How is the actual Phase III cleaning protocol determined for each patient?
A. All patients begin Phase III by cleaning their catheter in place with saline instillation and the cleaning rod two times per day. This is established during the first scheduled visit of Phase III. When the patient subsequently returns for their next visit, a careful history is taken with regard to mucus balls. If the patient reports that they have been producing mucus balls, two steps are immediately taken. First, they are told to increase their cleaning frequency to four times per day. Second, they are started on the mucoevacuent per the physician s prescription. (They may already be on this medication). The patient is scheduled for their next scheduled visit which will include a catheter stripping. Encourage the patient to increase their intake of systemic fluids (assuming no contraindications). It is very likely that over the time period that covers Phase III, you will further customize the patient s cleaning regimen. Patients with weak cough and higher flow rates are more likely
