Renal Program Switching to ‘Online’ Priming in Several Hemodialysis Units

After planning and preparation, Manitoba Renal Program is set to roll out a new way of priming in-centre dialysis machines. Previously, additional saline bags were brought to the machine and used to prime the blood lines and dialyzer before a patient’s treatment. Now, the machine will use the dialysate it creates and an existing connector to prime the machine. Manager of Dialysis Technology, Doug Franklin, says there are many benefits to online priming.

“We have a lot of workplace staff injuries from people repetitively lifting saline bags. The hope is we will eliminate a lot of those workplace injuries.”

He also says nurses will be able to give a saline bolus right from the machine instead of hanging a bag. “You can basically dial in and it will give it to the patient automatically – without the nurse having to watch the saline bag.”

In addition, the shift is expected to produce significant annual cost savings because of reduced use of supplies. Franklin says Winnipeg sites will save about $450,000 per year while a site like Brandon will save $55,000. This move helps MRP work on meeting a mandate set out by the Manitoba government to improve efficiency while not impacting the quality of patient care.

The process is complete at Health Sciences Centre and in progress at Seven Oaks General Hospital. St. Boniface Hospital units are expected to transition in early 2018.

This new process has no impact on the quality of a patient’s dialysis treatment. Because this is a new process, there may be delays in starting patients on dialysis in the afternoons and evenings. Every hospital will provide relevant information on how online priming is being implemented at your site.

It is important to ensure that you are able to receive your full dialysis treatment as prescribed by your nephrologist regardless of any possible delays. We appreciate your patience and understanding as we roll out this new process. Please ask to speak to the manager if you have any questions or concerns.

Dialysis technologists will be working with Winnipeg managers and educators to roll out training and education for nursing staff. Franklin says the training is fairly simple and expects the transition to be relatively smooth. Training is about one hour with on-site support for an additional two weeks. MRP nurse educators will assist with long-term training and support.

While this type of priming has been used for years in places like Europe, Manitoba Renal Program has planning for the change since transitioning to the currently used model of dialysis machine. Technologists had to validate that the process was working properly which included ensuring pharmaceutical grade water systems were tested monthly. Because of the extensive testing required, the program will not be implementing this new method of priming at any of the local renal health centres at this point.

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