I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Centers => Topic started by: Inara on November 18, 2006, 03:22:26 PM
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In the all the years I've worked in dialysis, the temperature of the dialysis bay has been an issue. I've been glued to this site for nearly 2 days now and it didn't take long for me to figure out that this is a common problem all over. Open access to the thermostat by staff and patients has proven to be disastrous because everyone prefers the room at different temps. So, I did a bit of experimentation and it was settled to leave the room at 72 degrees (my experiment consisted of letting everyone know that we would start at 70 degrees, then over the course of 2 weeks, increase it to 74, then everyone would vote on what day they felt the room was most comfortable to them). Once 72 was settled on, I had our tech department come in and lock down our thermostat.
Well, it was a good idea on paper, but I still receive daily complaints from my patients who are either too hot or too cold. We've already addressed and adjusted machine temps as much as is safe at this point. I had no intention of factoring staff comfort into the equation until I had 2 of our techs PASS OUT during change-over (that was not a fun day for anyone!). Both of them are deep into the "hot flash" mode of menopause and cannot tolerate the heat once we're up and moving around.
Help me out here if you can, please! Is there something anyone can suggest that's working at their unit?
Moved Topic To Correct Section - Rerun Moderator
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They keep the temperature cool during change over, then they will crank it up or off when change-over is over in our unit. I agreed with the director when she said during change over the temperature had to be down to keep workers comfortable and to keep the rate of infection down. It seems cold will help keep the count of bacteria down. That seems to me to be a good idea during change over when needles are in and out of people's arms.
However you need to watch the weather and how your building keeps the heat and cold in it. Also check where the vents are. Do they blow on patient chairs? Or does the air blow form the middle of the unit? I know in our unit there are some chairs that all the air blows on. I will not sit in one chair because of the cold from two areas blows on it all night long. I would suggest sitting in a few chairs and getting an idea of where the vents blow air. Sit people who like the cold in the colder areas. Be sure the cold complainers sit in warmer areas when they come in the unit.
Ask the patients where the cold chairs are. We know and can tell you. I can point out the cold chairs in my unit. Also as Rerun says try to sit people in the same spot when they come in. Changing them around leads to complaints about cold. If they like the chair leave them there. I do not have a preference personally where I sit, but I will complain if I am put into the cold corner. I will make the nurses turn off both air blowers if it is excessively cold. I am always the one who will say something if I cannot get warm under my blanket, especially since I bring a thick blanket into the unit now. If you are the person in charge of the temperature be sure to respond to complaints of excessive cold by the people you know are not complainers. Listen to your patients.
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At my clinic, I think the temp is okay, but some days I FREEZE. I wear a light hoodie to keep me warm, and sometimes I bring my blanket
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I think patients need to either A) Bring a blanket to keep warm or B) Have the unti offer blankets to keep the patients warm.... you need the unit to be cool for reasons of bacteria... patients need to deal with it and bring a blanket or something... or its their loss.
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Its definitely better to be a little on the cool side. You can always warm up with clothing or a blanket but there isn't much that can be done when things are too warm.
Most units seem to be kept on the cool side probably more for the comfort of staff who are doing all of the running around while the patients aren't going anywhere. Maybe having a work environment that is comfortable for the staff isn't a bad idea considering all they are doing for the patients.
Dialysis units, especially the larger ones seem to have little microclimates depending on where a person is actually located in the room. A person with a preference for a certain temperature could request to be treated in one of those areas.
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The above replies are very good.
All I would add is:
Check to see where the dialysis machine temps are set. Maybe they can be adjusted to suit the patient.
Have some well covered bags of rice ready to microwave for the ones who are too cold.
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Here is something we have recently found about temps during Sharon's treatments, We do home hemo on the NxStage system and the Pureflow Dialysate machine, We had settled on a dialysate temp setting of 13 as the most comfortable temp for her, but she was suffering from a bad headache during the last half-hour of treatment, one day we were late making a batch of dialysate and put her on as soon as it finished, at the end of the treatment she did not get the expected headache, We wondered if it might be linked to the dialysate temp and decided to reset it to 12, when I did so the monitor said temp had been reached which told me that she had went through the treatment at 12 instead of 13, she was much "colder" during the treatment, but that can be handled with a heating pad under her exposed arm and an extra blanket, if needed.
By the way, we have found that a cup of coffee had an immediate effect on the headache, cut the intensity immediatley.......
Tom