All ONS Member Community

Expand all | Collapse all

Mitomycin Bladder Instillation

  • 1.  Mitomycin Bladder Instillation

    Posted 12 days ago
    Good afternoon all!
    I work at a small cancer infusion center within the hospital. We have recently received an order for mitomycin bladder instillation. One of our RNs have witness bladder instillation with Urologist. The other infusion centers within our organization do not perform bladder instillation. Anyone have any protocols or suggestions on this topic?
    Thankful for any help!

    ------------------------------
    Kelli Matherne RN BSN

    ------------------------------


  • 2.  RE: Mitomycin Bladder Instillation

    Posted 12 days ago
      |   view attached
    Hello Kelli,
    Unfortunately, there is not a lot of literature or guidance. ​Information can be found at American Urological Association website:a https://www.auanet.org/guidelines/intravesical-administration-of-therapeutic-medication. I have also attached the competency fro our review.

    ------------------------------
    Cathy Ollom RN, MSN, AOCNS
    Miami Cancer Institute
    Miami, FL
    Work 786-527-7649
    Personal 931-358-9516
    ------------------------------

    Attachment(s)



  • 3.  RE: Mitomycin Bladder Instillation

    Posted 11 days ago
    ​An abbreviated set of steps for the process we use: When positioning the patient prior to the instillation, a chux is placed under buttocks to catch any residual drug. A Foley catheter is used by the urologist to instill drug into the bladder; the Foley is clamped to keep the drug inside the bladder. Patient is removed to recovery. All waste in procedure room that could have touched the drug during the procedure, including chemo-rated PPE, needs to be disposed of using antineoplastic hazardous drug protocols.  In recovery: after the prescribed dwell time, the nurse (wearing 2 pair chemo-rated gloves, chemo-gown, and possible goggles) unclamps the Foley and the drug drains into the Foley bag. The Foley is clamped to prevent drug from leaking out of the bag, removed from the patient and placed into a zippered bag and sealed, then a second zippered bag and sealed. The sealed bags are put into a black RCRA puncture-proof container and logged in on a sheet attached to the front of the RCRA container. The RCRA container can hold more than one set of zippered bags, but must not contain more than 3 gallons. Between uses, the container is closed, but not sealed. The PPE is disposed in yellow chemo-rated bags/container. When RCRA container is ready to be removed, it is sealed and Security/designee removes the RCRA container from area.
    Hope that helps :)

    ------------------------------
    Laurie Bowes
    Learning Business Partner
    Intermountain Health Care
    St George UT
    ------------------------------



  • 4.  RE: Mitomycin Bladder Instillation

    Posted 11 days ago
    Hi! I have a question, when we get these patients on our floor, how long after the Mitomycin instillation are you supposed to keep  patients on chemo precautions? We don't get this a lot and I would like to educate my floor. I appreciate your feedback.

    Michelle Brownlee RN
    University Hospitals Cleveland Medical Center
    Cleveland, Ohio​

    ------------------------------
    Michelle Brownlee RN
    Registered Nurse
    University Hospitals Cleveland Medical Center
    Willoughby OH
    ------------------------------



  • 5.  RE: Mitomycin Bladder Instillation

    Posted 11 days ago
    Kelli:
    On the ONS website search for "intravesicular" and there are resources for administration procedures as well as competencies for the nurses.
    In my organization, we use Equishield (closed system) and this has an adaptor for foley insertion of chemo drugs as a layer of protection for the RN administering.
    Hope this helps!

    ------------------------------
    Lori Sammartino, MSN, OCN, NP-C
    Oncology Nurse Manager
    Hackensack Merdian Health/JFK
    Edison, NJ
    ------------------------------