Bladder irrigation is a common and important clinical procedure performed across NSW Health hospitals.
It maintains urinary catheter patency, prevents clot retention, supports patient recovery following urological surgery and assists with the management of haematuria. It is undertaken by a range of healthcare professionals, including registered nurses, enrolled nurses, nurse practitioners, medical officers, urology registrars and urologists.
Bladder irrigation is performed frequently across a variety of clinical settings, so healthcare professionals need access to practical, evidence-informed guidance that supports safe, consistent and high-quality care.
This toolkit replaces the 2022 guide Bladder Irrigation: Management of Haematuria.
Why we developed this resource
The Urology Network developed this resource to provide clinicians with accessible, best practice guidance on bladder irrigation practice. It supports clinicians to quickly access guidance at the point of care and promotes a consistent approach across NSW Health services.
The resource addresses the need for contemporary, practical guidance on the 3 key methods of bladder irrigation:
- Manual bladder irrigation
- Continuous bladder irrigation
- Intermittent bladder irrigation
It also provides information on equipment, documentation requirements, patient care considerations, cultural safety, troubleshooting and clinician competency assessment.
How we developed this resource
We developed this resource through consultation and collaboration with clinicians and organisations involved in urological and continence care across NSW. This included urology and continence nurses, clinical nurse consultants, nurse practitioners, and specialist urologists working in both hospital and community settings.
Representatives from the following organisations provided input:
- Local health districts and specialty health networks
- Clinical Excellence Commission
- Urological Society of Australia and New Zealand
- Australia and New Zealand Urological Nurses Society (NSW-ACT Section)
The content was developed through a review of current evidence, clinical practice guidance and expert clinical consensus to ensure information reflects contemporary best practice.
Who this resource is for
This resource has been designed for healthcare professionals working in acute and inpatient settings who are involved in the assessment, management and performance of bladder irrigation for adult patients. It supports both experienced clinicians and those developing competence in bladder irrigation practice.
Considerations for culturally safe care
Care should be sensitive to cultural, religious and interpersonal differences, including (but not limited to) sexual orientation, gender identity, and physical and intellectual abilities.
As bladder irrigation involves close personal care and can be a sensitive procedure, clinicians should:
- use clear, respectful communication
- seek patient preferences, including clinician gender, where possible
- provide culturally safe, trauma-informed care.
Engage a professional interpreter service for individuals, their partners or support people who are deaf and hearing impaired, or from culturally and linguistically diverse backgrounds. Interpreters can be accessed via NSW Health Care Interpreting Services.
Provide care in a culturally safe and responsive way. For Aboriginal patients, include Aboriginal Health Workers and Aboriginal Liaison Officers in care pathways to help promote cultural safety, assist with navigating the health system, advocate for patient needs, and facilitate effective communication.
Bladder irrigation may be considered sensitive for many Aboriginal women, often recognised as Women’s Business, and should be approached with privacy and respect. Where possible, offer care from female clinicians to support cultural preferences.
Clinicians should take time to yarn with patients and engage in respectful, open conversations about their care. This helps clinicians understand individual preferences, avoid assumptions and, where appropriate, involve family or community supports. These discussions should:
- be guided by what is important to the patient
- be informed by best clinical practice
- use plain language and culturally appropriate resources.
Shared decision-making is important when making decisions in healthcare. The Finding Your Way shared decision-making model is a holistic, 2-way process where Aboriginal people and clinicians make decisions together.
Acknowledgements
We recognise and thank the following people who were involved in the development of this resource.
- Tammie Jones, Clinical Nurse Consultant, John Hunter Hospital and Co-Chair, Urology Network
- Jemma Archbold, Clinical Nurse Consultant Urology, Gosford Hospital
- Virginia Ip, Certified Urology Nurse Practitioner, private practice
- Eon Lee, Transitional Nurse Practitioner, War Memorial Hospital
- Jinwa Li, Clinical Nurse Consultant, Prince of Wales Community Health
- Anju Somanathan Nair, Continence Clinical Nurse Consultant, Western Sydney LHD
- Jennifer Mojica, Clinical Nurse Consultant Urology, Royal North Shore Hospital
- Madhuri Manandhar, Clinical Nurse Consultant Continence, St George Integrated Community Health
- Professor Manish Patel, Urological Cancer Surgeon, Westmead Hospital and Co-Chair, Urology Network
- Michelle Paul, Nurse Practitioner Continence, John Hunter Hospital