Authors (including presenting author) :
Lo WPJ(1),(2); Lau YS(1),(2); LEE CH(1),(2); So HM (1),(2); Kwan YF (1),(2); Yan WW (1),(2);
Affiliation :
(1)Department of Intensive Care, (2)Pamela Youde Nethersole Eastern Hospital
Introduction :
Haemodiafiltration with on-line replacement therapy is crucial to critically ill patients requiring advance renal support. The treatment regimens require the production of 2 to 6 liters per hour of infusion fluid for the patients. Apart from the use of ultrafilters, a scrupulous disinfection process including regular “Rinsing, Decalcification and Disinfection” procedure is essential to guarantee the provision of sterile infusion fluid to the patients. However, different disinfection procedures were adopted for renal machines from various suppliers. Therefore, a standardized and streamlined disinfection procedure is significant to ensure replacement fluid quality and patient safety.
Objectives :
1. To standardize and streamline the disinfection procedures for renal machines in providing ON-LINE renal replacement therapy 2. To evaluate the nurses’ compliance with the revised nursing procedures to ensure quality care and patient safety.
Methodology :
The disinfection procedures were streamlined according to the manufacturer’s recommendation. Briefing sessions of the revised guideline were conducted for all renal nurses in the Intensive Care Unit in July 2018. 1. The post briefing questionnaires were distributed to 30 ICU renal nurses to evaluate their familiarity with and knowledge of the newly revised disinfection policy before full implementation in August 2018. 2. Disinfection records were reviewed 4 months after implementation of new guideline.
Result & Outcome :
Results: A total of 30 questionnaires were received (100% return rate). Among them, 30 (100%) nurses agreed that the revised disinfection guideline was relevant for the daily clinical operation. All (100%) nurses correctly stated the indications and functions of disinfection. Moreover, 27 (90%) nurses could describe the newly revised disinfection procedures for renal machines. Finally, 29 (96.7%) nurses agreed that the newly adopted guideline was effective in achieving a high-level disinfection purpose without chlorine residue. After reinforcement on the new guideline, disinfection records were reviewed 4 months after full implementation. 100% compliance rate had been achieved. Conclusion: In conclusion, by incorporating new method of disinfections we can reduce staff occupational risk to chlorine residue and minimize the complexity of different types of disinfection procedures. Through our vigilant maintenance of renal machines with standardized disinfection guideline, the supply of ultra-pure and sterile infusion fluid for renal replacement is assured. Therefore, patient safety is ensured.