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Dialysis Program Outpatient Manual

Chapter 0 : Dialysis Program Organizational Chart

Organizational Chart

Chapter 1 : Administrative

DP003 : Management of Patients with Behavioral Issues - 6/2015

DP005 : Water Treatment Room Security - 6/2015

DP008 : Mission Statement - 6/2015

DP009 : Cell Phone Usage by Employees - 6/2015

DP010 : Health Care Provider Licensure Certification - 6/2015

DP011 : Employee Health Monitoring

DP012 : Dialysis Program Committees - 6/2015

AMI prepost Assessment of the Dialysis Flow Sheet Policy

Care Across the Continuum Admission and Discharge Policy June 2015

Dialysis EMR Access June 2015

Dialysis Program Attendance Addendum June 21 2016

ECP Outpt Dialysis Program 2016 - 01/2017

Flowsheet for Problematic Behavior Patients

Governing Body and Management

Home Hemodialysis and Peritoneal Dialysis Evaluation and Supervision

Medical Coverage of Dialysis Patients June 2015

Medication preparation and Administration Policy June 2015

Patient Assessment and Care Plan Policy June 2015

Patient Grievance Policy June 2015

Patient Memorial Fund Policy June 2015

Patient Rights and Responsibilities

Quality Assurance and Performance Improvement

Storage of Dialysis Medical Records Policy June 2015

Transplant Selection Criteria June 2014

Chapter 2 : Outpatient Dialysis Treatment

Section 1 : In-Center Outpatient Dialysis

Anaphylaxis Hypersensitivity Drug Reaction

Blood Cultures May 2014

Blood Product Administration During Dialysis and/or Apheresis March 2017

Braun Machine Dialyzer Build with Airless Bloodlines March 2017

Crit Line Monitoring 2014

Dialysate Delivery June 2014

Dialysis Specific Infection Prevention and Control Jan 2017

Fresenius Acid Clean Chemical (Bleach) Disinfect June 2012

Fresenius Acid Clean Heat Disinfect June 2012

Fresenius K Machine Dialyzer Build with Airless Bloodlines Jan 2014

Identifying Contact Isolation Patients March 2017

Machine Verification and Hourly Patient Checks May 2014

No Heparin Dialysis March 2017

Obtaining Post Dialysis BUN (Braun) June 2014

Obtaining Post Dialysis BUN (Fresenius) May 2014

Obtaining Pre-Dialysis Lab Specimens

Obtaining PT/PTT from Catheter June 2014

Preparation and Use of Bleach Solutions October 2013

Securement of dialysis needle sets during dialysis November 2013

Testing Dialysate Conductivity using the MyronL Meter May 2012

Ultrafiltration Only - Sequential Dialysis (Fres K) November 2012

Use of Hydrogen Peroxide Cleaner Disinfectant Wipes December 2013

Section 2 : Vascular Access Care

AV Fistula and Graft

Access Flow Fresenius K Surveillance March 2017

Buttonhole Cannulation March 2017

Clamp Fistula Use March 2015

Complications of Fistula and Grafts

Creating Constant Sites Buttonhole in Native AVF March 2017

Discontinatuion of Hemodialysis with an AV Fistula or Graft - Braun Machine May 2017

Discontinuation of Hemodialysis with an AV Fistula or Graft - Braun May 2017

Initiation of Dialysis for Fistula or Graft Braun June 2014

Initiation of Dialysis for Fistula or Graft Dec 2014

KECN Online Clearance May 2014

Kt/V Online Clearance May 2014

Management of New AV Fistula May 2014

Nipro Safety Fistula Needle

Transonic HD02 Recirculation Studies Jan 2013

Transonic HD03 Access Flow Jan 2014

Transonic HD03 Recirculation Studies June 2015

Vascular Access Bypass May 2017

Venous Dialysis pressure Monitoring April 2017


Catheter Disconnect Dec 2014

Catheter Disconnect with Tego Cap - Braun Dec 2014

Catheter-Secondary Access Care March 2015

Initiation of Dialysis for Dual Lumen Catheters - Tego Caps (Braun) Dec 2014

Initiation of Dialysis for Dual Lumen Catheters - Tego Caps Dec 2014

Patient Education

Bleeding from access after dialysis

How to care for your dialysis access

How to care for your dialysis catheter

Instructions: Patients going home after femoral catheter

Section 3 : Medical Complications

Air Embolism March 2017

Anaphylaxis March 2017

Angina March 2017

Arrhythmias March 2017

Blood Leak March 2014

Cardiac Arrest March 2017

Dialysis Disequilibrium Syndrome March 2017

Fever and Chills March 2017

First Use Syndrome March 2017

Heparin Overdose March 2017

Hyperkalemia March 2017

Hypertension March 2017

Hypotension March 2017

Muscle Cramps March 2017

Power Failure May 2014

Pruritus May 2014

Seizures March 2017

Section 4 : Medications

Calcitriol May 2014

Carnitor1 September 2014

Cathflow Activase April 2013

Cefazolin (Ancef) June 2014

Cefepime 2014

Cefoxitin Administration March 2017

Citrate Catheter Lock December 2016

Contrast allergy premed May 2014

Daptomycin (Cubicin) Administration June 2014

Diphenhydramine Hydrochloride (Benadryl) Administration

Engerix B (Hepatitis B) Vaccine Recombinant October 2015

Epinephrine 1-1000 Inection Administration March 2015

EPO Administration 2014

Ertapenem April 2014

Etelcalcetide (Parsabiv) Administration

Ferumoxytol (Feraheme) July 2016

Gentamicin (Garamycin) June 2014

Hectorol Doxercalciferol April 2015

Heparin Administration March 2014

IDPN Infusion Administration Dec 2016

Iron Sucrose (Venofer) June 2014

Meropenem Administration 2014

Methylprednisolone (Solu-Medrol) Administration

Pneumovax May 2011

Rocephin June 2014

Sodium Ferric Gluconate Complex Administration June 2014

Sodium Thiosulfate July 2016

Solu-cortef Administration May 2014

Tobramycin April 2013

Vancomycin Dosing and Administration May 2014

Zemplar - Paricalcitol March 2015

Section 5 : Protocols

Algorithm: Adequacy for Low Kt/V or URR Sept 2014

Algorithm: Catheter Malfunction May 2014

Algorithm: Conversion of Tunneled Catheters to AVF or AVG May 2014

Calcitriol (Calcijec) April 2015

Darbepoetin (Aranesp) April 2015

Doxercalciferol (Hectorol) April 2015

EPO Dec 2015

Ferric Gluconate (Ferrlecit) April 2015

Hep B Flow Chart 2015

Heparinization May 2014

Hepatitis B Vaccine Recombinant (Engerix-B) July 2015

Iron Sucrose (Venofer) April 2015

Lab Orders Jan 2017

Nutrition Algorithm June 2015

Nutrition Supplement Flow Diagram June 2015

Paricalcitol (Zemplar) April 2015

Chapter 3 : Acute Renal Failure/CRRT/Apheresis

Section : Acute Kidney Injury

Accessing catheters by non-renal staff in the ICU Setting

Albumin (Human) 25% Solution Administration August 2012

Calcium Bath Mixing August 2012

Citrate Anticoagulation July 2012

Crit Line

Culturing Catheter Tip

Dialysis in the Emergency Department

Guideline: Red Cell Exchange Transfusion in Sickle Cell Disease

Heparin Administration March 2014

Heparinization Protocol May 2014

Mannitol Infusion Protocol March 2013

Potassium Dialysate Protocol

Section : Apheresis

Apheresis Assessments May 2012

Apheresis Drug Removal May 2012

Apheresis Signs and Symptoms May 2012

Apheresis: Standing Guidelines May 2012

Section : CRRT

Albumin Priming in CRRT August 2013

Calcium Dosing in CRRT May 2008

Connecting CRRT to ECMO Jan 2010

CRRT Calcium Chloride Titration June 2013

Heparin Anticoagulation in CRRT April 2006

Section : Pediatric

Pediatric CRRT Protocol May 2014

Pediatric Guidelines

Chapter 4 : Home Therapy

Section : Check Sheets and Misc

Check List - CAPD CCPD Home Visit

Check List - Fresenius Hemodialysis Home Visit

Check List - NxStage Hemodialysis Home Visit

Home Patient Compliance Letter

Home Therapy Agreement

K Machine Training Schedule

New Patient Letter (KC Home)

Section : Home Therapy Guidelines

Guideline: CAPD CCPD Emergency Kit list

Guideline: CAPD CCPD Initial Patient Supplies

Guideline: CAPD CCPD Monthly Patient Supplies

Guideline: Exit site care for patients

Section : Home Therapy Procedures

DP900 : Adding Medication to Dialysate Bag - 5/2016

DP901 : Diastix - 5/2016

DP902 : Obtaining an effluent sample from a PD bag - 5/2016

DP903 : Converting Baxter Cath to Fresenius - Temp 5/2016

DP904 : Healed PD Exit Site Care - 5/2016

DP905 : Flushing PD Catheter - 5/2016

DP906 : Converting Fresenius Cath to Baxter - Permanent - 5/2016

DP907 : Converting Baxter Cath to Fresenius - Permanent - 5/2016

DP908 : Converting Fresenius Catheter to Baxter - Temp - 5/2016

DP909 : Changing PD Extension Tubying (Fresenius) - 5/2016

DP910 : PD Catheter Repair - 5/2016

DP911 : Catheter Dressing Change - 5/2016

DP912 : Initial PD Extension Tubing Placement and Flush - 5/2016

DP913 : PD Exit Site Care (Initial Post-Op) - 5/2016

DP914 : Resin Pack Exchange - 5/2016

DP915 : Silex Chemical Disinfection - 5/2016

DP916 : Silex Home Setup - 5/2016

DP917 : NxStage Training Procedure - 6/2016

DP918 : Ultra-Low Total Chlorine Test - NxStage - 6/2016

Chapter 5 : Water & Biomedical Service

Section : Water & Biomedical Service

Amherst Only: Ultra-Low Total Chlorine Test Feb 2015

Ascend Labs (Packaging and Shipping) Feb 2015

Millipore Sampler Feb 2015

MRO5 Chemical Disinfection March 2015

Myron L D-4 Calibration Feb 2015

Myron LD-4 Validation Feb 2015

pHoenix Meter Level 1 Calibration Feb 2015

pHoenix Meter Level 2 Calibration Feb 2015

pHoenix Meter Validation Feb 2015

Pryosate LAL Testing Feb 2015

Serim Residual Chlorine Testing Feb 2015

Surface Terminal Disinfection Feb 2015

Total Chlorine Chloramine Testing Feb 2015

Ultra-Low Total Chlorine Testing for the BioLab 4400 Feb 2015

Ultra-Low Total Chlorine Testing March 2015

Ultra-Low Total Chlorine Testing for the 23G RO Feb 2015

Water Culture Collection Feb 2015

Water Hardness (Steri-Chek) Feb 2015

Technical Service Request

Chapter 6 : Transplant

Chapter 7 : Emergency Management

DP001 : Emergency Management of Outpatient Dialysis Facilities

Section : Forms

FORM - Agreement to Comply with Established Procedures

FORM - Bulletin Board Consent

FORM - Chair-side Rounding Consent

FORM - Dialysis Downtime Worksheet

FORM - Dialysis Downtime Worksheet

FORM - Hepatitis B Declination

FORM - Technician Certification Acknowledgement

FORM - Transient/Transfer Information

FORM - Utility Failure

Section : Guidelines

Guideline: Bundled Medication

Guideline: Care for patients with Acute Kidney Injury December 2017

Guideline: Care Plans

Guideline: Code and Demise of Patient during dialysis November 2016

Guideline: ESRD Patients requiring gadolinium as contrast

Guideline: Hemodialysis Catheter Exit Site and Tunnel Infection May 2015

Guideline: Nutrition Supplement Jan 2014

Guideline: Parathyroidectomy

Guideline: Parsabiv

Guideline: Sensipar

Guideline: Standing Routine Outpatient Hemodialysis November 2017

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