I have a question. Do any of your units still practice "Pre-Stringing" of the dialysis lines at the end of the day for the next shift. My concern is that if you pre-string, sometimes these lines are pre strung for as much as 24-48 hours in advance, how can you guarantee the sterility of the lines has not been compromised.

It has always been our policy not to because you don't know if the janitors at night do to the lines. They could knock them onto the floor and then put them back, touch them, put something in them. It is just not a good practice to do.

That's a bit tachy to put blame on janitors. It's a product that is sterile in a package and is not meant to be opened the day before it is used. If a center wants to be ready the day, all products can be put on the machine the night before. What is DHS is there when you set up? Not good.

I have also seen big problems with things that happen when janitors come in at night: Things dropped on floor (especially dialyzers, which could cause blood leaks during Tx). Packs with "clean" gauzes, tape, Etc. Concentrate lines pulled from wall flooding entire clinics. While it may not be intentional, I would not consider that tacky. They just don't understand what we take forgranted.