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Dialysis and Infection Control

Dialysis patients require care from professionals who have a clear understanding of the implications of infection prevention beyond just universal precautions. Any infection can lead to serious complications for a dialysis patient. It is essential that all healthcare professional working with dialysis patients to understand and practice accepted infection control strategies. Moreover, healthcare personnel should understand the need for and follow the facilities' standard precautions and other policies to help ensure that the patient, other healthcare workers and visitors are all safe in the dialysis facility.

This resource takes a more in-depth look at infection control as it pertains specifically to the dialysis patient and facility and offers and essential guide for any healthcare professional working in this capacity.

After completing this resource, learners will be able to:

  • Explain the importance of controlling infection
  • Define blood-borne pathogens
  • List infection-control precautions
  • Explain cleaning and disinfecting procedures to prevent infection
  • List strategies for preventing environmental contamination
  • Describe how pathogens are transmitted to patients
  • Discuss the importance of aseptic technique and strategies for maintaining it
  • Describe the use of personal protective equipment (PPE)
  • List strategies for prevention TB, HBV, and HIV transmission
  • Discuss documentation and training to prevent and control infections
Anticoagulation and Heparin Administration

For healthcare professionals working in any setting, the needs and safety of the patient constitute the primary priorities. Dialysis patients, in particular, have numerous needs because of their renal failure an the sheer necessity of regular treatment. Anticoagulation is one of these special needs in which all healthcare professionals should be well versed. Once the blood leaves the body, it tends to clot very quickly. Clotting is the body's normal response to the blood coming in contact with something other than the normal intact blood vessel. The goal of clotting is to stop the bleeding making this mechanism vital to preserving life. But clotting can't happen during the dialysis treatments, so anticoagulation drugs must be administered to prevent the process.

To this end, this resource addresses the use of anticoagulants during dialysis as well as the healthcare professional's role in the administration of the most commonly used anticoagulants: Heparin.

After completing this resource, learners will be able to:

  • Describe the purpose of an anticoagulant in hemodialysis treatment
  • Describe heparin and its various types
  • Identify heparin dosage, uses, and laboratory tests
  • Identify the needles and equipment used for cannulation and proper needle placement
Access to the Bloodstream

Dialysis patients have numerous needs both because of their renal failure and the sheer necessity of regular treatment. Access to the bloodstream is one of these special needs in which all healthcare professionals should be well versed in order to best care for the dialysis patient. This access to the vein for dialysis treatment is called vascular access. It is accomplished by penetrating a blood vessel in such a way that the blood can leave the body, move through the dialysis machine and return to the body.

This resource addresses the different types of ways to access the veins and care for the access site that all healthcare professionals should be aware of and capable of performing.

After completing this resource, learners will be able to:

  • Describe arteriovenous fistula (AVF) including special care needs and potential problems
  • Explain patient assessment prior to cannulation and care after cannulation
  • Identify alternatives to AVF
  • Explain vascular access systems
  • Identify the needles and equipment used for cannulation and proper needle placement
  • List proper infection prevention techniques
  • Explain the National Kidney Foundation's Kidney Disease outcomes Quality Initiative (NKF K/DOQITM) guidelines for vascular access
Patient and Machine Monitoring and Assessment

One of the most important jobs for healthcare professionals working in dialysis is to monitor the patient and the dialysis equipment. For this reason, it is imperative to understand the scope of practice of healthcare professionals in your state as well as how they are supervised with respect to dialysis. this information is described by the Nurse Practice Acts. In some states, for instance, dialysis technicians can perform certain tasks such as infusing normal saline intravenously for priming and managing hypotension, injecting intradermal lidocaine before insertion of the dialysis needles in the vascular access and administering intravenous heparin for anticoagulation.

This resource walks through the complications that can arise during a treatment and the steps required to finalize the treatment, as well as the information necessary for proper documentation.

After completing this resource, learners will be able to:

  • Recognize the clinical complications that can arise during dialysis
  • Explain the technician's role in helping to alleviate any complications
  • Describe intradialytic assessment and patient monitoring
  • Discuss the process of discontinuation of dialysis
Dialysis and Nutrition Management

Dialysis patients require care from professionals who understand a number of healthcare areas. Nutrition is a critical element for the patient with renal disease undergoing dialysis. The diet needs vary considerably depending on the type and stage of the renal disease itself. Nutrition management is the responsibility of the dietician who is specifically trained in this area.

The dietician works closely with the nephrologist to design an effective diet, then trains and supports the renal disease patient in following this diet and monitoring blood and urine parameters to follow the progress. This resource covers ways to support the patient in their nutrition management.

After completing this resource, learners will be able to:

  • Explain the dietary needs of the patient who receives dialysis treatment
  • Compare and contrast dietary needs for hemodialysis patients and peritoneal dialysis patients
  • List reasons for fluid monitoring during dialysis treatment
  • Explain why supplements are often advised for dialysis patients