I have read, and I think the DOQI guidelines confirm that it is important for patients to cleanse their access area before beginning dialysis (in the unit at the sink). At my unit, at the insistence of several patients, they put a sign on the wall that patients should do this. But they don't instruct patients specifically to cleanse at the sink, and they have the attitude that most aren't going to do it so why tell them. A RN told me it doesn't matter if patients cleanse first as the RN stearilizes the sites before sticking. Infections are the third leading cause of death in dialysis patients , so shouldn't the arm be cleansed according to the DOQI guidelines? Wouldn't units who don't insist on patients cleansing properly be contributing to infection problems and be liable?

Renee:

Attached, please find the DOQI guidelines for access site care and cleansing pre treatment.

Like anything from a liability standpoint, what is important is standard of care, following policies and procedures, and education of staff. You should share your concerns with your nurse manager or physician regarding this issue.

Best wishes,
Carol
http://www.kidney.org/