Published Aug 27, 2006
Loribabble
143 Posts
Hi... I was just wondering what the standard of care was re: the frequency of changing dialysis cath dressings...
Thanks!
Lori
km5v6r, EdD, RN
149 Posts
The 2 national companies I have worked for required dressings be changed with each dialysis treatment and when soiled. Even if doing treatments daily the dressing was to be changed. The hospital program policy was with treatment or 3x's per week.
Thanks... my friend went into DIC/TTP which resulted in renal failure and required temporary dialysis but hasn't needed it since Aug 17, and they hadn't changed the dressing since then and it was falling off. The nurse was being pretty unreceptive about my concerns (esp since the whole thing started with sepsis)...
Hopefully the catheter is coming out soon anyway.
:)
Dressing changes after dialysis has stopped is one of those things that always seems to get missed. The dressing needs be changed at least as often as any other central line dressing. A TLC dressing would be changed every few days and so should and intact Quinton dressing. Problem is dialysis staff teach floor staff "DON'T TOUCH THE DIALYSIS CATHETER." for any reason. Once dialysis stops the dialysis staff become so busy with ongoing treatments they forget about lines. Since the dressing is changed with treatment you don't keep track of dressing changes on nontreatment days. The floor staff assume the dialysis staff will take care of it and the dialysis staff assume the line is either out or the floor staff are dealing with it. Advocate for your friend and insist that either the line come out or someone come and change that dressing. This is a hugh problem at every facility I have worked at.
Thanks... that's what I figured but wanted to get an 'experts' opionion/thoughts before I raised holy heck. I hadn't been in there for a while due to being out of town/work... I passed on the info to her daughter and hopefully something has been done. While I was there I did address it to the doc and it sounded like they were going to pull the line soon - that would be wonderful - one less port of possible infection!
Thanks again!