INFECTION CONTROL NEWSLETTER

July 2000
written by and for Long Term Care Infection Control Nurses

Broad Street Solutions
James Marx, RN, MS, CIC Editor
PO Box 16557
San Diego, CA 92176
(619) 656-7887 Voice/FAX
jmarx@concentric.net

Urinary Drainage Bags

The use of urinary catheters to manage specific urological conditions poses the risk of infection. Skilled nursing facility personal are usually vigilant about the appropriate use of urinary catheters. An indwelling catheter is attached to a drainage bag. To promote mobility and dignity, some residents may benefit from the use of a smaller "leg bag." While maintaining a closed catheter system has been show to be an effective way to reduce the occurrence of urinary tract infections, the risk and benefits of this device must be decided by the resident.

While there are no good studies on the use and re-use of urinary drainage bags in long term care facilities for the elderly, there have been several articles punished in the rehabilitation setting. The following are abstracts from those studies:

Daily cleaning of urinary leg bags was done using five solutions: tap water, 1/4% acetic acid (vinegar), 3% hydrogen peroxide, spoicidin 1:16 (a commercial disinfectant) and 0.06% sodium hypochlorite (1:100 bleach). The most cost effective and readily assessable daily disinfectant was 0.06% sodium hypochlorite. Giroux J, Perkash I. In vitro evaluation of current disinfectants for leg bags. J Am Paraplegia Soc 1985 Jan;8(1):13-5.

Another study used a 1% solution of sodium hypocrite to clean leg bags daily. The bags were then reuse on the same patient for two to eight days with no negative outcome. The facility had been changing the leg bag and bedside drainage bag daily. By cleaning the bags with the dilute bleach solution daily, they were able to save $3250 per patient in one year. Hashisaki P, Swenson J, Mooney B, Epstein B, Bowcutt C. Decontamination of urinary bags for rehabilitation patients. Arch Phys Med Rehabiul 1984 Aug;65(8):474-6.

This study also rinsed the urinary bags with dilute bleach solution. This group safety disinfected the bags daily and changed them monthly with very little growth of bacteria (4.4% of bags had > 100 CFU/mL). Dille CA, Kirchhoff KT, Sullivan JJ, Larson E. Increasing the wearing time of vinyl urinary drainage bags by decontamination with bleach. Arch Phys Med Rehabil 1993 Apr;74(4):431-7.

Another study looked at reuse of leg bags with no mention of disinfect ion. They found no increase in the incidence of UTI attributable to use of reusable leg bags for urinary drainage. Rooney M. SCI Nurs 1994 March. 11(1):16-8.

Did you Know...

..that hepatitis B vaccination is now required for entry to kindergarten?
... that restaurants in California must cook your hamburger to 165 F, unless you specifically request otherwise?
... that varicella vaccine is recommended for your employees who have never had chickenpox?
... that influenza vaccine can not cause influenza?
... that tuberculosis was the leading cause of death 100 years ago?