[banditrn]

My experience in the past has been with new trachs. We just got a resident with an old trach in - there is just the stoma, with no appliance.

This lady requires periodic suctioning, so I asked the question - how often are we to change the catheter? Never, I was told. They told me that running water thru it after use cleans it. But they're just using tap water!

How do other places do it?

[supernurse65]

check your policy and procedure manual. an "old" trach shouldnt be treated any differently than a fresh trach as far as sterility is concerned in a LTC facility.
a lot of people who have "old" trachs that have been home and caring for their own trach will practice this procedure of tap water and non sterile technique.

[banditrn]

Originally Posted by supernurse65

check your policy and procedure manual. an "old" trach shouldnt be treated any differently than a fresh trach as far as sterility is concerned in a LTC facility.
a lot of people who have "old" trachs that have been home and caring for their own trach will practice this procedure of tap water and non sterile technique.

We don't HAVE a P&P for trach care! This lady has been at home, and apparently has been using the same catheter for some time - when I first went into her room, it was just flopped there on her bedside table.

Now she's in a care center with medical staff, and I say we can't follow that same routine.

If they won't order any more catheters, I intend to clean it after use - what do you recommend?

[ktwlpn]

I think it depends on the payment source.Most of our folks are medicare or medicaid.Our p and p calls for changing the suction catheter daily-night shift does it at the same time they put in a clean cannister.Thats what we get re-imbursed for.......As recently as 2 years ago we still had a few glass cannisters that had to be emptied-a few nurses insisted on using them-the rest of us made sure they were "accidently" broken.

[supernurse65]

RUN DONT WALK to your Director of Nursing Services and GET a policy on this. When the State walks in they won't care what she was doing at home they want YOUR facility policy. There must be a policy for ALL procedures. IMO a pt should not have been admitted until the staff was trained on how to care for the pt. especially if taking care of a trach is a new procedure for the staff.

[NRSKarenRN]

At home they are exposed to their own and family members germs. In a facility, exposed to a zillion persons germs. Suctioning should be same procedure for canulated trach or just stoma tract AND part of P+P manual.

[banditrn]

This lady's status is 'hospice', but I don't know what that means in terms of reimbursement. I have got to find a way to learn about things like that.

This is in Iowa, BTW - I called the state to find out if they had any recommendations, and the lady there said she felt the catheter should be changed at least weekly. And I'm sure that rinsing it with tap water after use isn't going to fly.

I appreciate the input, guys.

[bollweevil]

Originally Posted by ktwlpn

I think it depends on the payment source.Most of our folks are medicare or medicaid.Our p and p calls for changing the suction catheter daily-night shift does it at the same time they put in a clean cannister.Thats what we get re-imbursed for.......As recently as 2 years ago we still had a few glass cannisters that had to be emptied-a few nurses insisted on using them-the rest of us made sure they were "accidently" broken.

What was wrong with glass cannisters?

Why wste them? They could be appreciated in a 3rd world country or something, LOL.

For OP: In one's home, only her germs are there so clean technique is sufficient. In the outside facility, sterile must be used. So I have always been taught about things like bladder cath'ing, wound changes, and other invasive procedures. Definitely check your P&P manual.

[michelle126]

I think what scared the OP (and this was last years post) was that there was no P and P in place? Don't ya just love it when they fall thru the cracks?

I've had a few people like that. I change it daily. It was only a few years ago that we got rid of the glass suction machine bottles. Yucky.

[sharlynn]

Originally Posted by michelle126

It was only a few years ago that we got rid of the glass suction machine bottles. Yucky.

Lucky you! The last place I worked at still had them!