Catheter care

[stavros_rn]

Anyone can help me, when is the best time to clean the catheter access? Before or after the dialysis?

[TakdaHDRN]

The best time is before treatment. Your assessment always includes placement of the catheter. You want to make sure the catheter is intact before proceeding with treatment. That's one reason. You also want to be able to treat any notable infections prior to the pt being discharged from the unit.

[Chisca, RN]

I'll assume you are talking about a hemodialysis catheter and not a PD catheter. For a hemodialysis catheter there are two types, a temporary vas cath or a more long term called a permacath which is tunneled. For the vas cath I change it at the end. The type we use is secured by a ring sutured to the skin and it can rotate. If it has to be manipulated in any way to obtain better flow you are going to mess up any dressing that is in place and have to redo it. Another consideration is occlusive verses transparent dressing. The local clinics here use an occlusive dressing so I would like to see the access site before I initiate the treatment and I change it in the beginning. In the hospital we use a transparent dressing with a bio patch so it is easier to visualize the site. I do wish the outpatient clinics would use a biopatch but I guess the 37 cents the patch costs is too much for them to bear.

[stavros_rn]

Thank you..

Because im in access commission so we have discussion regarding cleaning of temporary cath or permanent cath. Since we are using island plaster so we cant visualize the stoma site so i suggested to clean it first so that u also have oppurtunity to examine the catheter...

[jdethman]

I agree with the above posts on the best practice.

However I would simply look out your companys policy on the matter.