Reusing Catheters in Home Care? No Way!

  1. My SIL is an LPN who does private duty. Her patient is a quad and has to be straight cathed Q 6 hours. She claims that the patients case manager came by to make sure they were re-using the catheter. She said there was a doctors order to do so. My SIL said they are to soak the red rubber catheter in 1/2 H20 and 1/2 vinegar after use, rinse, dry and re-use! I have never heard of this. She said she did learn in LPN school that some home patients do
    re-use the catheters and that it's okay to do so in home care. I said "I would absolutely not do it". I said the insurance company will say whatever in order to save a buck. What do you think?
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  3. by   BionicNurse
    I'm a nursing student right now and also a cancer survivor who due to some long term effects of my tumor, i have to straight cath myself.. and what you've heard is true unfortunately. I don't use the red rubber catheters but it's the same princible. Basically it's bc of the insurance companies. It's a HUGE problem that not only outrages patients but alot of health care workers. Like for me.. before I got medicaid and medicare.. my insurance company was only paying for 4 catheters a month.. meaning that I was suppose to use one a week at most.. being left to "clean" them. As a result.. i had UTI after UTI for years. Now as we all know.. this can lead to drug resistance.. and if ur body becomes resistant to but so many antibiotics.. you're going to end up in a hospital bc of an UTI so you can get IV antibiotics.. which will end up with the insurance company paying for alot more, why they don't get this and do something about it i have no idea. The thing that helped me.. was to be close with the doctors and nurses that treated me on a regular basis, who hooked me up with boxes of catheters to help the problem. I had letters written to my insurance company and all sorts of things, and nothing worked. If i wanted more than what they were willing to pay for.. i had to pay for each catheter individually. I now have gotton on a good insurance plan and by chance found a wonderful company who files my insurance for me and gets my catheters to me once a month, never late, and who call me every single month to make sure i'm ok and make sure to let me know if i need ANYTHING there is a nurse on call for me to ask any questions i have.. they are honestly the nicest company i've ever dealt with.. anyways..I get a whole box of catheters (30) per month so I can use one a day and has cut down on the amount of UTI's i have.. even tho it hasn't gotten rid of them completely. Anywho, I hope I didn't ramble on and caught the interest of a few people. It really seems like something small but is a HUGE problem to those who have to live with these things on a daily basis.. and us as nurses should be aware of these problems and try to help the patient as much as possible seeing as not many people are willing to unfortunately.

    ~Heather :spin:
  4. by   TexasPediRN
    My first patient in Peds home health was a 5 year old spina bifida little boy with a few other problems. He needed to be straight cathed q4h.

    I was *shocked* when I was told that we "rinse and reuse". I beleive the pt was on prophylaxic antibiotics as well to prevent those UTI's...

    Needless to say, i've gotten used to the idea of 'rinsing and reusing', but i make sure I rinse quite well!!! Trachs are reused too by some parents..

    If I ever go back to hospital im going to be so confused because of how different hospital and home health care are!!!
  5. by   Tweety
    It's quite common for people who need lifelong straight caths to reuse them, as shocking as it sounds, since sterile technique is drilled into our heads.

    I think chronic UTI's are going to occur if one straight chaths themselves that often regardless of if they use clean sterile everytime or not. Of course I'd rather use sterile each and every time.

    People can't afford four or six cath kits a day.
    Last edit by Tweety on Mar 25, '06
  6. by   Nurse Ratched
    Bionicnurse is right on about this happening, the unfortunately natural repercussions. and how appropriate case management (as in the pleasantly surprising account of her current insurance company) gets past the "penny-wise, pound-foolish" approach so common in modern health care.
  7. by   DutchgirlRN
    I have seen many paraplegics and quadraplegics in HH who self cath I they use a new kit each time. I'm shocked about re-using. I could understand, I guess, if the patient did not have any insurance but how do the insurance companies get away with this and how can they be so cheap? [s]This really burns my arse![/s]
  8. by   Tweety
    It's not just insurance companies. It's the government.
  9. by   NRSKarenRN
    the day i walked into a ms patients home and saw a clear straight cath now yellowed lying directly behind bathroom sink handles was the day i investigated + learned about clean intermittent catheterization in home this patient had forgotten alot about infection control and cleaning.

    my experience is that those patients with urinary retention or neurogenic bladder capable performing clean intermittent self cath using good technique have lower infection rates than sedentary elderly with indwelling foley.

    the following articles are classic regarding cic: clean intermittent catheterization and catheter reuse.

    study often quoted : american family physician: clean vs. sterile intermittent bladder ...

    catheter cleaning for re-use in intermittent catheterization: new light on an old problem.

    clean intermittent catheterization is a common method of urinary elimination for people with spinal cord injuries. the methods of catheter cleaning for re-use, however, have not been validated with research studies. this study compared the effectiveness of hydrogen peroxide, vinegar, dishwashing detergent, and tap water alone to clean catheters contaminated with pseudomonas aeruginosa and escherichia coli. the effect of rinsing and drying before cleaning was also examined, as well as the effect of storage in paper or plastic bags after cleaning. results indicated that rinsing and drying catheters immediately after use was the most effective at reducing bacteria to very near zero. elements of a procedure are outlined, as well as plans for further development and testing of a rinse & dry procedure for catheter cleaning and re-use.
    catheter cleaning for re-use in intermittent catheterization: new ...

    guidelines i've used and similar to my agency recommendations:agencies uti level is way below state and national levels
    how to clean urinary catheters at home

    intermittent catheterization - how to reduce the risk of infection

    [color=#995522]nursing diagnosis: urinary retention ackley/ndh6e/constructor/index.cfm?plan=51
    several article citations
  10. by   suzanne4
    This has been done in the home health arena for years and years , and with proper cleaning techniques has never been an issue.

    Especially for suction catheters, straight caths, and tracheotomy tubes and their extra parts.
  11. by   renerian
    Been doing that with home health catheters since the 90s unless a family has enough money to buy more of them than payers pay for.

  12. by   nursemamma72
    I have quadrapelgic patient who has to reuse his foley tubing also. They are not only soaked in half H2O and half vinager. But right before he inserts the tube he cleans his hands with hand sanitizer and wipes the tubing off with a antibacterial wipe. He has very little trouble with UTI's.
  13. by   firstaiddave907
    oh ok renerian when i was frist reading the post i ws like what about health insurance kicking in to help butn then i just read your post and now i understand why they re use it.
  14. by   VivaLasViejas
    I remember keeping straight catheters in Rubbermaid containers filled with Betadine in resident rooms back when I started out as an LTC nurse.........and that was less than a decade ago! First you rinsed the catheter with warm water, did the procedure, then washed it with soap and water and put it back in the Betadine. We also changed the catheter once a week and the solution every other day.

    I guess the more things change, the more they stay the same.