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posted
I'm asking this question to gather knowledge of what other folks believe to be happening in acute units, and not asking for an admission of doing something wrong personally.

Question:
What is everyone's opinion/belief on how end-to-end machine disinfections are being completed in acute units, specifically units with only portables?

Choices:
Disinfectant loaded into a portable, and then flushed through the dialysis machine.
Integrated heat disinfection between portable and dialysis machine.
Homemade contraption used to push disinfectant into the machine.
Changing inlet lines at a specific interval.
Nothing at all, and hoping it doesn't lead to lab issues.
Other

 
 
Posts: 325 | Location: Georgia | Registered: 12 April 2012Reply With QuoteReport This Post
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We can't use heated portables as the hospitals do not want water left on when there is no staff present.
Our portables are cleaned/disinfected/cultured Monthly

Machines inlet lines are done monthly as well with bleach- we use a syringe with a couple check valves on them it's quite easy-let it sit for ten minute contact time then rinse.(this is also used as a high level disinfect procedure, if a machine is down for repair and waiting for back ordered parts and can't be run for more than 3 days) The lines are hung on the IV bag pole- then the syringe "contraption" is then rinsed with Ro water, but that last step usually get missed often and they need new syringes and or connections. That is correct procedure does it get followed each time? I bet not but it must be getting done enough as I haven't had a culture/endo issue that I can remember in the last 15 years.


Search me O God, and know my heart! Try me and know my thoughts! And see if there be any grievous way in me, and lead me in the way everlasting! (Psalms 139:23-24)
 
Posts: 108 | Location: In Christ | Registered: 16 November 2016Reply With QuoteReport This Post
<Guest>
posted
Cane, thanks for starting the poll. Acute units located in hospitals can be very small or as big as any out patient unit. The problem they have is that they are often isolated from good procedures developed by the large out patient centers that do only dialysis. Often their biomeds and dialysis techs have to find info on their own rather than receive it from a corporate memo. They can fall behind in best practices......My guess is a lot of acute unit readers do nothing but won't state that in your poll. Maybe your poll will change that. So thanks again.
 
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<De Nye the Science Guy>
posted
Yeah, and what about all the acute programs that use DI tanks. There's no real way to disinfect that mess. I think it's one of those, "don't ask, don't tell" types of situations.
 
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Thank you all for the feedback, and if you're not registered to vote please just send your thoughts. The mention of DI is not something I would have thought of, and I'd have to imagine could present some real challenges in an acute unit.

An additional question, as I've never used a portable to do a integrated heat disinfect. What portable is used, and is capable of producing enough hot water continuously to meet the contact time?
 
Posts: 325 | Location: Georgia | Registered: 12 April 2012Reply With QuoteReport This Post
<botech>
posted
BWI PB2's clean and disinfected monthly (the product and drain lines are part of the process). The T's get bleached every Monday and heat on Wednesday and Friday. T machines acid and heat after treatments, bleached after TX if Hep status is unknown. Cultures taken monthly.
 
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quote:
Originally posted by botech:
BWI PB2's clean and disinfected monthly (the product and drain lines are part of the process). The T's get bleached every Monday and heat on Wednesday and Friday. T machines acid and heat after treatments, bleached after TX if Hep status is unknown. Cultures taken monthly.



When/how are the inlet water lines to the dialysis machines disinfected in your units?
 
Posts: 325 | Location: Georgia | Registered: 12 April 2012Reply With QuoteReport This Post
<botech>
posted
The inlet water lines don't get disinfected. I haven't had any culture issues, but lines get changed out yearly.
 
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<Guest>
posted
Do you disinfect and rinse the new lines before they are installed ?
 
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<botech>
posted
No
 
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<Midwest biomed>
posted
In our Acute unit we have 9 portables and a central RO system. All get disinfected and cultured monthly. The dialysis machine inlet lines get disinfected with the central end to end disinfect. We rotate the machines each disinfect so that each machine gets done 3-4 times a year. We replace the hoses every other year.
 
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<mtw2>
posted
I remove and bleach disinfect the incoming lines to the dialysis machines monthly. I dwell for 15 minutes. gets rid of dark matter that begins to build.
 
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<Heat>
posted
WRO300H and the Millenium HX. Both work well, no culture issues. I prefer the Millwnium. Just my 2 cents worth
 
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quote:
Originally posted by Heat:
WRO300H and the Millenium HX. Both work well, no culture issues. I prefer the Millwnium. Just my 2 cents worth



When you say work well, are you referring to using them for an integrated heat disinfect so the machine inlet line is also disinfected, or just that those two RO's are easy to keep bacteria free? Just want to be sure I follow, cause I wasn't aware you could use either to disinfect a dialysis machine inlet line. Thanks and keep the feedback coming.
 
Posts: 325 | Location: Georgia | Registered: 12 April 2012Reply With QuoteReport This Post
<Heat>
posted
Cane. No you cannot do the end2end, still need to do the monthly. For overall culture control, my results have been consistently flat. Huge improvement over older machines. Hope that helps clarify.
 
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