Tunnel Catheter Repairs in the Chronic Unit

[KAT1994]

Just curious if any of the chronic units out there replace the ends of the tunnel catheters when the become cracked? We send the patient to the interventional radiologist, but they are wanting us to do it in the units. I don't think this is very safe. We have a very busy unit with tight staffing ratios. On the other hand, sometimes getting the pt scheduled for transportation, getting an appointment with radiology, and rescheduling a dialysis tx can take a huge amount of time and the delay in dialysis can be dangerous for the patient. What do you all do at your units?

[AmyLiz]

Not in our clinic. Pts have to go to the hospital for that. I wouldn't feel comfortable with this going on in our facility, unless we had all the equipment and a doc...but seeing as that would take a load of $$$$...that will never happen!

[diabo, RN]

I did it once and mechanically it's quite simple. Kind of like replacing the end of a garden hose with a small insert. Got my hand slapped too by our manager even though the nephrologist and the surgeon gave me the okey with instructions. I kept sterile with an assistant, so I know no harm came to the patient, but it's not within our scope as nurses. It's considered an invasive procedure and even though others may put pressure on you, you're putting your license on the line. In a mega law suit don't expect these guys to take any responsibility. You will be the one to get nailed. It would be interesting to make up a waiver for them to sign giving them full responsibility. The would quickly clear their throat and change the subject I'm sure.