Addition to the dialysis ritual at our centre

[Bajanne]

Now, after we weigh ourselves (those who weigh themselves), we have been asked to go to the sink and wash our access area with antibacterial soap.  This is a new directive.  Do any of you who do in-centre haemodialysis have to do this?  They say it is to keep down infection.  I found it a big strange since they always make a big deal of swabbing the area before inserting the needle.  But, of course, I gladly comply.

[petey]

The whole time Marvin was on in-center hemo, the patients were supposed to do this -- the hand washing sink was right next to the scales.  However, Marvin was the only patient who ever washed his access arm before treatments; the nurses didn't push it (even though there was a big sign in front of the scales).  Marvin pretty much does whatever he's told to do; he's a good boy.  And, he figured if it didn't help (because they did lather the access down pretty good with Bedadine when he got to his chair), it couldn't hurt.

[BigSky]

Been done here quite a while.

Good idea because you do not know what others might have and what they have been touching before you got there.  This way if everyone washes their hands and access that much less chance of picking something up.

[Meinuk]

I think that the washing is a universal precaution that not all units enforce.  But it really is a good idea - better safe than sorry.

I would always wash and purell my access arm when I was in center.

[kitkatz]

It is a real good idea to wash the access before you get a needle in it.  Just a good precaution to do.

[flip]

In my center the scales are portable and the nurses wheel them around to the individual chairs when we first come in. They swab the arm before sticking but there is no mandatory washing. The sinks are actually off limits to the patients.

[RichardMEL]

We wash oiur arms but it's suggested to do it - not enforced... I do mine every time though (but I have forgotten once or twice). While the staff do go and use the alcohol wipes to wipe down the area before needling it is a great idea to wash the access.

[KR Cincy]

I do home hemo, so I wash the arm with anti-bacterial soap and use paper towels to dry...then we alcohol swab and betadine the stick site...ohhh the processes!

[Hawkeye]

Having patients wash their access is actually part of the Fresenius Infection Control Policy.  We are all adults and no one can make you do it but every clinic should at least be educating patients on it's benefits and encouraging them to wash their sites.

[flip]

In my center many of the patients aren't ambulatory. They arrive in wheel chairs or gurnies. How does Fresenius handle this situation, especially if they have a catheter?

[Hawkeye]

In my center many of the patients aren't ambulatory. They arrive in wheel chairs or gurnies. How does Fresenius handle this situation, especially if they have a catheter?

For patients that aren't ambulatory it is suggested that before the patient is brought to dialysis that their caretaker washes their access and then the tech cleans it again at the chair using the typical alcohol pads.  There is unfortunately no good way to handle that in a clinic setting that has been proposed.  The reasoning behind washing the site is to make sure there is nothing on your skin that could possible cause you an infection when being stuck.  If you wash your site with antibacterial soap and then the tech wipes the site before sticking you are pretty much guaranteed that nothing is there.  As we all know there are techs out there who do better jobs than others and may actually clean the site as opposed to just giving it a quick swipe which does nothing.  This is also encouraged to try and help keep down infections in those patients that don't seem to bathe very often.  There is almost always at least one at every clinic that smells and doesn't look like they have bathed in a week.  Those people are going to have more grim on their access and cleaning it with alcohol pads may not be enough so the extra cleaning at the sink helps greatly.  As for catheters that is a whole different process that is done in the treatment chair by the tech/nurse.