Catheter-related blood stream infections are a major cause of dialysis patient mortality, and more than 80% of dialysis patients in the United States start hemodialysis with a catheter. You may wonder about the risks of infection from central venous catheters when dialysis patients shower. Also, do dressings make a difference in warding off infection? A new study funded by the American Nephrology Nurses Association had some surprising results.
This study followed 39 hemodialysis patients over six months with tunneled, central venous catheters that did not apply dressing to their catheter exit site. One group had regular showers, and one group bathed by hand. Both groups did conduct regular exit site care. Researchers looked at the impact on catheter infections of those who showered. Approximately 10%-20% of hospitalizations among renal patients are due to bloodstream infections from hemodialysis catheters. Some 12%-25% of patient deaths are also linked to infections.
There were 30 patients in the study who showered with their catheter (without dressing) while 9 patients hand bathed. It was found that patients who showered without the appropriate dressings were infected at a much higher rate than those who hand bathed.
The results showed the following:
- No exit site infections in either group after the six-month period
- Three tunnel infections, all in the shower group
- Two catheter-related blood stream infections, all in the shower group
- Two bacteria infections non-related to the catheters, one in each group
- There were two hospitalizations, one in each group. Older dialysis patients in the study had the highest infection rate, the researchers said.
There is no problem taking a shower while wearing a catheter, unless your healthcare team does not recommend it. However, do not take baths, and while showering, avoid excessive hot or cold water and apply the appropriate catheter protective dressings. Also, you should not use any lotions or powders at the catheter site. Ask your doctor for recommended lubricants to prevent irritation. Below are catheter care practices which you should employ to make your catheter use more pleasant:
- Wash twice per day at the catheter site, using soap and water.
- Put a piece of gauze around the catheter site in case of leaks. Replace each time the catheter is replaced.
- Do not pull or tug on the catheter.
- Bring to the attention of your nurse and/or physician any excessive swelling, redness, and drainage.
KidneyBuzz.com recommends that you talk to your healthcare team about any concerns you may have. Your health is too important to ignore symptoms of infection.
"Showers, Catheters, and Dialysis Patients: Nephrology Nurses Look at Best Practices." ephrology News.
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