cleaning straight caths between use.

Hi LPNandlovenit, I have had a case where the Pt swished her cath in some soapy water, rinsed and allowed to air dry. Had another who spit in hers to lubricate it prior to insertion, yuck! Doc said, 'oh well, it's her own cooties." Niether one ever had any problems.

One of my co-workers had a patient who soaked her caths in water with a little bleach!!! One has to wonder!

Finally got info in the mail from Bard re this topic.

Check out National Association for Continence (NAFC) :
www.nafc.org.

Info from their pamplet :

Clean intermittent catheterization
1. Procedure requires clean hands and fingernails with nails trimmed, clean catheter and clean meatus!
2.Reusable catheters clean using plain liquid soap without deodorant or fragerance, wash well and rinse until soap residue is gone.
3. Shake excess out then place on clean paper towel or in a clean basin to air dry.
4. Clean reusable catheters can be soaked in homemade vinegar solution: ONE PART WHITE VINEGAR to THREE PARTS WATER
(room temp). Soak for thirty minutes, rinse thouroughly, shake out excess water and air dry.
5. Storage: clean zip top bag, tampon case, toothbrush holder or small camera case ( if need to travel with client...ideas I didn't think of).
6. Discard catheters whe it becomes hard. brittle,crackes or if color of cathe changes.
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Medicare guidelines for replacement equipment + supplies covered( most insurances follow these guidelines):
Patients must have Permanent urinary retention or incontinence ( not expected to be medically or surgically corrected within a 3 month interval).

Intermittent caths, nonsterile technique, patient or caregiver performing:
1 per week=4 per month.
Nonsterile lubricating gel 8oz per month

Intermittent caths, sterile technique---
Pt resides in a nursing facility; is immunocompromised, pregnant spinal cord injured female with neurogenic bladder;raddilogically documented vesico-ureteral reflux; distinct, recurrent UTI's( twice within 12 months) prior starting sterile catheterization.

one cath and individual packet of lubricant or an intemittent cath kit---approx 4-6/day.

These clients DME charges routinely reviewed re need and documentation. Karen

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Indwelling Catheter supplies per month:
1 catheter
one insertion tray
1 bedside drainage bag
2 leg bags
anchoring device: 1 catheter leg strap or 5 yards of tape/month

Non-routine cath changes are covered when documentation substantiates medical necessity (tell why non-routine change occurring in nursing notes/60 day summaries)
1. Cath accidentally removed/pulled out.
2. Catheter malfunction: eg ballon doesn't stay inflated
3. Catheter obstructed by encrustation, mucous plug or blood clot
4. History or recurrent obstruction or UTI and acute event is prevented by a scheduled change at intervals of less than once per month.

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Condom catheters for males: 35 per month

Female meatul cup: one per week and one pouch per day

Adhesive anchoring devices for percutaneous cath/suprapubic tube/nephrosotmy tube covered one per month.

ANY UTILIZATION OVER THESE AMOUNTS NEEDS LETTER OF MEDICAL NECESSITY FROM DOCTOR (NP's can't order under current MC rules).

Hope this helps.

Karen, that is excellent info!!!! Where did you find out how much Medicare will pay for, is there a DME section of the hfca site? I need to check that out!

I have one question, what is a "female meatul cup?"

Learned amounts from when my HH agency also had DME company and included in info sent to me. I have a book at the office listing DME info re amounts approved per month too.

Re meatal cup:

A meatal cup female urinary external collection device is a plastic cup which is held in place around the female urethra by suction or pressure and is connected to a urinary drainage container such as a bag.

A pouch type female external collection device is a plastic pouch which is adheared to the periurethral area with adhesive and is connected to a urinary drainage container such as a bag.

http://www.umd.nycpic.com/ch16_prosth-urological.html

Thinking of posting re wound supplies approved per month if interested.

I am VERY interested in this!! One of the agenies I work for is very stingy with supplies, always has been, but worse since PPS. It seems like some of the sup's feel they have made a personal accomplishment by cutting the amounts of supplies I requested. Very frustrating, often get to a home, and no supplies there. How much can you take with you for the unexpected? Particularly difficult when you go the supply cabinet and there are no supplies on the shelf!!

I hope others will be interested too.

PS I heard a new one last month, I figure I'll share. Now, in order to get a motorized W/C from Medicare, they require a PT eval for the need for motorized chair, if you are not sure what needs to be done, check with your local DME providers, they will assist you to get the correct forms for PT and/or MD to complete. The PT came to see my pt early last month, and said 30 days til arrival of chair. Can't wait to see how she likes it. I am hoping it will give her the independence she needs to get out of the house for some recreational activities too.

Hi. Thanks Karen for the great information on catheters. Hoolahan, I'm not surprised about using PT for equipment evals. I guess when you think about it it does make sense for therapists to evaluate things that they need to teach the patient about. It's just like us evaluating equipment like pumps and monitors that we would teach a patient or family on.

NRSKarenRN that is good information to know because i have been laboring under the illusion that technique and catheter should be sterile.One stick, one use. I think i prefer it that way.I've had problems with some supplies but never caths.

Just saw your comments. I needed info for a patient. found the NAFC site and downloaded a copy of their newsletter for my patient and his wife. Timely find of info.... Thanks Daisymae