PROCEDURE CHECKLIST

Chapter 31, Skill 31-08: Performing Continuous Bladder Irrigation

Check () Yes or No

PROCEDURE STEPS YES NO COMMENTS

1. Gathers necessary supplies: IV pole, sterile
continuous urinary irrigation setup, a 3,000-mL
bag of sterile normal saline (NS) irrigation
solution, and a sterile drape.
2. Follows the “Initial Implementation Steps.”
3. Prepares NS irrigant and tubing, and primes
the tubing.
4. Cleans the outside of the third lumen and plug
with two alcohol sponges. Removes the plug
from the third lumen of the catheter using aseptic
technique and inserts the irrigation tubing into
the lumen.
5. Opens the roller clamp on the tubing, allowing
irrigation solution to flow into the bladder until
urine returns clear to light pink, without blood
clots.
6. Sets the flow rate of the irrigation solution.
Regulates the rate as necessary so that it keeps
the returning urine and irrigant light pink.
7. Monitors flow and bladder distention about
every hour to assess the color of the urine in the
drainage tubing and drainage bag.
8. Follows the “Ending Steps.”
9. Documents the procedure and patient’s
response.

Recommendation: Pass _____ Needs more practice _____

Student: Date:

Instructor: Date:

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