Reducing Long-Term Catheter (LTC) Use

Following are links to tools that will assist you in achieving your LTC/BSI reduction goals:

Catheter Tracking Form

• This Catheter Tracking form (XLSX) tracks the number of catheters in the facility by month. Use this tracker when completing your monthly reporting to the Network via Survey Monkey link.

Quality Assessment and Performance Improvement (QAPI) Resources

• Network 7—2020 LTC Quality Improvement Activity (QIA) Orientation Webinar (PDF)
• Network 17— 2020 LTC QIA Orientation Webinar slide deck (PDF)
• QAPI QIA LTC Monitoring Form (PDF)
  Use the QAPI QIA Monitoring Form for tracking the number of patients >90 days who are eligible and who have been referred for a permanent access, and for discussion of progress toward goals during QAPI meetings.

CDC Resources

• CDC Catheter Care Tools
  • Audit Tool: Catheter Connection and Disconnection Observations (For monthly reporting.)
  • Checklist: Hemodialysis Catheter Connection
  • Checklist: Hemodialysis Catheter Disconnection
  • Hemodialysis Central Venous Catheter Scrub-the-Hub Protocol

• CDC Catheter Exit Site Tools
  • Audit Tool: Catheter Exit Site Care Observations (For monthly reporting.)
  • Checklist: Hemodialysis Catheter Exit Site Care

• CDC Infection Protection Tools Page
  This page includes additional links to all CDC infection protection tools, including core interventions, the Scrub-the-Hub Protocol, all audit tools and checklists, as well as clinician education.

Other Provider Resources

• Vascular Access Consultation Appointment Sheet
  This appointment sheet is a helpful way to remind and encourage patients to seek a vascular access consultation.

• Vascular Access Options (English/ Spanish)
  This patient handout illustrates the vascular access options for patients. Review this handout with your patients upon admission to educate them on dialysis access types and to help keep track of their next vascular access appointment.
• Vascular Access Manager Job Description (PDF) A sample job description for staff offering suggested roles and responsibilities of a Vascular Access Manager (VAM).  This tool is designed to assist facilities in designating the role of a VAM to a staff member for more efficient tracking and monitoring of vascular accesses.
• Helping Patients Cope with Needle Fear (PDF) This one-page document explains the reality of needle fear and offers tips for staff in helping to reduce the fear of needles.

Patient Resources

• Benefits of Having a Permanent Access
  This document outlines the many benefits patients have shared for having a permanent dialysis access.
  • Network 7— English | Spanish
  • Network 17— English | Spanish

• Your CVC: What You Need to Know—Caring for Your Dialysis Catheter
  This tri-fold brochure is for patients who have a central venous catheter (CVC). It provides important information on CVC care, signs of problems, problem solving tips, and other important things to remember about their CVC. 
  
  • Network 7—Your CVC: What You Need to Know—Caring for Your Dialysis Catheter
  • Network 17—Your CVC: What You Need to Know—Caring for Your Dialysis Catheter
    
    
• Hemodialysis Vascular Access (English/Spanish)
  The resource lists the advantages and disadvantages to each hemodialysis vascular access type. Use this handout to educate patients and staff members about the different vascular access types.

• Sepsis Zone Tool
  This one-page document specifies and categorizes symptoms of sepsis and actions to be taken if those symptoms manifest by green—No Signs of Infection, yellow—Caution, and re—Medical Alert.

• Sepsis Zone Tool—Spanish
  This one-page document specifies and categorizes symptoms of sepsis and actions to be taken if those symptoms manifest by green—No Signs of Infection, yellow—Caution, and re—Medical Alert.
  
  
• Additional Tips for Needle Fear (PDF) (English/Spanish) This document offers strategies to help patients overcome the fear of needles so they can use their permanent dialysis access for dialysis treatments.

Quality Improvement Activities

End stage renal disease (ESRD) quality improvement activities (QIAs) are designed to assist dialysis facilities and transplant centers to achieve optimal clinical outcomes and experience of care for all dialysis and kidney transplant patients. Network 15’s QIAs are focused on enhancing the quality of service for Medicare beneficiaries by:

• Gathering information systematically to clarify issues or problems.
• Implementing interventions to achieve improvements.
• Measuring quality outcomes.
• Incorporating the patient voice in all activities to maximize learning 
  and cooperation between providers and patients through shared decision-making.
• Supporting the spread of best practices.

For additional information about Network 15’s QIAs for 2020 and access to QIA documents, trackers, toolkits and best practices, read more below. Download the ESRD Network 15 2020 QIAs for 2020 (PDF) document.

Getting Started

To assist with quality improvement (QI) within your organization, review the following videos on QI, finding the root cause, and the Plan-Do-Study-Act (PDSA) cycle:

• Illustrated Look at Quality Improvement in Health Care (8.09 minutes)
• 5 Whys: Finding the Root Cause (1.15 minutes)
• PDSA Cycle: Plan-Do-Study-Act (Part 1)(4.45 minutes)

Use the Root Cause Analysis (RCA): 5 Whys Worksheet (PDF) to find the root cause that may be creating barriers to success, and use the PDSA Worksheet (PDF) to initiate facility solutions. 

If your organization missed a live Learning and Action Network (LAN) call, you may use the Missed LAN Call Worksheet.

New Resource: Getting Back to Me: A Goal-Setting Journey (PDF)

Use this workbook to help patients identify personal goals and set a plan to achieve them. This resource was developed by kidney patients and family members and designed to help restore a sense of dignity and increase self-esteem through goal-setting.