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Reusing suction catheters

Posted

Has 23 years experience.

What do you all use to clean suction catheters (for trach) between uses? The patient gets 300 per month of sterile one time use suction kits.

Coming from acute hospital care, I've been using the catheters ONCE and guess who caused the patient to run out and have to purchase $400 worth out of pocket? I had 'help' from the other two conscientious nurses that work with this little boy, but at least they reused theirs twice . . .

So, what are some procedures you all have used to clean the suction catheters between use? This little guy has chronically copious secretions fairly well managed with Singulair, Robinul and PRN Benadryl. On a good day, he needs suctioned a heckuva lot more than ten times.

I did some googling and found research studies that show no increase in pneumonia/tracheitis when the catheters are properly cleaned, but would have had to pay for the article to find out how they were cleaned and what was used.

Thanks in advance :)

Medicaid sometimes will only cover 30 suction catheters per month. And some will get up to 90 per month. I clean them with distilled water or tap water. It depends on the family if they can afford distilled water. If the catheter is gross or gunk gets in it. Toss it. If I haven't used a suction catheter within a few hours I'll get a fresh one. Every case I've had, the catheter was kept in a sealed zip lock bag. I truly don't understand why Medicaid refuses to spend 0.05 cents on a suction catheter but would rather pay an intensive hospital bill d/t pneumonia.

brillohead, ADN, RN

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty. Has 5 years experience.

I had a client who used homemade acetic acid to rinse the catheter between uses. They only used two per day.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

You can request sleeved catheters that can be reused for an entire shift. The sleeved catheters come with a box lined with plastic that you put sterile water in to rinse out the catheters.

Take note of how many of each supply you get to figure out how often you should change out the item. For example, if you get two of something, you will change it twice a month. Then you will avoid this problem from happening again.

Good for you for recognizing the problem and trying to fix it.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

You can request sleeved catheters that can be reused for an entire shift. The sleeved catheters come with a box lined with plastic that you put sterile water in to rinse out the catheters.

Take note of how many of each supply you get to figure out how often you should change out the item. For example, if you get two of something, you will change it twice a month. Then you will avoid this problem from happening again.

Good for you for recognizing the problem and trying to fix it.

Any of my patients that have routine suctioning have sleeved catheters as described above. Sterile or distilled water used for rinsing. As long as clean technique is used these are good for 24hrs. The inline suction catheters, if capped between uses, are good for at least 48 hours. The suction canisters can be a venerable petri dish especially for pseudomonas and other nasty hydrophillic bacteria. Canisters often can only be changed weekly or every other week so hot soapy water and a rinse with acetic acid (white vinegar is 5% acetic acid) then thoroughly drying (not rinsing the vinegar) is often sufficient to have a canister last for 1-2 weeks.

If you have a client with intermittent bladder catheterization you will be washing the urinary catheters with warm soapy water not using a sterile one each day.

Even feeding bags are single use in a facility but only changed out every 1-2 days in home care. You must check the plan of care as many state that the change frequency for equipment. As a parent, I would be livid if I saw catheters allotted for daily use being used once and discarded. Rules are different in home care. Always ask the parent or the clinical nurse manager if you are not certain. Many items that are single use in a hospital are multiple use in the home and washed with hot soapy water and "sterilized". The "sterilization" may be vinegar, H2O2, dipped in boiling water (think how bottles were sterilized in the home or canning jars sterilized).

At least you know where the issue was in low supplies.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

Ask your clinical nurse manager for company policy regarding cleaning reusable catheters and supplies. All credentialed agencies MUST have a written policy. You an also check out the manufacturer's website for papers recommending cleaning regimes for items reused in the home, generally these are available free of charge as part of company sponsored continuing education.

Gooselady, BSN, RN

Has 23 years experience.

Thanks! We do have in-line suction catheters to use with the cough assist, which none of us have been using LOL due to the slightly insane way it hooks up to the trach adaptor. I'm going to experiment with one tonight, though, just to see how it goes hooking it straight up to suction. I'm much less familiar with the in-line (and so are the others) which explains more about why we haven't used them. But there's a big ole box in the closet . . .

I'll check with the office about a policy for reusing them, I never thought about that. Goes to show how much I rely on the office.

The patient gets 300 (ten per day) suction kits, which sounds so generous compared to some :( The school nurse uses the sterile kit once, which I think is fine, as gawd only knows what is growing in the school environment with so many fragile kids exactly like my patient. But while he's home we can 'hang' with using two or three over the course of a 12 hour shift.

We soak the trach ties in vinegar water to get two uses out of them.

I'd like to set up a 'system' of some sort, at least for myself to use on my nights. The day nurse uses the sterile paper to wrap the cleaned catheter (after sterile water rinse) and uses it for two hours or less, and I'm not sure what the other night nurse does, but we ought to have a 'system' of some sort. I'm not good at designing systems. Hopefully the office will have a policy. For now I'm going to try the in line and see how that goes. If that works, it would save several catheters on my shifts alone.

brillohead, ADN, RN

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty. Has 5 years experience.

If you have a client with intermittent bladder catheterization you will be washing the urinary catheters with warm soapy water not using a sterile one each day.

None of my Intermittent Straight Cath patients reuse urinary catheters even once, let alone over and over throughout the course of an entire day -- not even the ones with Medicaid.

UTIs are hard enough to keep at bay even using a new sterile catheter each time!!!!!

Yuck!

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

Simply call the supply company and ask if they are eligible for the sleeved catheters. Ok it with the parent and then order them instead of the unsleeved.

amoLucia

Specializes in LTC.

I see some things have not changed since I did HH sooooo looooong ago!

I learned that lesson real quick when I had a LOL with dressings and I liberally used the 4x4 sponges. That LOL went ballistic on me - "Miss Carol (her regular nurse - I was subbing) never used that many. She used X amt". I was new to HH.

Boy, did I have my nose smacked with the proverbial newspaper!

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

Supplies are definitely finite but I've been successful in getting quantities increased by proving with hard data. Four diapers a day for a kid with chronic c. Diff colonization? We submitted documentation of diaper changes. Urine cultures to get enough straight catheters for q4 ATC catheters. Respiratory data for enough sleeved catheters to change q12.

Increased GI system symptoms when insurance insisted change feeding bag (that must be refilled q8 for a 21 hour continuous feed) plus manufacturer bio burden data demonstrating why changing enteral feed bag q24 and not q48 would keep morbidity down.

Now kiddos with intermittent as in once every other month the regular non-sleeved catheters

smartnurse1982

Has 7 years experience.

I had never heard of using tap water or a vinegar/water mix to clean a suction catheter after suctioning a trach.

I have always used saline or sterile water.

I am not too sure about distilled water.

I have heard of using the catheters for a day,then instead of throwing them away,soak using vinegar/water,the store until reuse.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

I've seen tap water or bottled water used when a pt can't get sterile water...yeah, I know, gross. I will use NSS bullets in a pinch while out to appointments/outings.

I've also seen those cardboard boxes used for a week. I date them at the bottom so it's easy to tell who is changing them and who is lazy.