With regard to masks, my nurses don’t wear mouth masks they wear the clear face guards, they are again protecting themselves from my blood, not me from them.
In-center, masks are not used with arm accesses only neck catheters. Anyone know the reason? Sometimes nurse will wave hand over access to get betadyne to dry quicker. I’ve heard this should not be done. Similarly, seems breathing directly on the access etc. might not be a good idea.
At home, is it necessary to disinfect the chair, tv etc. post tx. for those who do SDD? Or for those who dialyze in bed, are there any precautions that must be taken such as changing sheets, bedding after txs? I’ve read where some of you say you dialyze with your pets sitting closeby… this is ok?
dialysis can be done anywhere…in the Grand Canyons, in the desert, ontop a tree house! :lol:
Under one condition, as long as the surface(your life-life/access) is clean! …
How about dialysis in a mud tub? :lol:
Btw, in-center is a high risk environment…face covers, masks, gloves, and gowns are mandatory!..simply put, its a high traffic environment with high risks of catching a virus or something…
The risk is very low at home…one of the reasons we’re are healthier and barely any hospital stays…
Heather, no, I do not use gloves for applying betadine etc. seems silly, since you are using those to sterilize your access area, without touching your access area. After washing I do not touch my access area with anything but a towel, then betadyne, then alcohol, then the needle, and I never touch the actual needle only the tabs and the cover.
Some people use gloves when disinfecting the r/o, but I don’t, just wash carefully after doing so and so far I haven’t reacted. I also don’t wear gloves when wiping down the machine and table, although I could if the bleach solution irritated my skin.
I change my sheets once a week, and I allow my cats to be in the same room even when dialyzing. If I had a catheter I probably wouldn’t do this but with a fistula and needles I don’t worry, although obviously I don’t allow them near me when I am actually cannulating or removing the needles.
I know one of the moderators posted recently about the possibilities of infection on hemodialysis vs PD, but truly, at home, reasonable precautions apply, and that’s mostly covered by using sterile technique when handling things (which for me does NOT include wearing gloves). You take the reasonable precautions you have been taught, and you have to assume things will be Ok. As for the bed, etc. - once you’re connected, you’re connected and if there’s some way for germs to get into your blood circuit, you’ve got big problems besides infection.
I clean my machine and immediate environment (table) with activated peroxide wipes which the hospital supplies to me.
I’m supposed to wear gloves when disinfecting my R/O, but that’s just to protect my skin from the concentrated peroxide. It has nothing to do with sterility. I could use dishwashing gloves I’ve used to wash the toilet and it wouldn’t make any difference. Frankly, the technicians themselves don’t even wear them when they do it.
You can get too obessed with this.
The nurses at my dialysis centre always wear a mask which includes a clear plastic visor for eye protection. Some of them are content with just the standard paper mask over the mouth and nose.
Heather, no, I do not use gloves for applying betadine etc. seems silly, since you are using those to sterilize your access area, without touching your access area. After washing I do not touch my access area with anything but a towel, then betadyne, then alcohol, then the needle, and I never touch the actual needle only the tabs and the cover
.
Do you use the betadyne in the small packages? The kind we use gets all over ones fingers, so using gloves is good for that step. And you say you put on betadyne before alcohol? Our facilty does it the reverse. When working around the house with bleach or cleaning products we use rubber gloves so I guess ppl are more or less sensitive to cleaning agents.
The nurses at my dialysis centre always wear a mask which includes a clear plastic visor for eye protection. Some of them are content with just the standard paper mask over the mouth and nose
It’s interesting how different unit protocols are. Our staff does not wear face shields, masks, or protective coats.
In the dialysis centre I went to, and then on home hemo, the first choice is the chlorhex swab followed by alcohol swab, but many patients including myself seem to develop a skin irritation with that, and so we use betadine (but alone, no alcohol).
Now, sometimes after removing the scab, there is a little bleeding. When that happens, I wipe it off with an alcohol swab so I can see the hole better.
By the way, when I first started doing this stuff at home, I was always afraid that I had inadvertently contaminated something. Nothing ever happened, so I learned to relax
The part that worried me the most was blood work night. The little Vacutainer needle is kind of hard to handle since it’s so small, plus for an upper arm fistula, the needle line itself is a little on the short side, so it makes it harder to manipulate the whole thing. Then there was the morning I dropped the open end of my arterial bloodline on the floor just before rinseback. I didn’t want to lose the blood circuit, so I picked it up and cleaned the end with an alcohol swab. I didn’t know if that was the proper thing to do, but I decided to go ahead anyway. Later I talked to my nurse and she reassured me it was Ok. So… you learn from experience. You have to be meticulous about it, but not to the point of being obsessed. I do keep an eye open for any symptoms of possible infection I might have though.
Not me, and after 3 years I don’t know anyone on hemodialysis who has - but plenty on peritoneal dialysis (almost everyone). There’s always a first time though.
Pierre
My fathers fistula got infected after 2 years while doing in-center hemo. His catheter got infected after 5 years on home hemo. Soon will be starting the fistula with buttonhole. Hope this end the infections…
I had peritonitis twice on PD, and my first permacath got infected after 4 weeks. I reckon it was because it got wet in the shower a few times. The second one I had didnt get infected, and didnt get wet in the shower. Have never had an infected fistula, fingers crossed.
In the U.S. staff and patients have their blood tested for Hepatitis B regularly. Dialysis patients and staff at dialysis clinics get Hepatitis B shots. They’re Medicare covered for patients and clinics provide the shots for staff. Hepatitis B shots are given in a series of 3 shots. I don’t know if home dialysis patients get these shots because they aren’t at as high a risk as if you’re dialyzing in a clinic. People who test positive for Hepatitis are dialyzed in an isolation room and are supposed to be treated by staff that don’t go back and forth between a patient that has hepatitis B and patients that don’t have it. http://www.cdc.gov/ncidod/diseases/hepatitis/b/factvax.htm
Hepatitis is a very weak virus and killed by bleach. Although hepatitis was relatively common in the early days of dialysis, we have found that following infection control procedures carefully reduces the risk of a dialysis patient getting hepatitis today. This is why I’m sure the people at this clinic are wondering how their patients are getting it.
One of the real advantages to doing dialysis at home is that you’re not exposed to hepatitis or any other viruses except those that you and your family are exposed to every day – unless you’re engaging in other high risk behaviors.
As far as I know all Dx patients get the Hep B Vac. Which reminds me I need to get mine. When I studied nursing at uni, you had to have hepb and TB vaccinations before you started doing prac in the hospitals. I couldnt have the TB vac, so you just had to provied a chest xray to show you didnt have TB.
Everyone gets the hep B vaccine at the dialysis centres here, that’s for sure. They don’t force it, but it’s actively encouraged. There’s a potential for there being a lot of blood around in a dialysis centre. Some patients aren’t as careful as they should be. It always seemed to me like you could easily have people touching things after holding or during bathroom breaks without having washed their hands: kitchenette items, washroom, elevator buttons, telephone, etc.
I made it a point never to touch anything unless I had to, and if I did, to use one of the many Purel dispensers afterwards.
Just by touching things its pretty unlikely that you would get infected, unless you touched it with an open wound.
I have however noticed a few times that theres been blood on the sides of the tables that has been missed in cleaning, and not just in the dialysis unit. If I go in centre I clean the table down myself before I set up.
Hepatitis virus remains active for 24 hours or more on surfaces. A person holds his sites bare-fingered, then goes and handles the kettle in the kitchen for a coffee or tea while waiting for the para bus to come. Someone else comes along, touches the same thing, and then inadvertently touches mouth, eyes, etc. It’s not likely to transmit infection, but it can happen. Or a patient bleeds a bit after walking out and doesn’t mention it to anybody… Lots of times I saw patients start to bleed a little from a site while walking out of the hospital.
I never trusted any other patients to be careful about this. The stakes are just too high. It’s just not a clean environment, no matter how dedicated the staff is or thorough the cleaning schedule. In the dialysis centre I used to go to, there were 30 patients each shift, probably a dozen nurses, nursing aids, volunteers, visitors. That’s a lot of people.
