How Many Wet Bags Should I Register For?

AHRQ Condom 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 projection team of clinical kinesthesia, and practice not represent the official position of the Bureau for Healthcare Research and Quality or the U.S. Department of Wellness and Human being Services.

General Recommendations

Maintaining a reusable disposable leg pocketbook requires make clean technique, and compliance with the Usa Food and Drug Administration and manufacturers required product labeling and instructions for utilize. Prior to handling the leg pocketbook, health care personnel should commencement perform paw hygiene and so put on (don) clean gloves. Upon completion of care, remove the gloves and discard in the trash. Perform hand hygiene again.

LTC facilities should make up one's mind their optimal approach (leg pocketbook vs. a continuous, large-chapters urine collection bag) and each care exercise recommendation based on national recommendations, evidence-based practices, this FAQ, their own facility risk assessment and best practices in shared conclusion-making with residents and/or families. References should be added to the policy and procedure, as needed.

In the absence of clear cleaning and storage instructions for the manufacturer or national guidelines, it is critical to clinch that staff treatment these devices can demonstrate cognition of basic aseptic technique.

Using Leg Bags

What is the recommendation for using leg numberless?
Residents and patients with an indwelling urethral urinary catheter will sometimes suspension a airtight urinary drainage organisation (with its large urine collection purse) in lodge to utilise a smaller leg pocketbook for mobility, dignity and comfort bug. The leg bag tin can exist concealed under wear and may assist with optimizing independence with activities of daily living.

This practise requires a intermission in the airtight urinary drainage organization when the collection bag is changed to a smaller leg bag and conflicts with recommendations in Centers for Disease Control and Prevention (CDC) Guideline¹ and the Social club for Healthcare Epidemiology of America (SHEA) Compendium² that recommend maintaining a airtight drainage organization following aseptic insertion. All the same, the evidence supporting these recommendations comes from investigations among acute care, short term use catheters. To avoid breaking the closed organisation at the indwelling catheter level, some products attach the larger drainage bag to the end of the leg purse for night drainage.

While there is no compelling evidence to recommend discontinuing the use of leg bags, the facility should perform an infection risk assessment prior to initiating leg bag use and assure there are policies and procedures in place to aseptically maintain the leg bag.
How often should the leg bag be changed?
Leg bags that are labeled past the manufacturer as reusable may be reused for a single resident in the LTC setting for convenience, price savings and decreased environmental waste. Following the manufacturer'southward instructions for use is imperative. If the manufacturer recommends its product for single utilize only, information technology should not be used off-label due to a potential safety risk to the resident (eastward.yard., infection, compromised structural integrity leading to device failure). In the event of a product-related incident such as infection, there may be liability issues for the user and the LTC facility.
An alternative arroyo is to perform a multi-disciplinary risk cess that addresses the benefits and disadvantages of reusing leg drainage bags labeled by the manufacturer as reusable. The cess should be documented and approved by the appropriate facility committee(s), such as a safety committee. Risk Management perspective may be helpful. If leg bags labeled as reusable by the manufacturer will exist used more than once for the same person, it is of import to develop a policy and process that follow the manufacturer instructions for employ including:
- Performing hand hygiene and wearing personal protective equipment (PPE)
- Step-by-step instructions to adhere to hygienic technique
- When and how to wipe all connecting tips with an alcohol wipe
- Ensuring the connecting tips are kept covered and make clean while being stored
- Cleaning the exterior of the pocketbook and leg straps
- Rinsing the interior of the bag
- Storing the pocketbook
- Replacing the leg and drainage bag on a schedule (e.g., weekly), and as needed (e.g., urinary tract infection, bag cleanliness is compromised).

Cleaning and Storing Leg Handbag Materials

Leg Pocketbook Intendance

How should the outside of the leg bag and straps be cleaned, and how oft?
1. Manufacturer instructions should exist followed for products and methods of cleaning all parts of the reusable dispensable urinary leg bag. Not all straps are cleanable (east.g., Velcro, fabric), and not all products can be cleaned with bleach or vinegar.
2. Both the exterior of wipeable leg bag and the leg straps, which take prolonged skin-to-pare contact, should be cleaned using basic aseptic technique
  1. Wiped downwardly during routine, daily bathing care with the resident'south preferred bathing method (e.g., soap, make peel cleaner).
  2. Rinsed and promptly dried. Do not allow prolonged peel-to-pare contact with wet/damp materials.
How should the interior of the leg bag exist cleaned?
1. Both diluted vinegar (i role vinegar to iii parts water (one:3)) and bleach (1 part bleach to 10 parts water (1:x)) have bactericidal properties and may exist used to clean the interior of the leg handbag if consistent with manufacturer's instructions. Either amanuensis disinfects to reduce infection and may reduce smell and lessen embarrassment. When using any chemical such as vinegar or bleach, ensure a consistent dilution protocol is developed. Alternatively, a ready to utilise bleach agent may exist preferred.
2. It is very important to take a facility policy and procedure for cleaning the leg bag especially if you are requiring CNA's to mix caustic solutions (bleach) for cleaning due to the potential for occupational health injury. Also, appropriate personal protective equipment (PPE) should be worn to prevent a splashing injury.
3. Advisable aseptic steps to take to clean the interior of the leg bag include:
  1. Don appropriate PPE.
  2. Fill up the leg bag with the preferred agent.
  3. Ensure both caps are secured and the within components are covered with the chemical.
  4. After the soaking fourth dimension, don appropriate PPE and carefully empty the contents into the toilet; avoid potential splashing.
  5. Rinse the handbag and caps, using tap h2o.
  NOTE: While there are many types of lather with varying bactericidal properties, lather is generally recommended to exist used on the skin and non every bit a disinfecting production for the interior of the handbag, per manufacturer'south instructions.
How should the leg bag be stored?
1. The articles instructions for storage of reusable leg bags should be followed if available.
2. Prior to initial use and when storing the leg bag, ensure a resident identifier (e.yard., name, initials) is on the leg handbag.
3. Allow the leg bag and caps to air dry by:
  1. Placing upright in a clean container¹ (e.g., bathroom basin with a resident identifier)
  2. Place a clean paper towel in the bottom of the container and modify daily.
  3. Storing container, leg bag, straps and caps in the bath when not in use.²

Leg Bag Nozzle and Cap Intendance

How should the leg bag caps be cleaned?
1. Leg purse caps tin be cleaned the same way the interior leg pocketbook is cleaned. For more information, go to the "Leg Pocketbook Care" section, question two.
2. The manufacturer's instructions for cleaning leg bag caps on reusable leg bags should be followed if available.
3. Alternatively, the inside of the cap tin can exist disinfected with alcohol prep pad for 5 seconds and allowed to air dry. Store the leg bag cap in a make clean container or on a clean newspaper towel, in the bathroom.
How should the following be 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: Apply appropriate hand hygiene and don gloves. Remove leg purse caps and drain fluid into the receptacle (i.e., urine collection container or toilet). Disinfect the nozzle by rubbing an alcohol prep pad on the leg bag nozzle for 5 seconds and allow information technology to air dry. So insert the leg pocketbook nozzle into the urinary catheter.
3. Cap: Change when contaminated and when the entire organisation is changed, per policy. Disinfect the cap by rubbing an booze prep pad on and in the cap for five seconds and allow it to air dry.
4. Storage Containers: Make 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 cantankerous-contagion to clean items in the resident's room and other resident'southward equipment in a semiprivate setting.

References

ⁱGould CV, Umscheid CA, Agarwal RK, Kuntz Grand., Pegues DA, and the Healthcare Infection Control Practices Informational Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Accessed Nov 29, 2015.
²Lo Eastward., Nicolle LE, Coffin SE, Gould C., Maragakis LL, Meddings J., Pegues DA et al. Strategies to prevent catheter-associated urinary tract infections in acute intendance hospitals: 2014 Update. Accessed Nov 29, 2015.

Folio last reviewed July 2017

Page originally created March 2017

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