This process has varied from facility to facility and even from staff to staff. A tool developed by the CMS NOTICE initiative (National Opportunity To Improve Infection Control in ESRD) is a checklist for “Cleaning and Disinfection of the Dialysis Station,” can standardized and allow for a consistent method of cleaning and disinfection.
It is currently in the pilot stage and pending community review and response prior to final draft. The tool is specific on the type of disinfectant used and the steps to correctly disinfecting the surfaces. The following are the different points of the checklist.
- Remove all bloodlines and disposable equipment and discard in biohazardous waste; dialyzer for reprocessing cap all ports; transport dialyzer in a manner to prevent contamination of other surfaces.
- Remove gloves; hand hygiene; don clean gloves.
- Obtain wetted disinfectant cloths/wipes
- Use disinfectant cloth/wipe to visibly wet all machine top, front and side surfaces, dialysate hoses, Hansen connectors, and outside surfaces of concentrate jugs.
- Empty prime waste receptacle; disinfect all internal and external surfaces.
- When chair is vacated, remove and discard disposable supplies or dedicate to that patient not returned to common supplies.
- Recline chair fully, use a fresh disinfectant cloth/wipe to visible wet all external front-facing and side chair surfaces, including along sides of seat cushion and side tables.
- Apply disinfectant to all non-disposable items: BP cuffs and tubing, TV controls, call button, data entry station and counters around station.
- Discard cloths/wipes
- Remove gloves, hand hygiene.
Note: All items listed above must be disinfected using an EPA-registered tuberculocidal disinfectant prepared and used per manufacturer’s instructions for use. Staff personal protective equipment (PPE) PPE must be gown, face shield or mask/eye protection, gloves.
A consistent and standard method of cleaning and disinfection has the potential of minimizing the challenges in performing proper environmental cleaning and disinfection and mitigating the harm to the dialysis patient.
Mr. Concepcion has been a dialysis technician since his honorable discharge from the U.S. Navy as a Corpsman in 1975. He is currently the operations manager for Renal Services at St. Joseph Hospital, Orange, Calif. He is a contributing author on several dialysis manuals, including the Amgen Core Curriculum, the APIC Tool Guide—“Guide to the Elimination of Infections in Hemodialysis. He serves on numerous nephrology organization committees and is a member of the Renal Disease Detoxification Committee for AAMI.
