Could anyone provide me with a link to any guidelines related to the disinfection of fistula clamps.
Thanks in advance.
I appreciate the help.
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.
Just throw them away and hold pressure.Better for the patient
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.
I agree with guest.
Everyone has their opinion.I only express mine.
Opinions are like belly-buttons, everyone has one and they all stink Just messing with you old school.
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.
|Powered by Social Strata|