I have worked in outpatient dialysis for years and the conductivity / pH check was performed at the start of the day. Are now regulated to check between patients?

Does this apply to Acute Hospital Treatments as well?

Please if someone could list a website where I can also substantiate these regs to my charge nurses.

Thanks
JR

I work for the Fres. and it is our policy to check in the morning and in between patients. We also do this in the acute units. I could find a web page though. Hope this helps.

You should check conductivity and pH any time you change/replace bicarb or the dialysate. Think about whyyou are checking it and this will make sense. If you run out of dialysate in the middle of the treatment and replace it, then you should recheck.

Patient safety. Whether it be checking in between treatments or with each bath change, you are ensuring pt. safety and it is documented.

Check AAMI for the regulation about testing between each patient treatment.

AAMI RD52 states...

5.6 Dialysate proportioning: monitor pH/conductivity It is necessary for the operator to follow the manufacturer’s instructions regarding dialysate conductivity and to measure approximate pH with an independent method before starting the treatment of the next patient.

Tag V250 of the Interpretive Guidelines goes on to say...

Each machine must be tested for pH using a hand held meter or other appropriate testing device (i.e., adequately-sensitive testing strips) before every dialysis treatment and whenever a different composition of acid concentrate is used. If the dialysis machine manufacturer requires testing of conductivity, this must also be tested using an independent testing device prior to each treatment and before using a different composition of acid concentrate during the same treatment. The facility must have set limits for the allowable variability of the hand held values from the machine readings. As new technology evolves, the manufacturer’s guidance related to this requirement should be followed.

Chuck