MDS Alert

Published on Thu Jan 26, 2006 PDF

F315 guidance spells out scenarios for catheter use exceeding 14 days.

Indwelling catheters are generally out under revised F315 guidance. "Appropriate indications for continuing use of an indwelling catheter beyond 14 days include" the following three conditions:

1. Urinary retention that cannot be treated or corrected medically or surgically (and where alternative therapy isn't feasible). The urinary retention is characterized by:

• documented post-void residual  volumes in a range over 200 ml

• inability to manage the retention/incontinence with intermittent catheterization; and

• persistent overflow incontinence, symptomatic infections, and/or renal dysfunction.

2. Contamination of a Stage III or IV pressure ulcer with urine that has impeded healing, despite appropriate personal care for the incontinence.

3. Terminal illness or severe impairment, which makes positioning or clothing changes uncomfortable or causes intractable pain. Clinical tip: Often a dying resident's refusal to move is a comfort issue--and the interdisciplinary team should in that case focus on pain management, say palliative care experts.