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     Is there any support for the practice of changing transfer sets upon hospital admission when peritonitis is not suspected? I've seen the practice involving five-minute iodine soak/scrubs and I've also heard about outpatient clinics using CHG in a similar fashion, but is there a specific recommendation for this? Lastly, should the connection of an adaptor (e.g. a Baxter adaptor being added on top of a Fresenius transfer set) be performed the using the same sterile transfer set exchange procedure? Thanks!
    ANSWEREDDaniel G answered May 23, 2025
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     What are the concerns / possible complications of a long-unused PD catheter? After many discussions and many, many no-shows and missed training appointments, we are definitely not doing PD. However, this patient has also no-showed / canceled the appointments for the catheter to come out. It’s been in for months, approaching a year. I will, of course, keep trying to get her in for a catheter removal, but what should I be on the lookout for?
    ANSWEREDCaroline H answered June 23, 2024
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     I recently asked if the dwell time of dianeal matters in diagnosing peritonitis. The answer was (paraphrased) as long as it's in for 2 hours or longer. The second part of the questions is, does the amount of dianeal matter. If a patient comes in for peritonitis testing, and the center drains 300 cc's of fluid; can that amount of fluid be tested, and would the results be correct? Is there any type of dilution or concentration that may throw labs off?
    ANSWEREDAnthony Mc Connell answered May 19, 2024
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     I was asked to do a home visit on a patient who needs to use a personal hot tub to relieve symptoms of a medical condition. He really wants to do PD. Is there anything a patient can do to mitigate the higher risk for infection if using a personal hot tub? We always educate patients that they are not allowed to submerge their PD catheter in bath/hot tub/lake water but okay to use personal well chlorinated pool and ocean. Any data on microbial bioburden of well maintained/chlorinated hot tubs?
    ANSWEREDAna, B answered May 19, 2024
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     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?
    ANSWEREDKaren A. answered March 8, 2023
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     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?
    ANSWEREDAna Miriam Cabrera Delgado answered February 13, 2023
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     I'm an educator at a providence hospital in Portland, Oregon and am looking for best practices/procedure for instilling alteplase in PD catheters for obstructions. From our own personal literature review, we've notice most of the literature is for the early 2000s. Does anyone have more current resources we can utilize to understand best practice for this intervention as we review our current process?Thanks!Allison Young MSN, RN, CMSRN
    ANSWEREDallison young answered December 11, 2022
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