Zany Filter MIX UP!!!

[Robby712]

So my favorite tech, a middle-aged foreign woman from an undetermined eastern-European country was hooking me up today.  She is usually is only allowed to hook non-fistula folks up b/c she is such a butcher with the needle, but sticking hasn't been a problem since my fistula is pretty well developed.   But she's gotten me pretty good a couple times, unhooked my lines without clamping, and pulled a needle on accident while removing the tape...but I digress...

My needles went in without incident.  The arterial clamps were open, blood was entering the system, the venous clamps were about to be opened ...when from across the room another tech yelled "Hey, what is Chris's (me) filter doing on Charlie's machine???...Who's Filter is on Chris's?!?!?"  She looked over, turned bright red and turned off the machine.  Unhooked me, told me it was going to be "a few more minutes", broke the machine down, set the new one up, and went on lunch break.   25-30 minutes later she came back and hooked me up. 

She never even directly acknowledged her mistake...I'm getting the feeling she's out to kill and/or maim me.

Question 1: Are the benefits of reusing a filter really that great that I shouldn't just walk in there Wednesday and say I want a new filter every time from here on out?

Question 2:  What the hell would have happened if I would have gotten part are all of my treatment with the filter of another patient on my machine? 

Discuss!

[flip]

The option of using reuse filters is up to you. They can not require you to use them. If she is as bad as you say, I wouldn't let her near me.

[twirl]

that happened to me last week and I was almost hooked up when the charge nurse saw the mistake
the tech made no big deal out of it
I was upset
she is or was my favorite tech and the other day she stuck me and hurt me and I think she did it on purpose
she has never hurt me before
I did not report her but the charge nurse found the mistake and probably did report it  --  I guess
everyone was acting like it was no big deal
I am still upset
only the other patients were not acting like it was no big deal
I guess the techs could still but you on the wrong machine even if you do not reuse filters
I would not let anyone known as a butcher do my needles
frightens me to think of it
do not let her near you for several reasons
I asked the charge nurse what would have happened to me
she did not give me an answer
I figure someone like Flip would tell me on this post

[twirl]

I know on next visit on rounds when a doc comes by I will ask him
in front of the social worker, nurse, dietitian and anyone else on rounds
I was seconds away from being hooked up to a man's filter
and he is very sick
and where was my filter

[twirl]

I promise I will quit after this post
and the tech that did that to me unhooked me that day
she kept saying I have pretty blonde hair and do not ever cut it
and I have beautiful children
and compliments all over the place
I did not answer her
I kept thinking "shut the F up"

[Adam_W]

Depending on the company, putting an incorrect reused dialyzer on a patient's machine is an automatic firing. Giving a patient the wrong dialyzer could lead to cross-contamination and possibly very serious complications. If I was still doing in-centre, I would never reuse a dialyzer.

Adam

[flip]

Dialysis centers will get away with as much as you let them. I don't reuse filters and I don't let anyone stick me that I am not comfortable with. I manage to stay in control of my dialysis even if I have to be an SOB sometimes.

[dkerr]

My nephrologist doesn't like reused filters.  Can you insist on new ones every time?  Is there any benefit to reusing?

[flip]

You have the right to new filters every time you dialyze. There are some advantages to reuse filters if they are done properly.

[BigSky]

If using reuse you need to look at the filter every time before treatment to make sure its yours along with being shown the test strip to make sure there is no cleaning agent still in the filter.

Reuse does have some benefits.  However if you feel uneasy about reuse the time is probably right to use what happened as an excuse to not do it anymore.

Centers that use reuse often let patients have bigger, better filters as the cost per use is lower each time the filter is used.  Its not uncommon if not using a reuse the center may give you a smaller less efficient filter as its a one time use  in trying to keep the cost down since its a  one time use filter.

[pelagia]

Can you stencil your name on the side in fluorescent orange paint or something like that?  Sounds like the big reuse filters are better.  Hooking up the wrong filter should be grounds for termination.

[Zach]

There are some advantages to reuse filters if they are done properly.

And that is the problem, when "done properly."  Having a reuse program increases possible human error.

The "advantage" of reuse was partially true for the "old" cuprophane or cellulose acetate filters.

But with the modern synthetic, biocompatible filters, such as those made of polyamide, polyacrylonitrile and polysulfone, there is no improvement with reuse in most cases. In fact, the rate of removal of the larger middle molecules is reduced by reuse on some of these filters.  Not good.

The only advantage in this case is perhaps the financial advantage for the center.  And so, Big Sky is right, the alternative filter you may be offered could be even less effective.

Here's one article from 2000:
http://ndt.oxfordjournals.org/cgi/content/full/15/1/5

Unfortunately, there is no single study that has all the answers.
 

[flip]

We had one nephrologist who said that reuse filters retained some of your antibodies. I don't know if that's true or not.

[Robby712]

I plan to at least inquire about the reuse program the next time I go in and find out what my options are if I choose to discontinue my willing participation...

I have heard that there are some medical benefits to reuse...however I have always suspected it was more of a cost cutting method by either the unit, or the insurance company.    I would guess the possibility of human error would outweigh any possible medical benefits.

Regardless I won't sit down in that chair until I see my name on the dialyzer from here on out...

Thanks for all your input guys.

[devon]

I know you may not be in a position to implement this but at my center (I'm such a "pro" now... been there a WHOLE WEEK!) they require TWO people to check the machine settings before the clamps are opened.  They each note and sign the chart.  The check includes the filter and the patient's name.  They ask me if I am Mr. So and So while looking at the filter and then note that in the chart.  Considering the danger of reusing filters, this is a simple but reliable method.

Also, I have a responsibility and signed a statement specifying that I would personally check the filter and make sure my name was on it before I sat in the chair beside that machine.  I take this very seriously and do so because even the most experienced tech can make mistakes.

In the case of that tech you describe... really, she shouldn't be in this business.  She doesn't seem to have the right sense of responsibility. AND, the center seems to have a poor set of procedures!  They both need some careful review!

-Devon

[twirl]

Devon, you are a fast learner with sound advice--- thankyou----- I will suggest this to our main person --whatever she is called ---- they do not use tourniquets anymore and stopped reading our info - to get patients on faster----- it is not as safe

[devon]

Good morning Twirl!

That's all I had to say.  Glad to "see" you.  Hope you are doing well today.

(I tried to send this as PM, but it said something about it couldn't because of PM limit... whatever that is)

-Devon

[Gramapat]

I use a reuse filter.  I always check to make sure my name is on the filter before I sit down.  My center (which is Davita) also requires 2 people to check name, numbers and test strip.  I also check to make sure they are taking the correct amount of fluid off.

You must be your own health advocate and learn what to look for and learn what the numbers mean.  Don't rely on others!  I learned this lesson long ago and it has served me well.

[kitkatz]

I am currently on the "Patient refuses reuse" list at the center.  I had to, it almost killed me in 2004.  I am either allergic to the fibers or the renalyn. What fun!

[Robby712]

So I asked the two girls that took me off at the end of the night what the benefits of filter re-use are.  They said honestly...cost only.  They told me that when they were introduced to it they heard something about how proteins bind to the filter and make dialysis easier on the patient...but another nurse told them it's just to save money.  They both agreed that the chemicals they run through them to clean them out probably aren't all that great for you either...and said if they were on dialysis they wouldn't do the re-use thing. 

So I am going to ask to switch to a new one every time...

Oh, and interesting side-story...I told them the whole story after I asked about the dialyzers, and about how it was Charlie's filter that was on my machine...and they said "Are you sure, b/c we just threw his out tonight b/c it looked like it had been used too many times?"

Which means there is a possibility that even though they started the arterial flow and were sucking my blood out into the lines...they figured since it hadn't hit the filter yet they could still get another use or two out of it.

That reason alone should make you ALL consider not doing re-use anymore.

[thegrammalady]

my center reused filters when i first started but have since stopped doing that, using a new one each time.