Grant: Project Grant

This study is testing a protocol that allows patients to shower after receiving training on how to perform their own dialysis central venous catheter (CVC) dressing changes at home. The goal of this study is to see if the shower protocol improves patients' quality of life while still maintaining low infection rates. Why this matters: A CVC is a common dialysis access. Unfortunately, CVCs increase infection risk, in particular bloodstream infections. To minimize infection risk, strict procedures are followed in the hemodialysis unit when using the CVC for dialysis. The area around the catheter is cleaned regularly with an antiseptic solution, sterile procedures are followed, and a dressing is placed over the CVC. Patients are told not to touch or remove the dressing in between dialysis sessions and are told not to shower. If the dressing gets wet, this could increase infection risk. In a survey of dialysis patients, most patients found being told not to shower moderately to very bothersome, and many patients were showering on their own despite being told not to. Who can join: Adults who are on regular hemodialysis using a CVC as their dialysis access and are cleared by their kidney doctor to participate. Patients must want to shower and be willing and able to learn how to care for their CVC dressing at home. What will happen: Participants will be randomly assigned (similar to the flip of a coin) to either shower using a protocol on top of receiving usual CVC care or to continue with usual CVC care. What the study will measure: The goal will be to determine the balance of CVC-related infections and patient quality of life and satisfaction with their dialysis access. Timeline: Participants will be followed for 6 months. Why the study is important: If we find that the CVC shower protocol improves quality of life and satisfaction while maintaining a low infection risk, then showering could be routinely offered to patients on dialysis with CVCs.