To avoid introducing microorganisms into the bladder, you should irrigate an indwelling catheter only when necessary. The procedure is generally performed to remove an obstruction—such as a blood clot that develops after bladder, kidney, or prostate surgery.
Ordered irrigating solution (such as normal saline solution) 
sterile graduated receptacle or emesis basin sterile bulb syringe or 50-mL catheter-tip syringe two alcohol pads sterile gloves linen-saver pad intake-output sheet optional: basin of warm water.
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Commercially packaged kits containing sterile irrigating solution, a graduated receptacle, and a bulb or 50-mL catheter-tip syringe are available. If the volume of irrigating solution instilled must be measured, use a graduated syringe instead of a noncalibrated bulb syringe.
Check the expiration date on the irrigating solution. To prevent bladder spasms during instillation of solution, warm it to room temperature. If necessary, place the container in a basin of warm water. Never heat the solution on a burner or in a microwave oven. Hot irrigating solution can injure the patient's bladder.
- Identify the patient with two patient identifiers. Perform hand hygiene and assemble the equipment at the bedside. Explain the procedure to the patient and provide privacy.
- Place the linen-saver pad under the patient's buttocks to protect the bed linens.
- Create a sterile field at the patient's bedside by opening the sterile equipment tray or commercial kit. Using aseptic technique, clean the lip of the solution bottle by pouring a small amount into a sink or waste receptacle. Then pour the prescribed amount of solution into the graduated receptacle or sterile container.
Fill'er up
- Don sterile gloves and place the tip of the syringe into the solution. Squeeze the bulb or pull back the plunger (depending on the type of syringe) and fill the syringe with the appropriate amount of solution (usually 30 mL).
- Open the package of alcohol pads. Clean the juncture of the catheter and drainage tube with an alcohol pad to remove as many bacterial contaminants as possible.
Don't let go
- Disconnect the catheter and drainage tube by twisting them in opposite directions and carefully pulling them apart without creating tension on the catheter. Don't let go of the catheter—hold it in your nondominant hand. Then place the end of the drainage tube on the sterile field, making sure not to contaminate the tube.
- Twist the bulb syringe or catheter-tip syringe onto the catheter's distal end.
Flash flood
- Squeeze the bulb or slowly push the plunger of the syringe to instill the irrigating solution through the catheter. If necessary, refill the syringe and repeat this step until you've instilled the prescribed amount of irrigating solution.
- Remove the syringe and direct the return flow from the catheter into a graduated receptacle or emesis basis. Don't let the catheter end touch the drainage in the receptacle or become contaminated in any other way.
- Wipe the end of the drainage tube and catheter with the remaining alcohol pad.
- Wait a few seconds until the alcohol evaporates, then reattach the drainage tubing to the catheter.
- Dispose of all used supplies properly.
- Catheter irrigation requires strict aseptic technique to prevent bacteria from entering the bladder. The ends of the catheter and drainage tube and the tip of the syringe must be kept sterile throughout the procedure.
In-stall-ation
- If you encounter resistance during instillation of the irrigating solution, don't try to force the solution into the bladder. Instead, stop the procedure and notify the doctor. If an indwelling catheter becomes totally obstructed, obtain an order to remove it and replace it with a new one to prevent bladder distention, acute renal failure, urinary stasis, and subsequent infection. (See Documenting catheter irrigation.)
Outline