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<Guest>
posted
Could anyone provide me with a link to any guidelines related to the disinfection of fistula clamps.

Thanks in advance.

I appreciate the help.
 
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<RN>
posted
Source: CDC
http://www.cdc.gov/hicpac/Disi...aminatedDevices.html


Disinfection in the Hemodialysis Unit
Hemodialysis systems include hemodialysis machines, water supply, water-treatment systems, and distribution systems. During hemodialysis, patients have acquired bloodborne viruses and pathogenic bacteria 245-247. Cleaning and disinfection are important components of infection control in a hemodialysis center. EPA and FDA regulate disinfectants used to reprocess hemodialyzers, hemodialysis machines, and water-treatment systems.

Noncritical surfaces (e.g., dialysis bed or chair, countertops, external surfaces of dialysis machines, and equipment [scissors, hemostats, clamps, blood pressure cuffs, stethoscopes]) should be disinfected with an EPA-registered disinfectant unless the item is visibly contaminated with blood; in that case a tuberculocidal agent (or a disinfectant with specific label claims for HBV and HIV) or a 1:100 dilution of a hypochlorite solution (500–600 ppm free chlorine) should be used 246, 248. This procedure accomplishes two goals: it removes soil on a regular basis and maintains an environment that is consistent with good patient care. Hemodialyzers are disinfected with peracetic acid, formaldehyde, glutaraldehyde, heat pasteurization with citric acid, and chlorine-containing compounds 249. Hemodialysis systems usually are disinfected by chlorine-based disinfectants (e.g.,sodium hypochlorite), aqueous formaldehyde, heat pasteurization, ozone, or peracetic acid 250, 251. All products must be used according to the manufacturers' recommendations. Some dialysis systems use hot-water disinfection to control microbial contamination.

At its high point, 82% of U.S. chronic hemodialysis centers were reprocessing (i.e., reusing) dialyzers for the same patient using high-level disinfection 249. However, one of the large dialysis organizations has decided to phase out reuse and, by 2002 the percentage of dialysis facilities reprocessing hemodialyzers had decreased to 63% 252. The two commonly used disinfectants to reprocess dialyzers were peracetic acid and formaldehyde; 72% used peracetic acid and 20% used formaldehyde to disinfect hemodialyzers. Another 4% of the facilities used either glutaraldehyde or heat pasteurization in combination with citric acid 252. Infection-control recommendations, including disinfection and sterilization and the use of dedicated machines for hepatitis B surface antigen (HBsAg)-positive patients, in the hemodialysis setting were detailed in two reviews 245, 246. The Association for the Advancement of Medical Instrumentation(AAMI) has published recommendations for the reuse of hemodialyzers253.
 
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<old school>
posted
Just throw them away and hold pressure.Better for the patient
 
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<Guest>
posted
Thank you RN. Very helpful.

Old School, that is a wonderful thought but I do not really buy into the idea that clamps distroy accesses. They exert less pressure than the typical person would with their fingers. I guess the danger would be in forgetting to remove the clamps, but in today's dialysis climate with staff hurrying to turn over the chair it seems unlikely. Clamps are a useful tool and unless we suddenly double our floor staff, they are necessary.
 
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<guest too>
posted
I agree with guest.
 
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<old school>
posted
Everyone has their opinion.I only express mine.
 
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<butters>
posted
Opinions are like belly-buttons, everyone has one and they all stinkSmiler Just messing with you old school.
 
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<q>
posted
quote:
Originally posted by butters:
Opinions are like belly-buttons, everyone has one and they all stinkSmiler Just messing with you old school.
 
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<Katie RN>
posted
Anyone have experience not using hemo stat clamps at all? After 35 years of providing dialysis, I thought the idea was crazy. But I am guilty of being a preacher of in my day blah blah. So, being a desk jockey these past few years, I tried it out. Well guess what? You don't need clamps to put on or take off a patient. All the clamps you need are on the extracorporeal lines and cannula needles. And no making bleach solution daily. Also,it will prevent the infection control problems clamps can cause . Give it a try. You will be surprised.
 
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<guest too>
posted
quote:
Originally posted by Katie RN:
Anyone have experience not using hemo stat clamps at all? After 35 years of providing dialysis, I thought the idea was crazy. But I am guilty of being a preacher of in my day blah blah. So, being a desk jockey these past few years, I tried it out. Well guess what? You don't need clamps to put on or take off a patient. All the clamps you need are on the extracorporeal lines and cannula needles. And no making bleach solution daily. Also,it will prevent the infection control problems clamps can cause . Give it a try. You will be surprised.


The question is not about bloodline clamps but clamps used to stop access bleeding.
 
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