Nursing & Healthcare Programs

Measuring and Recording Output from a Urinary Drainage Bag

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Accurate measurement of urination (aka, the output portion of intake and output) allows medical personnel to assess kidney and bladder function. Changes in output quantity or quality can reflect health status changes including new-onset infection or renal injury.

  1. Gather your supplies:
    • Gloves
    • Graduated measuring container. Make sure that the measurement on the container reflects the accuracy required by the doctor or institutional policy.
    • Antiseptic wipes
    • Paper towels or an absorbent pad
  2. Give the resident privacy by closing the door or curtain.
  3. Perform hand hygiene and don gloves.
  4. Lay the paper towels or absorbent pad on the floor below the urinary drainage bag.
  5. Place the measuring container on the towels or pad.
  6. Without allowing the drain to touch any part of the measuring container, open the drain and allow all urine to drain into the container.
  7. Clamp the drain and clean the end with an antiseptic wipe. Place the drain back in its holder.
  8. Note the amount of urine in the container. Note the characteristics of the urine. What is the color? Is there sediment or blood present? Does it smell strongly? Is there a decrease or increase in the amount of urine versus the last time the bag was emptied?
  9. Remove the paper towel or absorbent pad.
  10. Pour the urine into the toilet and rinse the measuring container. Pour the rinse water into the toilet and flush.
  11. Disinfect and store or dispose of the measuring container.
  12. Remove gloves and perform hand hygiene.
  13. Record the quantity and characteristics of the urine in the appropriate section of the resident’s chart per institutional or unit policy. Report any changes to the nurse per policy.

References

S. A. Sorrentino, & L. N. Remmert. (2012). Urinary elimination. In Mosby’s textbook for nursing assistants (8th ed., pp 399). St. Louis, MO: Elsevier Mosby.

More Resources

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

person wearing orange and white silicone band

Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Passive Range of Motion Exercises

Range of motion exercises are used to help prevent or decrease contractures, improve flexibility of joints, and improve strength [1]. Bedridden patients as well as those with reduced mobility may greatly benefit from passive range of motion exercises. However, do not perform these exercises without an order to do so, as it may be contraindicated in certain situations.

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Handwashing for CNAs

Handwashing is considered the single most important practice to prevent the spread of infection. Even when hands look clean, they could potentially be crawling with dangerous microorganisms and pathogens. Using soap and friction during handwashing helps loosen the oils on the skin, allowing dirt and pathogens to be rinsed away.

Moving the Resident to the Side of the Bed

Residents are usually kept in the center of the bed for safety reasons. However, moving a resident to the side of the bed is an important step to take before turning a resident onto his or her side. Performing this action allows the resident to end up side lying in the center of the bed and not smashed up against the side rail.