Purpose

• A closed drainage system is used for indwelling catheters. Only urine should enter the drainage bag.
• A urinary tract infection (UTI) can occur if microbes enter the drainage system. The microbes travel up the tubing or catheter into the bladder and kidneys.
• The two types of drainage bags are leg bags (which hold less than 1,000 mL of urine) and standard drainage bags (which usually hold at least 2,000 mL of urine).
• Some people wear leg bags when up. The leg bag attaches to the thigh or calf.
• Leg bags are changed to drainage bags when the person is in bed. You need to open the closed drainage system. You must prevent microbes from entering the system.
• To prevent UTIs, keep the drainage bag lower than bladder level.
• Tell the nurse at once if the drainage system becomes disconnected.
• Empty drainage bags and measure urine:
  • At the end of every shift
  • When changing from a leg bag to a standard drainage bag (or vice versa)
  • When the bag is becoming full

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Bedpan

Sterile cap and plug

Drainage bag and tubing

Bath blanket

Gloves

Antiseptic wipes

Catheter clamp

Waterpoof pad

Paper towels

Delegation

• Follow delegation guidelines. Before changing a leg bag to a drainage bag, obtain this information from the nurse and care plan:
  • When to empty the drainage bag
  • If the person uses a leg bag
  • When to switch a standard drainage bag and leg bag
  • If you should clean or discard the drainage bag
  • What observations to report and record
  • When to report observations
  • What patient or resident concerns to report at once

Preparation

• Observe quality-of-life measures.
• Review the information under Delegation and Safety and Comfort.
• Collect the equipment.
• Arrange paper towels and equipment on the over-bed table.
• Identify the person. Check the ID bracelet against the assignment sheet. Call the person by name.
• Provide for privacy.

Safety

• Urine may contain microbes and blood. Follow Standard Precautions and the Bloodborne Pathogen Standard.
• This procedure requires you to open sterile packages. You must keep sterile items free from contamination.
• Leg bags fill faster than standard drainage bags. Check leg bags often. Empty the leg bag if it is becoming half full. Measure, report, and record the amount of urine.

Comfort

• Urine in a drainage bag embarrasses some people. Visitors can see the urine. To promote mental comfort, have visitors sit on the side away from the drainage bag. Sometimes you can empty the bag before visitors arrive. Make sure you measure, report, and record the amount of urine.
• Some agencies have drainage bag holders. The drainage bag is placed inside the holder. Urine cannot be seen.

Follow-up Care

• Provide for comfort.
• Place the call light within reach.
• Lower the bed to its lowest position. Raise or lower bed rails. Follow the care plan.
• Unscreen the person.
• Put on clean gloves. Discard disposable items.
• Empty the drainage bag, as in the Video Skill “Emptying a Urinary Drainage Bag.”
• Discard the drainage tubing and bag—or clean the bag—following agency policy.
• Clean and disinfect the bedpan. Place it in a clean cover.
• Return the bedpan and other supplies to their proper place.
• Remove and discard the gloves. Practice hand hygiene.
• Complete a safety check of the room.
• Follow agency policy for soiled linens.
• Practice hand hygiene.

Reporting/Recording

• Report and record your observations, including:
  • The amount of urine measured
  • Urine color, clarity (or cloudiness), and odor
  • Particles or blood in the urine
  • Complaints of pain, burning, irritation, or the need to urinate
  • Drainage system leaks