Hep B infection control practices in hospital based hemodialysis programs

[Lana Kay]

I would like to hear various infection control practices that are used in hospital based acute settings for hemodialysis patients.

I am only wanting practices used in HOSPITAL based programs. Thanks

[Chisca, RN]

There is not going to be any variation in hospital practice concerning Hep B as this is dictated by CMS guidelines. Essentially Hep B status checked every 6 months, hep B psoitive machines internally bleached, unknown status patient's machines treated as positive and bleached, and my favourite, hep b positive patients isolated and not paired with any other patient in staffing pattern.

[westieluv]

I work in acute dialysis. If we get a patient whose Hep B status is unknown, we order a Hep B panel to be drawn and treat them as infected until we know differently, which means we have to bleach the machine we use on them until we have a lab verified, hard copy of a nonreactive or immune Hep B status. If they are a chronic patient, we can obtain Hep B results from their chronic unit, as long as they were drawn within the previous thirty days. If it was even thirty-one days, we have to draw another one and bleach until it comes back nonreactive or immune.

[Chisca, RN]

30 day period is from CDC guidelines and after looking at the CMS regs they refer back to the CDC. It appears there are some variations as the hospitals and clinics locally test at 6 month intervals. Have to research more on why this is. If I were a patient I think I would prefer the monthy cycle.

[DialysisRN34, BSN]

If patient is in-center we can use the center's results. Either a negative Hep B Ag within 30 days or positive Hep B AB (>10) with in a year. If patient is new or unable to get up with the unit we treat the patient as infected till we have our own Hep panel back.