Questions About PD

  1. Good Morning, when training patients our nursing team has always taught the learners to do a 20 second hand wash with antibacterial soap and water and drying with clean paper towel, before gathering supplies and proceeding with their capd exchange or setting up their cycler. During the exchange procedure and cycler set up we instruct the patients to reinforce the cleanliness of their hands by using sanitizer (after masking) before any sterile connection or disconnection moments. I spoke to a Nurse yesterday who was teaching a patient that if the patient thought her hands weren't soiled, she didn't need to wash with soap and water before gathering her supplies, but to just use sanitizer. My colleague's rational was that our hospital policy stated sanitizer is the superior choice over antibacterial soap and water for "unsoiled hands" and that as this is hospital policy, this should apply to PD patients as well. Is there a best practice guideline for performing PD exchanges that clarifies hand hygiene methods and procedure?

  2. In order for the patient to start their PD therapy at home, it is requested that they have a safe area; however, the imprecision of the term has given rise to a great variety of criteria, where the remodeling of the space (walls, floors and furniture) has been requested. This situation sometimes delays the start of home therapy, because patients do not have the support or resources for such modifications and during that time intermittent dialysis is performed in the hospital, with the risks that this represents. So, is there any guide or evidence that specifies the minimum conditions to consider a safe space for home PD?

  3. Hello, is there a best practice guideline for dwell time for optimal fluid removal when using a 4.25% dianeal twin bag on a hypervolemic patient? Thank you, Karen Grant RN Ontario, Canada