Bladder washouts in the management of long-term catheters

It has been estimated that 40-50% of patients with long-term catheters can suffer with catheter blockage. This not only causes distress to the patient but also increases the demands on community nurses' time and resources. Infection with bacteria such as Proteus causes the urine to become alkaline. Crystalline deposits can then form inside the catheter lumen which causes blockage. Nurses often manage blocked catheters with the use of bladder 'washouts' or bladder instillations. However, the literature is confused over the terminology of 'bladder washouts', instillations and irrigation and a great deal of controversy surrounds the effectiveness of these procedures. Crisis management of catheters occurs when nurses wait for catheters to become blocked before changing them; this often occurs at inconvenient times and patients frequently have to wait several hours before help is available. To avoid crisis management, nurses should aim to assess individual patients' 'pattern of catheter life' and plan changes accordingly. This would improve patient care and allow nurses to utilize their time more effectively.