Reducing Long-Term Catheter (LTC) Use
The Network has been tasked with decreasing LTC rates in the Network-service area by at least 0.25 percent by an evaluation based on data available in 2019. The goal of this project is to increase the number of patients dialyzing via arteriovenous fistula (AVF)/ arteriovenous graft (AVG) and reducing long-term catheter (LTC) use for dialysis access.
About Long-Term Catheter Use
Reducing the use of LTCs for dialysis access is key to provide optimum care for patients. A dialysis patient is identified as having an LTC when he or she has been dialyzed with a catheter for 90 days or longer, regardless of whether the catheter has been replaced. The Centers for Medicare and Medicaid Services (CMS) has set two quality goals for facilities that are linked to the QIP. These quality goals are each hemodialysis facility's AVF/AVG rate should be greater than or equal to 68 percent and each hemodialysis facility's LTC rate should be less than or equal to 10 percent.
The Network will:
- Educate target facilities on the CDC Core Interventions and assist the facilities in implementing these interventions
- Assist facilities in monitoring and tracking their progress towards the reduction of long term catheters
- Monitor the progress of QIA facilities and assist facilities that are unable to progress towards the goal
- Involve patient SMEs and/or caregivers at the facility level in a discussion about infection control practices and ways to feel more comfortable bringing issues to the attention of staff members
- Support facilities in completing the annual National Healthcare Safety Network (NHSN) Dialysis Event Surveillance Training.
Tools & Resources
Provider Education
- Vascular Access Planning for Professionals: Guide
- Routine Continuous Quality Improvement (CQI) Review of Vascular Access: Link
- Timely Referral to Nephrologist: Link
- Vascular Access Management Weekly Steps: Link
- Arteriovenous Graft (AVG) Assessment and Intervention Algorithm: Link
- Catheter Reduction: Toolkit
- Look, Listen, Feel: Handout
- Vascular Access Data Cleanup in CROWNWeb: Guide
- Vascular Access for Hemodialysis Poster: Network 1|Network 2|Network 6|Network 9
- Engaging Patients in the Infection Prevention Conversation: Tips for Staff
Patient Education
- Kidney Chronicles - How to Have a Healthy Vascular Access: English|Spanish
- Fistula First Catheter Last (FFCL) for Patients: Link
- Lifeline for a Lifetime: Planning for Your Vascular Access (English): Network 1|Network 2|Network 6|Network 9
- Lifeline for a Lifetime: Planning for Your Vascular Access (Spanish): Network 1|Network 2|Network 6|Network 9
- Questions or Concerns About Permanent Access? Let's Talk Booklet: Network 1|Network 2|Network 6|Network 9