acceptable catheter diagnosis

[Txnursekristi]

Is there a list of acceptable diagnosis for a foley catheter in a LTC facility in Illinois? Want to make sure that public health doesn't think we are using catheters for "convenience". I know that incontinence is NOT an acceptable diagnosis, but is there a place to find what IS?

[LucasRN]

BPH, CA, Documented retention.

[steelcityrn, RN]

urinary retention, incomplete bladder emptying

[FLArn]

Multiple decubs stage 3-4, neurogenic bladder, etc.

[P_RN, ADN, RN]

A catheter isn't a diagnosis. Potential for injury related to incontinence, presence of multiple skin break downs etc.

When I worked rehab I had a cerebral palsy lady who had a catheter all her life, she was in her 40's. Believe it or not a 30 fr was too small. In fact you could have used two 30s side by side. The rehab doc suggested a suprapubic, a urostomy etc but she refused all. This was before they had the continent ostomy devices.

[Talino]

This is what the regulation says...

Indwelling Catheter Use

The facility's documented assessment and staff approach to the resident should be based on evidence to support the use of an indwelling catheter. Appropriate indications for continuing use of an indwelling catheter beyond 14 days may include:

• Urinary retention that cannot be treated or corrected medically or surgically, for which alternative therapy is not feasible, and which is characterized by:
  
  1. Documented post void residual (PVR) volumes in a range over 200 milliliters (ml);
     
  2. Inability to manage the retention/incontinence with intermittent catheterization; and
     
  3. Persistent overflow incontinence, symptomatic infections, and/or renal dysfunction.

  [*]Contamination of Stage III or IV pressure ulcers with urine which has impeded healing, despite appropriate personal care for the incontinence; and

  [*]Terminal illness or severe impairment, which makes positioning or clothing changes uncomfortable, or which is associated with intractable pain.

A valid indication for use, however, is not sufficient. Rather, know what the surveyors would be looking for w/ this INVESTIGATIVE PROTOCOL from p252

[CapeCodMermaid, RN]

I asked the doc once what diagnosis we were going to use for the foley. He told me to write "Because I said so." Great.

[caliotter3]

A very good LVN at a facility I once worked at one time had this issue with a doctor. I could tell she was having an especially stressful day because she charted that she called the doctor's office a second time regarding the inappropriate start of care order for a catheter, and her cursive handwriting turned into a printed script in capital letters that looked weird like the kind of stuff teens sometimes will doodle in. I was surprised that the DON didn't have her rewrite the documentation. Not long after this stressful day among many, the LVN moved on to a much better job.

[Nascar nurse, ASN, RN]

I asked the doc once what diagnosis we were going to use for the foley. He told me to write "Because I said so." Great.

Wow.. we have the same Doc working across many states lines...

[cebuana_nurse]

I asked the doc once what diagnosis we were going to use for the foley. He told me to write "Because I said so." Great.

LOL! This reminds me when a nurse notified the doctor thru fax about the resident's missing eye glasses. He replied with a note, "Do you want me to look for them?"

[Txnursekristi]

This is what the regulation says...

A valid indication for use, however, is not sufficient. Rather, know what the surveyors would be looking for w/ this INVESTIGATIVE PROTOCOL from p252

THANK YOU, THANK YOU, THANK YOU!!! This is exactly what I was looking for!

[P_RN, ADN, RN]

Taliano is that State regs or Medicare regs?

Never mind I see it's a .gov site (Medicare)