Who are those pateints requiring Single Use Dialyzer?

DeLana_RN, BSN, RN · Nov 2, 2007

In the outpatient clinic I used to work at, it was policy that all HIV/AIDS pts had to use dry packs (single use dialyzers), as well as Hep B pts (who were also dialyzed on designated machines in an isolation room). Hep C pts, on the other hand, were allowed to use reuse dialyzers (I should rephrase, encouraged to use reuse dialyzers, as this saved the company lots of money).

In a sister clinic, HIV pts were also encouraged to use reuse dialyzers (which makes sense if you allow Hep C pts to use them; Hep C is more infective than HIV). Hep B, of course, is a much hardier virus and therefore dry packs are a must for these pts.

Another reason for single use dialyzers could be a reaction to the sterilant (e.g., Renalin) used in the reuse process, although I have never heard of a case.

HTH,

DeLana

P.S. All patients have the right to a single use dialyzer, although the companies who practice reuse don't emphasize this fact.

bogchi2000 · Nov 2, 2007

Hi, thank you for ypur reply.. I am also working in Out-patient basis and private dialysis center in Singapore as we practice Single Use for All hepatitis B,C so far we havnt encounter any HIV+.. We dont re-use any Hep+..

How about in the case of having MRSA or VRE for one of the regular patient which before that he/she dont have.. Coz we are using one Reprocessing Machine but we off-course change those RC connectors in every patient's AK..

GeauxNursing · Nov 6, 2007

Hi, thank you for ypur reply.. I am also working in Out-patient basis and private dialysis center in Singapore as we practice Single Use for All hepatitis B,C so far we havnt encounter any HIV+.. We dont re-use any Hep+..
How about in the case of having MRSA or VRE for one of the regular patient which before that he/she dont have.. Coz we are using one Reprocessing Machine but we off-course change those RC connectors in every patient's AK..

We have lots of MRSA'ers, some are on re-use, some aren't. HIV, dry packs. Davita certainly "encourages" everyone to go with re-use, sves money.

Hellllllo Nurse, BSN, RN · Nov 6, 2007

Pts who tend to clot should use single use, as well.

DeLana_RN, BSN, RN · Nov 9, 2007

Hi, thank you for ypur reply.. I am also working in Out-patient basis and private dialysis center in Singapore as we practice Single Use for All hepatitis B,C so far we havnt encounter any HIV+.. We dont re-use any Hep+..
How about in the case of having MRSA or VRE for one of the regular patient which before that he/she dont have.. Coz we are using one Reprocessing Machine but we off-course change those RC connectors in every patient's AK..

I don't see why pts with MRSA or VRE should require dry packs, since these are not spread in the same way as blood-borne illnesses. Contact isolation of the pt is a better idea.

Of course, I was always shocked that the clinics did not isolate MRSA pts in any way (hospitals do... frankly, I don't see how a clinic environment is any less infective than a hospital environment). Or have any the outpatient centers started MRSA insolation?

DeLana

Lacie, BSN, RN · Nov 9, 2007

I don't see why pts with MRSA or VRE should require dry packs, since these are not spread in the same way as blood-borne illnesses. Contact isolation of the pt is a better idea.
Of course, I was always shocked that the clinics did not isolate MRSA pts in any way (hospitals do... frankly, I don't see how a clinic environment is any less infective than a hospital environment). Or have any the outpatient centers started MRSA insolation?
DeLana

I work for Davita and have yet to see any patient isolated for MRSA, VRE, or Hep B. We do internal bleaching of the machine in between pt use only if HIV/Hep. Of late we have seen our share of MRSA also. Usually after they have returned from CVC insertion or de-clotting. We seat them right next to unaffected patients nor are we really informed of Hep/HIV status anyway by administration. I only know if I'm the one who collected the lab reports. We only use dry packs on Hep pts or HIV pts. We also have a few who are allergic to dry packs and must have a second re-use dialyzer available if needed. And with the recent staffing cuts Davita has made it's getting harder and harder to even keep up. We had to use mostly dry packs this past week due to sending our re-use techs home due to so called "productivity" requirements, so no dialyzers were processed in a timely manner lol. How is this saving $?

jnette, ASN, EMT-I · Nov 10, 2007

Pts who tend to clot should use single use, as well.

Yep... helps a lot.

And of course any patient who requests single use! Don't forget that !

They DO have the right to request single use dialyzers. :)

kenzy · Nov 11, 2007

In the unit that I worked for it was my understanding that the Insurance companies paid for a new dialyzer each Tx. regardless if the pt. was on reuse or not. We were encourage to suggest that the pt. go on reuse, so that the unit I guess could benefit from the money when the the dialyzer in all actuality was being used 20+ times. I personally would request a new dialyzer each tx. knowing what I know now. Just my thought.

jnette, ASN, EMT-I · Nov 11, 2007

I did the reuse processing for quite some time while I worked in dialysis... I can't say that I would request a new dialyzer as opposed to a reuse dialyzer. There are many, MANY steps involved in reuse to ensure quality and safety. So many, in fact, that this is one of the very reasons companies were finding it more cost effective to offer single use disposables vs. reuse.