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  1. #1
    Senior Member wheeliegirl's Avatar
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    Switching between leg bags and night bags

    There just isn't enough info on the net about specific questions like this.

    When using a leg bag during the day, and then switching back to the night bag for bed time, is it necessary to use a brand new or clean bag each time you switch between the bags (and vice versa switching between night and leg bag in the morning)?

    I read on one web site that recommended leaving the leg bag on at night and hooking the night bag to it then disconnecting the night bag in the morning. Does anyone do this? I would think that would be too much bulky stuff on your body while trying to sleep and there is risk of the bags coming apart and the straps or bags cause irritation while sleeping.

    How long can a bag be off before it has to be cleaned and sanitized?

    Also, what is the best way to clean and sanitize the bags? Ive been using liquid antibacterial soap with hot water, rinsing with hot water and sanitizing with cool water and vinegar for 30 minutes and then cool rinse and letting the bag hang with valves open until next use.

    Thoughts?

    Thank you!

  2. #2
    Senior Member lynnifer's Avatar
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    This is a great question that gets lots of different answers depending upon the year, lol.

    I think* the latest is vinegar and water (though I think that encourages pseudomonas and that is in my bladder right now) ... then bleach with water once per week.

    I too was using antibacterial soap and water.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  3. #3
    There is a lot of evidence that maintaining a closed system for indwelling catheters decreases the risks for introducing foreign bacteria. At our center we changed to the system you describe with the leg bag kept permanently attached to the indwelling catheter, then attaching a bedside bag to that bag's drain port at bedtime for drainage. We encourage our clients to continue this practice at home. There is really little bulk, as the leg bag just lays flat on the bed (it does not accumulate urine as long as the bed bag is kept dependent) and we just remove the straps during the night.

    There have been studies on the best methods for cleaning urinary drainage bags. We continue to clean our bedside bags each morning before storing. The best done studies have shown the following to be the best procedure:

    Supplies:
    Drainage bag
    Urinal or other quart container dedicated to this purpose alone.
    Funnel (we use a 60 cc. catheter tipped syringe barrel)
    2 short lengths of extension tubing
    Basin
    Clean towel

    Procedure:

    1. Drain urine into toilet. Close drain port.
    2. Place basin on floor next to toilet and hold bag over the basin to catch any spillage.
    3. Attach funnel to inflow connector of bag with short length of extension tubing.
    4. Fill bag 1/3-1/2 full with tap water (do not touch funnel to faucet)
    5. Shake bag vigorously for 10 seconds. Drain. Close drain port.
    6. Repeat tap water rinse/shake. Drain. Close drain port.
    7. Using the urinal or other container containing freshly made 10% bleach solution (50ml of bleach plus 450ml of tap water), pour bleach solution into bag through the funnel. Shake bag vigorously for 30 seconds.
    8. Drain. Leave drain port open.
    9. Tip any water out of the basin (into the toilet).
    10. Arrange clean, dry towel in the bottom of the basin.
    11. Place bag, funnel with short length of extension tubing, and the urinal into the basin and fold the towel over them to cover completely.
    12. Store this way until ready to reapply to the leg bag that evening. Put that towel in the laundry (use another clean one the next morning). Don't forget to close the drain port when applying it to the leg bag!!


    (KLD)

  4. #4
    Senior Member wheeliegirl's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    There is a lot of evidence that maintaining a closed system for indwelling catheters decreases the risks for introducing foreign bacteria. At our center we changed to the system you describe with the leg bag kept permanently attached to the indwelling catheter, then attaching a bedside bag to that bag's drain port at bedtime for drainage. We encourage our clients to continue this practice at home. There is really little bulk, as the leg bag just lays flat on the bed (it does not accumulate urine as long as the bed bag is kept dependent) and we just remove the straps during the night.

    There have been studies on the best methods for cleaning urinary drainage bags. We continue to clean our bedside bags each morning before storing. The best done studies have shown the following to be the best procedure:

    Supplies:
    Drainage bag
    Urinal or other quart container dedicated to this purpose alone.
    Funnel (we use a 60 cc. catheter tipped syringe barrel)
    2 short lengths of extension tubing
    Basin
    Clean towel

    Procedure:

    1. Drain urine into toilet. Close drain port.
    2. Place basin on floor next to toilet and hold bag over the basin to catch any spillage.
    3. Attach funnel to inflow connector of bag with short length of extension tubing.
    4. Fill bag 1/3-1/2 full with tap water (do not touch funnel to faucet)
    5. Shake bag vigorously for 10 seconds. Drain. Close drain port.
    6. Repeat tap water rinse/shake. Drain. Close drain port.
    7. Using the urinal or other container containing freshly made 10% bleach solution (50ml of bleach plus 450ml of tap water), pour bleach solution into bag through the funnel. Shake bag vigorously for 30 seconds.
    8. Drain. Leave drain port open.
    9. Tip any water out of the basin (into the toilet).
    10. Arrange clean, dry towel in the bottom of the basin.
    11. Place bag, funnel with short length of extension tubing, and the urinal into the basin and fold the towel over them to cover completely.
    12. Store this way until ready to reapply to the leg bag that evening. Put that towel in the laundry (use another clean one the next morning). Don't forget to close the drain port when applying it to the leg bag!!


    (KLD)
    I asked my doc about this cleaning method. She was head of urology or the residents program or something at UCI and Long Beach VA and said that the VA uses bags that are really heavy that are intended to last a year or so, and for the disposable bags that method could be used, or vinegar. She really had no strong opinion of a way the bags should be cleaned, and even said some of her patients never even clean them. I would never not clean them, but I wish she would give me better guidance. The paperwork the hospital gave me says to use vinegar. However, it's really expensive, so I'm wondering if bleach is better for me.

  5. #5
    Quote Originally Posted by wheeliegirl View Post
    I asked my doc about this cleaning method. She was head of urology or the residents program or something at UCI and Long Beach VA and said that the VA uses bags that are really heavy that are intended to last a year or so, and for the disposable bags that method could be used, or vinegar. She really had no strong opinion of a way the bags should be cleaned, and even said some of her patients never even clean them. I would never not clean them, but I wish she would give me better guidance. The paperwork the hospital gave me says to use vinegar. However, it's really expensive, so I'm wondering if bleach is better for me.
    I think SCI nurse KLD works at the Long Beach VA hospital. Maybe your doc and KLD need to talk.

    All the best,
    GJ

  6. #6
    Quote Originally Posted by wheeliegirl View Post
    I asked my doc about this cleaning method. She was head of urology or the residents program or something at UCI and Long Beach VA and said that the VA uses bags that are really heavy that are intended to last a year or so, and for the disposable bags that method could be used, or vinegar. She really had no strong opinion of a way the bags should be cleaned, and even said some of her patients never even clean them.
    When you have seen one VA, you have seen one VA. They are all different. That VA does not represent care standards at all VA hospitals or SCI Centers, and at our VA we pride ourselves in evidence-based (ie, based on research) practice which has validated this method, including an endorsement of this method by SUNA (Society of Urology Nurses and Associates). I know of no bags, including the latex bags which this provider may be alluding to, which are safe to last a year, or indeed will last a year without leaking. We rarely issue latex bags anymore, since we have so many latex allergic patients, and even these are replaced every 3 months. "Disposable" bags are fine for cleaning and reuse for up to a month.

    Quote Originally Posted by wheeliegirl View Post
    I would never not clean them, but I wish she would give me better guidance. The paperwork the hospital gave me says to use vinegar. However, it's really expensive, so I'm wondering if bleach is better for me.
    Use the bleach. Frankly, physicians are not very expert on infection control and CAUTI prevention. Nurses are much more, and have conducted much of the research.

    And no, I don't work at the VA Long Beach...never have.

    (KLD)

  7. #7
    Senior Member wheeliegirl's Avatar
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    I will use bleach, it's cheaper anyway. Thanks for your clarification.

  8. #8
    Quote Originally Posted by SCI-Nurse View Post
    And no, I don't work at the VA Long Beach...never have.
    (KLD)
    Right. Sorry, I remember now...the article about you and the VA Secretary's Award said, San Diego. Mea Culpa.

    All the best,
    GJ

  9. #9
    Senior Member wheeliegirl's Avatar
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    What kind of funnel or syringe is used? Extension tubing? Pictures or video will help as I will don't fully understand all the instructions and I will need to buy supplies. Right now I'm using my sink and hold the opening under the running water and poor the vinegar in as carefully as possible. Also, I dont think I will be able to do it with the basin on the floor. I wouldn't be able to pick it up when its full of water. And I cant reach the water controls of my bathtub without getting onto my commode chair, which defeats the whole purpose of having the catheter as transferring to it is causing skin tears on my newly closed flap surgery.

    I have not even transferred to my tub bench for fear that contributed to the tears as well.

    Oh and how often do you switch to a new leg bag and bed bag?
    Last edited by wheeliegirl; 11-06-2016 at 04:08 PM.

  10. #10
    Quote Originally Posted by wheeliegirl View Post
    What kind of funnel or syringe is used? Extension tubing?
    As above. We make a funnel out of a 60cc catheter-tipped irrigation syringe. You could use a household funnel if you use it only for this. We cut off two short 2-3" lengths of extension tubing from the leg bag kit when assembling the leg bag (our kits come with the bag, straps, and extension tubing). One goes at the drain valve of the leg bag, then other is attached to the funnel (and then, when cleaning, to the inflow connector of the drainage bag).

    Quote Originally Posted by wheeliegirl View Post
    Pictures or video will help as I will don't fully understand all the instructions and I will need to buy supplies. Right now I'm using my sink and hold the opening under the running water and poor[sic] the vinegar in as carefully as possible. Also, I don't think I will be able to do it with the basin on the floor. I wouldn't be able to pick it up when its full of water. And I cant reach the water controls of my bathtub without getting onto my commode chair, which defeats the whole purpose of having the catheter as transferring to it is causing skin tears on my newly closed flap surgery.
    Don't have videos or photos. Our clients sit in their wheelchair in front of the toilet and put the basin on the floor. You can put it on the counter or a chair if you can raise the tubing high enough over the bag so that it drains from the funnel down into the bag. Generally most most just continue to hold onto the drainage bag tubing and lift the bag up by the tubing to drain into the toilet. You should not have to lift the basin until the end, and there should be very little liquid actually in the basin.

    Quote Originally Posted by wheeliegirl View Post
    Oh and how often do you switch to a new leg bag and bed bag?
    New bag and bed bag whenever you change your indwelling catheter. Studies have shown this bag cleaning protocol is good for at least a month.

    (KLD)

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