Routine Catheter Changes Without Clinical Indication
Penalty
Summary
A deficiency was identified when a resident with a history of neurogenic bladder and urinary retention, who had an indwelling Foley catheter, received catheter changes on a fixed 90-day schedule without documented clinical indication. The facility's policy and professional standards require that indwelling catheters and drainage bags be changed only when clinically indicated, such as in cases of infection, obstruction, or compromise of the closed system, and not at routine, fixed intervals. However, the resident's treatment administration record showed that the Foley catheter was changed every 90 days per physician order, but there was no supporting documentation in the medical record to justify this scheduled change. During interviews, both a registered nurse and the Director of Nursing confirmed that the catheter was being changed on a scheduled basis, and the DON acknowledged that there was no documented rationale for this practice. The lack of clinical justification for routine catheter changes was inconsistent with both facility policy and current standards of practice, leading to the deficiency.