S 12 CES Diaverum

Omega 1

Session content:
The importance of dialysis water
Jan Cowperthwaite

Ensuring chemical safety
Israel Silva

Promoting microbiological quality
Maria José Guerra

Introduction of a Dialysis Education Programme
Experience from Poland
Anetta Cekala

Abstract:

Background: Water is usually not considered as part of the haemodialysis prescription; however it is a fundamental part of the haemodialysis treatment. Due to the nature of their illness and the dialysis treatment patients are vulnerable to suffer ill effects from poor quality dialysis water. With an average weekly exposure to water of around 360 litres and the potential for diffusion of a range of substances into the patient’s blood, the content and quality of the dialysis fluid and therefore dialysis water becomes extremely important!
Despite ever tighter guidelines for dialysis water and dialysis fluid both chemical and biological contaminants still presents a high risk to patients. The effects on patients from contaminants in dialysis water can: occur rapidly and many incidents have resulted in patient deaths. It is therefore important that all staff, nurses as well as technicians with a responsibility for any aspect of the water treatment system has the knowledge to identify hazards which may create a risk to the patient’s health and safety and take appropriate corrective actions
Objectives: The objective of this Corporate Education Session is to discuss the important aspects of dialysis water treatment and how patient safety can be promoted using a combined and structured approach to the management of dialysis water.
The session aims to discuss the aspects of dialysis water that affect patient safety and how these can be managed in order to minimise the potential risks to our patients.
Method/discussion: The potential risk to patients from dialysis water and fluid can be decreased by understanding both the microbiological and chemical hazards that can be present in dialysis water.  To protect patients from potential contaminants requires: appropriate water treatment system design, proper monitoring, appropriate disinfection, sensitive microbiological analysis, compliance to current water treatment standards, education of staff  and a coordinated team approach. Within our dialysis clinic network we have introduced several initiatives to ensure that these aspects are imbedded into our working philosophy:

Policy and procedure: help to define the required components of the system, how these should be measured, monitored and maintained.
Water Advisory Group: to support clinics when new systems are to be installed and to give advice when  problems are encountered.
Water Education Programme: to ensure that all staff with responsibility for any aspect of the water treatment system have the necessary knowledge and skills to undertake the required tasks.
Audit: to ensure that maintenance and monitoring, system design and functioning and staff education are appropriately implemented in every clinic to minimise the potential risk.
Conclusion: Ultimately success depends on excellent technology, procedures, and policies that are appropriately tailored to the circumstances of individual water treatment systems. This requires absolute compliance with required procedures and testing. It also mandates that personnel in dialysis units be trained to keep watchful eyes on all aspects of the operation. Ultimately, safety rests in the hands of the people in charge. Education and knowledge are vital.