Skill 80
Urinary Catheter Irrigation
There are two types of irrigation: closed catheter irrigation and open irrigation. Closed catheter irrigation provides intermittent or continuous irrigation of a urinary catheter without disrupting the sterile connection between the catheter and the drainage system (Fig. 80-1). Intermittent irrigation involves insertion of a sterile catheter into a catheter port to irrigate a bolus of fluid.
Open catheter irrigation is used only when intermittent irrigation of the catheter and bladder is required. The skill involves breaking or opening the closed drainage system at the connection between the catheter and the drainage system. This procedure should be avoided unless irrigation is needed to relieve or prevent obstruction (Senese et al., 2005). Strict asepsis is required throughout the procedure to minimize contamination and subsequent development of a urinary tract infection (UTI).
Delegation Considerations
The skill of catheter irrigation cannot be delegated to nursing assistive personnel (NAP). The nurse directs the NAP to:
▪ Report if the patient complains of pain, discomfort, or leakage of fluid around the catheter.
▪ Monitor and record intake and output (I&O); report immediately any decrease in urine output.
▪ Report any change in the color of the urine, especially the presence of blood clots.
