Bladder dysfunction is common in patients with neurologic disability. Management of bladder dysfunction frequently requires the use of vinyl urinary drainage bags for urine collection during indwelling catheterization or intermittent catheterization protocol. The usually closed urinary drainage system is disrupted each day on rehabilitation units because often the patients wear a leg bag during the day and a bed bag during nighttime hours. Both types of vinyl bags are marketed as disposable, single-use items. The purpose of this proposed study is to investigate the possibility of safely using both bags for a four-week period when decontaminated daily with a rinse-through procedure of a 1:10 solution of 5.25% sodium hypochlorite (household bleach) and water. Patients (n=150) will be randomly assigned to control (C) and experimental (E) groups. Both will receive the usual daily procedure for bag decontamination. Group C will have weekly replacement of sterile bags while Group E will have bag replacement after four weeks. A urine colony count will be obtained and a baseline assessment completed on admission. At the end of weeks 1, 2, and 4, colony counts will be done on a urine specimen and the bags. Vital signs, observed urine characteristics, signs and symptoms of urinary tract infection, and aesthetic changes of the bags will be noted. At discharge, urine and bag colony counts and clinical data collection will be repeated. ANCOVA will be performed to assess differences in the incidence of bacteriuria when four types of bladder management equipment are used. Covariants may include baseline urine colony counts, age, and number of days of catheterization. If no significant differences are found, regression lines will be fitted for urine colony counts of E and C over the various time periods. Tests of difference for slope of lines will be performed. If no risk is found, cost savings will also be calculated. Potential benefits of this study include an easy, low cost method of cleaning urinary drainage bags with extended bag wearing time.
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