Name of the Procedure:

Insertion Tray with Drainage Bag but without Catheter (HCPCS Code A4354)

Common name: Urinary Drainage Bag Kit
Technical/Medical term: Sterile Insertion Tray for Urine Collection with Drainage Bag (Excluding Catheter)

Summary

An insertion tray with a drainage bag (A4354) is a sterile kit used in the medical field to collect urine. The kit includes all the necessary items for the setup, except the catheter. Typically used for patients who already have an indwelling catheter, this tray simplifies the process of connecting a new drainage bag to the existing catheter.

Purpose

This procedure is primarily performed to:

• Facilitate hygienic and efficient urine collection
• Prevent urinary tract infections (UTIs) by ensuring sterile connections
• Replace an old or contaminated drainage bag

Indications

The insertion tray with drainage bag is most commonly indicated for:

• Patients with chronic conditions requiring long-term urinary catheterization
• Individuals recovering from surgery that impairs normal urinary function
• Cases where current drainage bags need to be replaced due to wear or contamination

Preparation

Patients should:

• Continue their regular medications unless otherwise advised by a healthcare provider
• Maintain personal hygiene, focusing on perineal care if self-managing

Healthcare professionals may:

• Review patient history for previous UTIs or catheter-related issues
• Ensure all materials are assembled in a sterile manner

Procedure Description

1. Setup: Assemble the sterile tray, maintaining sterility.
2. Disconnecting the Old Bag: The existing drainage bag is carefully disconnected from the catheter, ensuring sterility is maintained.
3. Connecting the New Bag: The new drainage bag from the sterile tray is then connected to the catheter.
4. Securing the Bag: Secure the new bag in the appropriate position, ensuring the tube is not kinked and urine can flow freely.

Tools/Equipment: Sterile gloves, sterile drainage bag with tubing, alcohol swabs, protective drapes.
Anesthesia/Sedation: None required for this procedure.

Duration

The procedure typically takes about 10-15 minutes.

Setting

This procedure can be performed in various settings, including:

• Hospitals
• Outpatient clinics
• Home care settings

Personnel

Typically, this procedure is performed by:

• Nurses
• Trained primary caregivers in home settings

Risks and Complications

Common risks include:

• Mild discomfort during the swap of drainage bags
• Potential for brief urinary leakage

Rare but possible complications:

• Introduction of infection if sterility is not maintained

Benefits

• Improved hygiene and reduced risk of infections
• Comfort and convenience for the patient
• Effective urine management

Expected benefits are typically realized immediately after the procedure.

Recovery

Post-procedure care includes:

• Monitoring for signs of infection (redness, swelling, fever)
• Ensuring the drainage bag is emptied as per physician's instructions
• Follow-up appointments if any issues arise

Patients usually resume regular activities immediately, with minimal restrictions.

Alternatives

• Continuous use of a single drainage bag until it fails, though this increases infection risks
• Use of different urine collection methods (e.g., intermittent catheterization) Pros of the insertion tray with a drainage bag:
• Convenience and reduced infections Cons:
• Needs regular replacement, slight cost implications

Patient Experience

During the procedure, the patient may experience:

• Minimal discomfort or mild pressure
• Occasionally, a brief sensation of leakage

Pain management measures:

• Ensure gentle handling by the healthcare provider
• Use of lubricating jelly if needed for existing catheter adjustments

Comfort measures:

• Explain each step to the patient to reduce anxiety
• Reassure the patient about the sterility and safety of the procedure