?? Personally I think this is kind of ridiculous, but I need feedback please!!

[Trekfan]

Why would you not clean them ?

I just use alcohol to clean my bags and tubing but they do make a cleaner just for the bags.

[casi, ASN, RN]

sounds like the norm

[jocelynlpn, LPN]

But you know, it's confusing because this resident has had a leg bag in the past year and my manager JUST posted this memo. And why do we have to clean the leg bag at night and not clean the other bag in the morning?

[K+MgSO4, BSN]

Why are you taking the leg bag off at all? I just connect the night bag to the leg bag and leave it open. Pts that go home with IDCs get instructions to clean the night bag with Milton

[honeykrown, MSN, NP]

that is standard care to cleaning leg bags. maybe people were not cleaning it adn someone complained of the smell. I worked in homecare for a while and this was the norm with my pt and i changed the leg bag q2weeks or when it got to dirty to be cleaned the regular way. And to keep it from smelling after the soap and water, i used vinegar to rinse it out

[One Flew Over]

And why do we have to clean the leg bag at night and not clean the other bag in the morning?

The drainage bag should be cleaned in the same manner when disconnected in the morning. I would just mention to your manager that she should add that to the memo.

I find it strange that your facility is so against the use of leg bags.. we use them during the day for anyone who is ambulatory. I've always thought of it as a dignity thing, not to mention having the drainage bag hanging on the w/c etc.. impedes with their ability to freely move about their rooms. I guess it depends on your resident though.

[thehipcrip]

A study funded by NIH and done at the University of Utah recommends cleaning all urinary leg bags with a solution of 10% bleach. The procedure should be two rinses with tap water, sloshed vigorously for at least 10 seconds, then filled 1/3 full with the bleach solution, and slosh for another 30 seconds. Do not rinse.

Never use vinegar. It can foster the growth of pseudomonas, a common pathogen in SCI UTIs.

You should always use aseptic technique when connecting/disconnecting collection bags.

Just a bit of advice from one of those meddlesome patients and Foley users who insist on butting into a *nursing* discussion.

[JDZ344]

The night bag connects to the leg bag, so it should all be pretty sterile.

[mjmcca]

I dont understand why you think this is ridiculous. Where I used to work we didn't have any fancy stuff to clean the bags so we rinsed with tap water and soap until clear. We only used leg bags to train people who would be using them at discharge or with people who came to the hospital with them. In the later case if they were ambulatory and alert we let them do whatever care was their regime at home.

[thehipcrip]

Sorry, I had to come back to this thread and address the fact that a nurse thinks that cleaning urinary collection bags is "ridiculous".

Urinary tract infections (UTIs) are the most common type of nosocomial infections, accounting for 40% of all infections in hospitals per year (Burke and Zavasky 1999). In addition, several studies have reported that about 80% of nosocomial UTIs occur following instrumentation, primarily catheterization (Asher, Oliver and Fry 1986). Further, retrograde contamination [the transfer of bacteria from the urine collection bag into the bladder] is the cause of 15-20 percent of UTIs in patients who use indwelling catheters. [source] So the proper cleaning of all urine collection bags is a critical element in preventing UTIs in those who manage their bladders using either indwelling catheters.

There are two reasons that are likely responsible for your facility's policy about not using leg bags during the day - [1] it will help reduce the chance of infection because the collection system remains closed, and [2] it's less work for the staff.

However, as a previous poster has noted, requiring patients to haul around an overnight collection bag negatively affects both their dignity and mobility. The use of leg or belly bags that can be discreetly concealed under clothing enables those of us who use catheters to move about freely and feel like people, not patients by respecting our dignity and privacy [i.e. it's no one's business how we manage our bladders].

I apologize for the curt tone of this post. I do my best to be positive when replying, but this subject hits home in a big way and the original post has been eating at me all day.

[jocelynlpn, LPN]

I didn't mean that leg bags or washing them was ridiculous. I meant the fact that my manager is posting this memo now after having this resident in my facility for over a year.

"The use of leg bags should be discouraged" - that's from the memo my manager wrote. I don't know why.

Unfortunatly, we don't have the kind of leg bags that hook up to the night bags. When I was in school I was taught not to wash the bags, and to just get a new one. So I posted this thread for more opinions and ideas. I'm a new nurse, I'm just trying to learn here. I will ask my manager on Tuesday if she wants us to clean the night bags when we switch them again in the morning. Because that would make more sense to me.