Hygiene Maintenance with a Catheter
According to the CDC, up to 1 in 4 patients who get a bloodstream infection from having a central line will die. (CDC Vital Signs, March 2011)
The Renal Network, Inc. strongly advocates for fistulas and reduction in catheter use, but we recognize that for various reasons, some patients do have catheters. While the hope is that they quickly move to a safer vascular access, this is not possible for some patients, and all must learn to live safely with their catheter until its removal. The Network wants to help decrease catheter infections while also ensuring that those who have catheters are able to perform personal hygiene, which is an important activity of daily living.
The mission of The Renal Network, Inc. is to facilitate the achievement of optimal wellness for renal patients. To this end, we believe catheter patients need access to supplies included in the Medicare bundled payment system that may enhance hygiene, potentially improve a sense of control over care, and therefore facilitate an increase in quality of life.
In the Medicare Benefit Policy Manual, The Composite Rate for Outpatient Maintenance Dialysis (Rev. 136, Issued: 01-28-11, Effective: 01-01-11, Implementation: 02-25-11)[PDF, 65Kb], states “all dressings or protective access coverings, including catheter coverings, used to conceal a dialysis patient’s access site, for any purpose, including allowing dialysis patients to bathe or shower as well as perform other day-to-day activities, are included in the composite rate.”
Personal hygiene and grooming are a basic activity of daily life, and a patient’s personal sense of inadequacy in this area may lead to frustration and decreased quality of life.
We understand that some patients have used products such as plastic wrap to cover their catheters during hygiene maintenance, and there are no data available to determine the effectiveness of this in prevention of infection. However, the Centers for Disease Control’s (CDC) most recent guidelines for the prevention of catheter related infections, Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011 [PDF, 1.04Mb], strongly recommends use of impermeable dressings for bathing and showering, as water is implicated in these serious infections.
We encourage you to discuss hygiene issues with your patients using catheters and assist them in developing an individualized plan for maintenance of personal hygiene. We also would like to hear your feedback on what means your catheter patients are using for hygiene maintenance, how frequently those who bathe or shower do so, and any ideas that we could share with others.
We would greatly appreciate it if you could take a moment to complete our short survey on catheters and hygiene by clicking the link below:
https://www.surveymonkey.com/s/D9N5WY3.