Centers with REUSE

[MooseMom]

oooh, 2007.  Long time ago.  May I ask...which other systems did you consider, and how did you arrive at your decision to use NxStage?  Which elements of the whole equation influenced you the most?  Did you ever seriously consider going back incenter?  Are you presently looking at any new machines which may be available soon for home hemo?  What feature might a new machine have that would make you consider leaving NxStage? 

[dialysisadvocate]

My advice which is my opinion, after reading surveys and talking with many, many patients, is the following:

If you can do home dialysis DO IT   You have more control of your life...............many take less medications, feel better, etc..

Roberta Mikles BA RN Dialysis Patient Safety Advocate
www.qualitysafepatientcare.com

[lmunchkin]

Quote from Bill Peckman
With reuse you can use better quality materials. The Aksys used a blood tubing made out of silicone instead of the standard plastic blood tubing set that are single use disposable.

Bill, do you know of any case where if made a differents in patients from using the plastic blood tubing?  I know that we are to inspect all materials for defects, but this concerns me now!  Is there actually plastic going into my husbands bloodstream?  Or some residue from the plastic blood tubes?

My goodness, is there something else I should be concerned with?

lmunchkin     

P.S.  Please understand, I want the best dialysis my husband can get, that I can still work at my job!

[Bill Peckham]

Quote from Bill Peckman
With reuse you can use better quality materials. The Aksys used a blood tubing made out of silicone instead of the standard plastic blood tubing set that are single use disposable.

Bill, do you know of any case where if made a differents in patients from using the plastic blood tubing?  I know that we are to inspect all materials for defects, but this concerns me now!  Is there actually plastic going into my husbands bloodstream?  Or some residue from the plastic blood tubes?

My goodness, is there something else I should be concerned with?

lmunchkin     

P.S.  Please understand, I want the best dialysis my husband can get, that I can still work at my job!

http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealthNotifications/ucm062182.htm


Aksys is no longer in business so I think it is just something we have to accept.

[lmunchkin]

Well, as the article specified, high levels, but as you say, it is something we have to accept!  Ok, I get it about the plastic, but seriously, SILICONE?  Seems like that would be worse as far as it getting in to the blood stream!  Oh well, what do I know!

Thanks for the extra stress, BILL!  LOL, just kidding!


lmunchkin     

[HILINE]

I used my dialyzer the 67th time today, 100 and I get a new one

[Lindia]

Wanted to let the forum know that we did rescind the form for reuse.   Hubby is now getting the one time dialyzer, so that is one less issue for us to think about.      Thanks Everyone !     

[CebuShan]

I didn't know that any centers reused dialyzers! Mine always uses the single use disposable.

[Lindia]

Is your center a Fresenius ?     I have heard that they quit reuse sometime in the past.   Our DaVita center certaintly DOES push reuse.      I imagine it saves them some money -  and its all about the money   

[Bill Peckham]

Is your center a Fresenius ?     I have heard that they quit reuse sometime in the past.   Our DaVita center certaintly DOES push reuse.      I imagine it saves them some money -  and its all about the money   

I'm sure it is just a coincidence that Fresenius makes artificial kidneys.

[dialysisadvocate]

Sharing a story --- when my father was at his FMC unit, there was a staff (technician) who worked at another facility (not an FMC unit). This technician told us that at the unit he was told to use the dialyzer more than it should have been used. I forget the number of times this technician said the dialyzer should have been used.. but the nurse told the technician to use it more than it should have been
Roberta

[HILINE]

Sharing a story --- when my father was at his FMC unit, there was a staff (technician) who worked at another facility (not an FMC unit). This technician told us that at the unit he was told to use the dialyzer more than it should have been used. I forget the number of times this technician said the dialyzer should have been used.. but the nurse told the technician to use it more than it should have been
Roberta

why do you think that happened ?

[CebuShan]

Is your center a Fresenius ?     I have heard that they quit reuse sometime in the past.   Our DaVita center certaintly DOES push reuse.      I imagine it saves them some money -  and its all about the money   

I'm sure it is just a coincidence that Fresenius makes artificial kidneys.

   Yep, my center is a Fresenius.

[Keith98058]

I have been on Hemo for 13 years.  I stared with Reuse and then went to the throw away filter.  After about 3 months on the throw away I started to have serious reactions to them and could manage if lucky a 1/2 hour run.  It is because of the chemical Ethylene oxide that is in the single use Dialyzers and causes severe reaction in a few people much like a First user reaction.  If I had stayed on those I wouldn't have made it simply put.

There are Pro's and Cons to both types.. for me the Reuse is a Pro for sure.  I like it because I have a membrane buildup of my blood cells in there that is compatible with my body.  I have never had a issue with Infection or known anyone on the days I run with this issue from them during my 13 years.  The short time I was on the 1 use ones was at another center and out of the 30 patients that I ran with there was several that had issues with them.  Until something improves in the area of the 1 use model I simply will stay on Reuse for now. 

[MomInDialysis]

My unit use to have re-use dialyzers and I use to be the one that cleaned them. In my opinion go with non-reuse. When cleaning them I was told try not to fail them and push them through their tests so that are numbers stayed good. Also, the chemicals used are horrible. If they are not checked right you could be infused with that chemical that could cause more sickness or death if enough was infused. After hearing some of the stories about the staff at some centers, I wouldn't trust them. Even if they are checked by 2 people. Mistakes happen and this is not one that should. Again, I think it is too risky and not worth the chance of causing more health concerns.

Thank you for your honesty.

[dialysisadvocate]

opinions of Roberta Mikles BA RN - Dialysis Patient Safety Advocate
Advocates4QualitySafePatientCare www.qualitysafepatientcare.com

(1) I was informed by a technician, who moonlighted at a facility where they did reuse,  (California) that he was instructed to use the dialyzors past the date he felt was safe ---
(2) Reuse is probably safe - however, in reading the California surveys (inspection reports ) www.qualitysafepatientcare.com it is alarming to see the number of mistakes that were done as a result of staff NOT following policies and procedures for ensuring that reuse procedures were carried out correctly.
(3) MORE alarming and of concern is that patients are given the wrong dialyzer - there are procedures to check to ensure the right patient gets the right dialyzer -- If staff are implementing policies and procedures of their facility, there is NO reason that any patient should be getting another patient's dialyzer

I remember, a while back, one of the providers made media attention when a wrong dialyzer was give to a patient -- the corporate spokesperson stated that they would  increase their policy from two staff checking to three staff checking. HELLO -- this is NOT necessary especially when staff are already, maybe, overworked having to get patients in and out quickly... All that needs to be done is to RE=EDUCATE staff and have effective training/education and ongoing inservies -- as well as effective UNIT LEVEL SUPERVISION - to ensure correct practices are implemented.

[M3Riddler]

I'm just a bit curious...what the feelings are towards reuse.  What have been the past experiences or have you opted out of reuse? 

I had a discussion with an LVN about reuse.  She said dialyzers have been known to be used beyond their capacity, with suboptimal results and sent back to reuse for another cleaning! I can't say for sure but unless I was having a reaction to new dialyzers I would opt out of reuse....I think.  To me it seems like a way to cut cost...afterall its all about saving a buck. *rolls eyes*


this turned out to be kinda' rant-ish...sorry all.

Nae

I certainly would not accept a reused filter.  Not only do they lose their viability and break down with each treatment, why should you  accept 2nd hand when there is no reason why they cannot use a new filter with each treatment.
iIm willing to be that the insurance is still paying for a new filter even though they are using them over and over.

Also, did you know that they use Formaldeyde to clean them?  Yes, they test to make sure it is removed, but this is not something I would want in my opinion.   
Also, there is chance where you may recieve someone else's filter by mistake. There are procedures to prevent this, but it does happen - Not often, but still occurs.

You deserve new equipment with each treatment. it is affecting your body, not the clinics....They are ust trying to save money and has nothing to do with the quality of your treatments...