Intermittent bladder irrigation provides clinicians with an effective management option for specific clinical scenarios, when required. It is performed via an existing indwelling 2-way or 3-way catheter using a special urinary drainage system with an irrigation port for instilling irrigation fluid.
Maintain the closed catheter system to minimise risk of catheter-associated urinary tract infection.
This intermittent irrigation system can be used for the following patients:
- Patients with moderate haematuria with a 2- or 3‑way catheter. This system can be the first‑line treatment. The catheter does not have to be changed to a 3‑way for continuous irrigation and changed back to 2‑way when haematuria settles.
- Palliative patients whose catheters are frequently blocked with clots or debris. This system will minimise the discomfort associated with catheter changes.
- Patients with a problematic supra‑pubic catheter. This is preferable to manual irrigation, which repeatedly breaks down the closed catheter system.
Review and consider frequency of prior irrigation. Based on the degree of bleeding, and number of clots or amount of debris returned, consider continuous bladder irrigation.
Use the Manual (intermittent) bladder irrigation checklist (PDF 226.4 KB) to demonstrate competency to safely perform this procedure.
Before undertaking the procedure, the nurse, medical officer or student should be able to demonstrate an understanding of the procedure and be able to carry it out safely, in accordance with the standards and protocols established by the local health district (LHD) or healthcare provider.
Equipment
- Personal protective equipment (PPE)
- Irrigation set (single spike)
- Irrigation fluid: 1–2 L sodium chloride 0.9% for irrigation (use IV sodium chloride 0.9% if dedicated irrigation fluid is not available)
- Bard irrigation pump bag, or similar (2 L urine collection bag with T irrigation port and hand pump bulb)
- Disposable underpad
- Cleaning wipes, as per LHD supply and environmental cleaning protocols
- 6 x swabs, as per LHD supply (70% alcohol swabs, or 2% chlorhexidine and 70% alcohol swabs)
- Non‑sterile gloves
- IV pole
- Irrigation chart or fluid balance chart
Intermittent bladder irrigation procedure
Intermittent bladder irrigation aims to remove clots, restore urinary drainage and maintain catheter patency. Throughout the procedure:
- maintain aseptic technique
- minimise contamination
- support patient comfort and safety
- accurately document outcomes and fluid balance.