| Definitions |
- A "dialysis station" is the space and equipment within a dialysis unit that is dedicated to an individual patient. This may take the form of a well-defined cubicle or room, but there is usually no material boundary separating dialysis stations from each other or from the shared areas of the dialysis unit.
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- A "potentially contaminated" surface is any item of equipment at the dialysis station that could have been contaminated with blood or fluid containing blood since it was last disinfected, even if there is no evidence of contamination.
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| Education |
- A program of continuing education covering the mechanisms and prevention of crossinfection should be established for staff caring for hemodialysis patients.
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- Appropriate information on infection control should also be given to nonclinical staff, patients, caregivers, and visitors.
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| Hand hygiene |
- Staff should wash their hands with soap or an antiseptic hand-wash and water, before and after contact with a patient or any equipment at the dialysis station. An antiseptic alcohol gel rub may be used instead when their hands are not visibly contaminated.
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- In addition to hand washing, staff should wear disposable gloves when caring for a patient or touching any potentially contaminated surfaces at the dialysis station. Gloves should always be removed when leaving the dialysis station.
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- When practical, patients should also clean their hands, or use an alcohol gel rub, when arriving at and leaving the dialysis station.
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| Equipment management |
- Single-use items required in the dialysis process should be disposed of after use on one patient.
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- Nondisposable items should be disinfected after use on one patient. Items that cannot be disinfected easily (for example, adhesive tape, tourniquets) should be dedicated to a single patient.
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- The risks associated with the use of physiologic monitoring equipment (eg, blood pressure monitors, weight scales, access flow monitors) for groups of patients should be assessed and minimized. Blood pressure cuffs should be dedicated to a single patient or made from a light-colored, wipe-clean fabric.
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- Medications and other supplies should not be moved between patients. Medications provided in multiple-use vials, and those requiring dilution using a multiple-use diluent vial, should be prepared in a dedicated central area and taken separately to each patient. Items that have been taken to the dialysis station should not be returned to the preparation area.
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- After each session, all potentially contaminated surfaces at the dialysis station should be wiped clean with a low-level disinfectant if not visibly contaminated. Surfaces that are visibly contaminated with blood or fluid should be disinfected with a commercially available tuberculocidal germicide or a solution containing at least 500 parts per million hypochlorite (a 1:100 dilution of 5% household bleach).
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| Waste management |
- Needles should be disposed of in closed, unbreakable containers that should not be overfilled. A "no-touch" technique should be used to drop the needle into the container as it is likely to have a contaminated surface. If this is difficult due to the design of the container, staff should complete patient care before disposing of needles.
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- The used extracorporeal circuit should be sealed as effectively as possible before transporting it from the dialysis station in a fluid-tight waste bag or leak-proof container. If it is necessary to drain the circuit or to remove any components for reprocessing, this should be done in a dedicated area, away from the treatment and preparation areas.
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