All I know is that when I took the bc apart, one of the membrains had a small tear in it. how it got there is unknown to me. I put in a new one and machine works fine.
<user of machines>
Posted
Whenever I get an intermittant low or high flow error, I learned over the years ( 20 years of working on Fresenius machines ) to just order a whole new balance chamber from factory and install it. This nt only solves the immediate problem, but it also eliminates any future problems with the balance chamber for about 6 more years . I tried everything over the years to fix those stupid annoying flow errors, can't tell you how many times I dismantled them and re-installed new membranes etc etc etc...but a new BC solves them everytime.
<Robb>
Posted
I bet it does, However, I work for an independant dialysis provider and although I've never tried it, I can tell you that the owners would rather me replace a 20 dollar part than a 1,200 dollar part. doesn't that solution get a little costly?
<TTech>
Posted
quote:
Posted 08 October 2009 06:37 AM I bet it does, However, I work for an independant dialysis provider and although I've never tried it, I can tell you that the owners would rather me replace a 20 dollar part than a 1,200 dollar part. doesn't that solution get a little costly?
I totally agree with Robb. I only have 11 "H" machines that are almost 10 years old. They are used exclusively in an Acute setting and I had to replace all of the balance chamber membranes when then machine only had 11,000 hours. Excessive bleaching cause the premature failure. They were bleaching after EVERY patient treatment. I finally convinced them to stop last year and just bleach once a week and heat daily.
<Robb>
Posted
The only problem with bleaching once a week is the potential for bio film build up.
<WCT>
Posted
Also with bleaching twice a week, you can start having acid pump springs braking in half.
<Jim>
Posted
I thought Fresenius recommended once/wk bleach.
<Robb>
Posted
We were getting to much biofilm in the drain lines. that stuff is gross and the supervisor here implemented the 3x a week bleach schedule. Now we have no biofilm but the machines suffer a little.
I had this problem occur in 56 machines in a three month period. The root cause was the FA and Biomed Supervisor. I Checked the machine records and discovered that the machines were being bleached 2x a week before I arrived. That in it self does not present a problem, but when the FA/Charge Nurse, is worried about the budget, other things happen that you do not see when you go home. For example, supervision may send the pct's home while the machines are bleaching,and the charge nurse will finish the disinfect on that day. My unit had 49 machines on the floor so at least 12 - 20 machines were still in bleach disinfect awaiting to be rinsed. That bleach dwelled in the machine until the charge nurse but the machine in rinse. This longer than normal dwell time (1-2hrs) erodes the membranes, which are made of rubber, which in turn shortens the life span of the membrane which equates to material failure. All of the events mentioned above took place because of high bacteria levels found in the machines from culture testing. Probaly a result of machine disinfect procedures not being adhered to, charge nurses that are not in charge, fa's counting pennies, biomed supervisors/dba's wanting to put on a band aid, and finally no one in charge observing the floor at least once a week to catch the root cause. Policy and Procedure not being followed. In closing did get the 2x a week bleaching reduced to 1x a week. But the FA and my ABS never really trusted my suggestions, but my suggestions came from actual observations and putting the machines in rinse 2 hours later when i returned to the clinic and all the staff was gone. Remember this, it is not what you know in dialysis it's who you know and the who you knows are running things. This realization forced me to quit this job, because it had no resources for parts,overtime if needed, a living wage or a ear to hear good suggestions from the personnel on the floor. So if your company practices are the same, I suggest that you order new chambers period! Then tell the MD's to sell their beach houses.
Thanks for that last post. Tells what really goes on. The more I'm in this business the more I realize it's all about the money.
Hey Robb, there's a rinse option for heat disinfect that's supposed to eliminate drain slime problems. I don't have the book but can someone explain it? It's something you program in the service mode. Maybe default settings.
<Guest>
Posted
It is called "extended pre-rinse."
quote:
Originally posted by dspicer: I had this problem occur in 56 machines in a three month period. The root cause was the FA and Biomed Supervisor. I Checked the machine records and discovered that the machines were being bleached 2x a week before I arrived. That in it self does not present a problem, but when the FA/Charge Nurse, is worried about the budget, other things happen that you do not see when you go home. For example, supervision may send the pct's home while the machines are bleaching,and the charge nurse will finish the disinfect on that day. My unit had 49 machines on the floor so at least 12 - 20 machines were still in bleach disinfect awaiting to be rinsed. That bleach dwelled in the machine until the charge nurse but the machine in rinse. This longer than normal dwell time (1-2hrs) erodes the membranes, which are made of rubber, which in turn shortens the life span of the membrane which equates to material failure. All of the events mentioned above took place because of high bacteria levels found in the machines from culture testing. Probaly a result of machine disinfect procedures not being adhered to, charge nurses that are not in charge, fa's counting pennies, biomed supervisors/dba's wanting to put on a band aid, and finally no one in charge observing the floor at least once a week to catch the root cause. Policy and Procedure not being followed. In closing did get the 2x a week bleaching reduced to 1x a week. But the FA and my ABS never really trusted my suggestions, but my suggestions came from actual observations and putting the machines in rinse 2 hours later when i returned to the clinic and all the staff was gone. Remember this, it is not what you know in dialysis it's who you know and the who you knows are running things. This realization forced me to quit this job, because it had no resources for parts,overtime if needed, a living wage or a ear to hear good suggestions from the personnel on the floor. So if your company practices are the same, I suggest that you order new chambers period! Then tell the MD's to sell their beach houses.
<Guest>
Posted
OOPS: I meant to quote THIS post and say It is called "extended pre-rinse."
quote:
Originally posted by Guest: Thanks for that last post. Tells what really goes on. The more I'm in this business the more I realize it's all about the money.
Hey Robb, there's a rinse option for heat disinfect that's supposed to eliminate drain slime problems. I don't have the book but can someone explain it? It's something you program in the service mode. Maybe default settings.
