Hemodialysis Flow Sheet- Catheter

Hemodialysis Flow Sheet – Catheter Resident Name

Goal 

To ensure the safety and well-being of residents undergoing hemodialysis with a permanent catheter by providing structured monitoring and documentation of the catheter site and related health indicators. 

Policy 

To ensure continuous and effective monitoring of residents with permanent catheters undergoing hemodialysis, ensuring timely identification and management of any complications or issues. 

Hemodialysis Flow Sheet – Catheter Resident Name:  __________________________________ 

Access Site Permanent Catheter Location: _________________________________    Dialysis Schedule:  _____________________ 

Abnormal Findings Require Documentation in the Nurse’s Notes & MD Notification                                                         New 9/07 

References: 

• Centers for Medicare & Medicaid Services (CMS), State Operations Manual (SOM) 

• Requirements of Participation for Nursing Homes, CMS