Patients’ perceptions of hemodialysis catheter care practices at home before and after eliminating a protective dressing and implementing a showering protocol

Catheter-related bloodstream infection is a major cause of patient morbidity, mortality, and cost for patients undergoing hemodialysis. Healthcare personnel have control over central venous catheter care in the healthcare setting, but patient practices in the home environment may play a role in catheter-related infections. This qualitative study investigated hemodialysis catheter-related care in the home environment and developed an understanding of the experience of catheter care for which patients were responsible. The themes that emerged from the data were perceptions of catheter care practices, feelings of freedom, fear, a few frustrations, and patient empowerment. The findings from the analysis provide a snapshot of the variability in catheter care practices in the home as self-reported by the patients undergoing hemodialysis before and after involvement in a protocol that eliminated the dressing over the catheter insertion site and taught participants ways to care for the site during showering. The data may be used to inform care that decreases catheter-related infections, to describe the impact of showering on catheter-related infections, and to influence patient adherence to best practices through enhanced patient empowerment, comfort, control, and perceptions of personal hygiene.