How Often Should A Urinary Drainage Bag Be Changed?

AHRQ Safety Program for Long-Term Care: HAIs/CAUTI

Disclaimer: Answers to the following frequently asked questions (FAQs) are based on consensus of experts from a national project squad of clinical faculty, and do not represent the official position of the Agency for Healthcare Research and Quality or the U.S. Section of Health and Human being Services.

General Recommendations

Maintaining a reusable disposable leg bag requires clean technique, and compliance with the United states of america Food and Drug Administration and manufacturers required product labeling and instructions for use. Prior to treatment the leg bag, health intendance personnel should first perform hand hygiene and so put on (don) clean gloves. Upon completion of care, remove the gloves and discard in the trash. Perform mitt hygiene over again.

LTC facilities should determine their optimal approach (leg pocketbook vs. a continuous, large-chapters urine collection bag) and each care practice recommendation based on national recommendations, prove-based practices, this FAQ, their own facility take a chance assessment and best practices in shared controlling with residents and/or families. References should be added to the policy and procedure, every bit needed.

In the absence of clear cleaning and storage instructions for the manufacturer or national guidelines, it is disquisitional to assure that staff handling these devices tin demonstrate knowledge of basic aseptic technique.

Using Leg Numberless

1. What is the recommendation for using leg bags?

   Residents and patients with an indwelling urethral urinary catheter volition sometimes suspension a closed urinary drainage arrangement (with its large urine drove bag) in guild to use a smaller leg bag for mobility, nobility and comfort issues. The leg bag tin be curtained nether vesture and may assist with optimizing independence with activities of daily living.

   This practice requires a break in the closed urinary drainage system when the drove pocketbook is inverse to a smaller leg bag and conflicts with recommendations in Centers for Affliction Command and Prevention (CDC) Guideline¹ and the Society for Healthcare Epidemiology of America (SHEA) Compendium² that recommend maintaining a closed drainage system following aseptic insertion. Nonetheless, the evidence supporting these recommendations comes from investigations among acute care, curt term use catheters. To avert breaking the closed system at the indwelling catheter level, some products adhere the larger drainage bag to the finish of the leg bag for dark drainage.

   While there is no compelling testify to recommend discontinuing the use of leg bags, the facility should perform an infection risk assessment prior to initiating leg bag utilise and clinch in that location are policies and procedures in place to aseptically maintain the leg bag.

2. How often should the leg bag be changed?

   Leg numberless that are labeled past the manufacturer equally reusable may be reused for a unmarried resident in the LTC setting for convenience, price savings and decreased ecology waste matter. Following the manufacturer's instructions for employ is imperative. If the manufacturer recommends its product for unmarried use only, it should non exist used off-label due to a potential safety risk to the resident (due east.chiliad., infection, compromised structural integrity leading to device failure). In the issue of a production-related incident such equally infection, there may be liability issues for the user and the LTC facility.

   An alternative approach is to perform a multi-disciplinary risk assessment that addresses the benefits and disadvantages of reusing leg drainage numberless labeled by the manufacturer as reusable. The assessment should be documented and approved by the appropriate facility committee(s), such as a rubber committee. Take chances Management perspective may exist helpful. If leg bags labeled as reusable by the manufacturer will be used more than once for the same person, it is important to develop a policy and process that follow the manufacturer instructions for apply including:
   • Performing hand hygiene and wearing personal protective equipment (PPE)
   • Step-past-stride instructions to adhere to aseptic technique
   • When and how to wipe all connecting tips with an alcohol wipe
   • Ensuring the connecting tips are kept covered and clean while being stored
   • Cleaning the exterior of the pocketbook and leg straps
   • Rinsing the interior of the pocketbook
   • Storing the pocketbook
   • Replacing the leg and drainage bag on a schedule (e.g., weekly), and as needed (eastward.m., urinary tract infection, bag cleanliness is compromised).

Cleaning and Storing Leg Purse Materials

Leg Bag Care

1. How should the exterior of the leg purse and straps be cleaned, and how ofttimes?
   1. Manufacturer instructions should be followed for products and methods of cleaning all parts of the reusable dispensable urinary leg bag. Not all straps are cleanable (east.m., Velcro, fabric), and not all products can be cleaned with bleach or vinegar.
   2. Both the outside of wipeable leg bag and the leg straps, which have prolonged peel-to-skin contact, should be cleaned using bones aseptic technique
      1. Wiped downward during routine, daily bathing care with the resident's preferred bathing method (e.thou., soap, brand skin cleaner).
      2. Rinsed and promptly dried. Exercise non allow prolonged skin-to-pare contact with wet/damp materials.
2. How should the interior of the leg bag exist cleaned?
   1. Both diluted vinegar (1 part vinegar to 3 parts water (one:3)) and bleach (1 part bleach to ten parts h2o (one:10)) have bactericidal properties and may be used to make clean the interior of the leg bag if consistent with manufacturer's instructions. Either agent disinfects to reduce infection and may reduce aroma and lessen embarrassment. When using any chemic such as vinegar or bleach, ensure a consequent dilution protocol is developed. Alternatively, a ready to use bleach agent may be preferred.
   2. Information technology is very important to have a facility policy and procedure for cleaning the leg bag especially if you lot are requiring CNA's to mix caustic solutions (bleach) for cleaning due to the potential for occupational wellness injury. Too, appropriate personal protective equipment (PPE) should exist worn to prevent a splashing injury.
   3. Appropriate aseptic steps to have to make clean the interior of the leg bag include:
      1. Don appropriate PPE.
      2. Make full the leg bag with the preferred agent.
      3. Ensure both caps are secured and the within components are covered with the chemic.
      4. After the soaking fourth dimension, don appropriate PPE and advisedly empty the contents into the toilet; avoid potential splashing.
      5. Rinse the bag and caps, using tap water.
      
      NOTE: While there are many types of soap with varying bactericidal backdrop, soap is generally recommended to be used on the skin and not as a disinfecting production for the interior of the pocketbook, per manufacturer'southward instructions.
3. How should the leg pocketbook be stored?
   1. The manufactures instructions for storage of reusable leg bags should exist followed if available.
   2. Prior to initial use and when storing the leg bag, ensure a resident identifier (e.g., name, initials) is on the leg bag.
   3. Allow the leg bag and caps to air dry by:
      1. Placing upright in a clean container^one (e.thousand., bath basin with a resident identifier)
      2. Place a clean newspaper towel in the lesser of the container and change daily.
      3. Storing container, leg pocketbook, straps and caps in the bathroom when not in employ.²

Leg Bag Nozzle and Cap Care

1. How should the leg bag caps exist cleaned?
   1. Leg bag caps tin be cleaned the aforementioned manner the interior leg bag is cleaned. For more than data, go to the "Leg Bag Care" section, question ii.
   2. The manufacturer'southward instructions for cleaning leg bag caps on reusable leg bags should be followed if available.
   3. Alternatively, the within of the cap can be disinfected with alcohol prep pad for 5 seconds and allowed to air dry out. Shop the leg purse cap in a clean container or on a make clean newspaper towel, in the bathroom.
2. How should the following exist cleaned/disinfected prior to connecting the leg bag to the indwelling catheter?
   1. The manufacturer's instructions for cleaning and disinfection and storage of nozzles, and caps for reusable leg bags should be followed if available.
   2. Nozzle: Use appropriate mitt hygiene and don gloves. Remove leg bag caps and drain fluid into the receptacle (i.e., urine collection container or toilet). Disinfect the nozzle past rubbing an alcohol prep pad on the leg pocketbook nozzle for 5 seconds and permit it to air dry. Then insert the leg bag nozzle into the urinary catheter.
   3. Cap: Modify when contaminated and when the entire system is changed, per policy. Disinfect the cap by rubbing an alcohol prep pad on and in the cap for 5 seconds and allow it to air dry out.
   4. Storage Containers: Clean/disinfect the container when soiled or discard. Change the basin per facility policy. Store the leg bag in the resident's bathroom in a clean labeled container. This minimizes contamination (from aerosols, grit, etc.) and also prevents cross-contagion to make clean items in the resident's room and other resident's equipment in a semiprivate setting.

References

¹Gould CV, Umscheid CA, Agarwal RK, Kuntz Grand., Pegues DA, and the Healthcare Infection Command Practices Informational Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Accessed November 29, 2015.
^twoLo E., Nicolle LE, Bury SE, Gould C., Maragakis LL, Meddings J., Pegues DA et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 Update. Accessed November 29, 2015.

Page concluding reviewed July 2017

Folio originally created March 2017

Internet Citation: Ofttimes Asked Questions Virtually the Use of and Intendance for Leg Bags in the Long-Term Intendance Setting. Content terminal reviewed July 2017. Agency for Healthcare Research and Quality, Rockville, Doctor.
https://world wide web.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/prevent/leg-bags-faqs.html

Source: https://www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/prevent/leg-bags-faqs.html

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