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Clinical Resources
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Policies & Procedures
30.10.01 Use of Fresenius 5008 Delivery System using 0.9% NaCl *revised*
30.10.02 Fresenius 5008 Preparation for Hemodialysis using the ONLINEplus ™ System
30.10.03 Initiation and termination of Treatment using the Fresenius 5008 ONLINEplus™ System *revised*
30.10.05 Providing a bolus using the Fresenius 5008 ONLINEplus ™ System *revised*
30.10.06 Fresenius 5008 ISO Ultrafiltration (Sequential Therapy) *revised*
30.10.07 Fresenius 5008 Air Detected Below the Venous Bubble Catcher
30.10.08 Fresenius 5008 Blood Leak Alarms; responding to
30.10.11 ONLINE Circulation of Bloodlines with Substituate After Blood Reinfusion *revised*
30.10.12 Single Needle (Click-Clack) Hemodialysis for Fresenius 5008 Dialysis Delivery System *revised*
30.10.13 Providing Hemodialysis without Heparinization *revised*
30.10.14 Intradialytic Blood Product Administration
30.10.14a How to Order Blood *revised*
30.10.14b Appendix B: Notification Card Sample *revised*
30.10.15 Calcium Chloride Additive for Hemodialysis Patients *revised*
30.10.16 Administration of Intradialytic Parenteral Nutrition to the Hemodialysis Patient
30.10.16a Intradialytic Parenternal Nutrition *revised*
30.10.19 Changing Dialysate Concentrate During Hemodialysis Treatment *revised*
30.10.20 Providing Heparin Bolus During Hemodialysis Treatment *revised*
30.10.21 Manually Opening Arterial Pressure Measurement Unit *revised*
30.10.22 Emergency Reinfusion Procedure using the Fresenius 5008 *revised*
30.10.23 Manual Reinfusion Procedure in the Event of Power Failure and Empty Battery/System Failure *revised*
30.20.01 Venipuncture of Arteriovenous Fistula/Graft
30.20.02a Anticoagulant/ Thrombolytic/Antibiotic Lock Solutions for Hemodialysis *new*
30.20.03 Establishing and Maintaining Buttonhole Venipuncture Sites
30.20.04 Use of Closed Needleless Access Device with Hemodialysis Central Venous Catheters (CVC)
30.20.05 Hemodialysis Central Venous Catheter Dressing and Care of Catheter *revised*
30.20.05a Statlock Application Procedure *revised*
30.20.06 AVF/AVG Vascular Access Assessment *revised*
30.20.07 Removal of Non-Tunneled Hemodialysis Central Venous Catheters
30.20.08 Alteplase for Clearing Hemodialysis Catheter Thrombosis using the Push (30 minute) Method
30.20.09 Alteplase IV Infusion for Clearing Hemodialysis Catheter Thrombosis
30.20.10 Alteplase for Hemodialysis Central Venous Catheter (Dwell procedure)
30.20.11a Anticoagulant/ Thrombolytic/Antibiotic Lock Solutions for Hemodialysis *new*
30.20.12 Use of BARD Dialysis Catheter Repair Kit *revised*
30.20.13 Use of Covidien™ Acute and Chronic Catheter Repair Kit: Palindrome™ Chronic Care and All Mahurkar™ Acute and Chronic Care Catheters *revised*
30.20.14 Use of the HEMOdialert™ device with hemodialysis *revised*
30.20.15 Obtaining Blood Specimens Pre and Post Hemodialysis
30.20.16 Collection of Blood Culture Specimen from a Hemodialysis Access
30.20.16a Blood Cultures for Hemodialysis *revised*
40.10.01 Attachment of Minicap Extended Life PD Transfer Set to Peritoneal Catheter
40.10.02 Changing Titanium Adapter in a Peritoneal Catheter *revised*
40.10.03 Installation of Medications into Peritoneal Dialysis Solution
40.10.03a Instillation of Medication into Peritoneal Dialysis Solution (IP Drugs Manual) *revised*
40.10.04 Application of Locking Cap to Peritoneal Catheter *revised*
40.10.05 Peritoneal Catheter Flush *revised*
40.10.06 Peritoneal Exit Site Care
40.10.06a Physician Management of Exit Site Infection Algorithm *revised*
40.10.06b Peritoneal Catheter Exit Site Care Resource *revised*
40.10.06c Peritoneal Dialysis Exit Site Images *revised*
40.10.07 Intraperitoneal tPA for Obstructed Peritoneal Dialysis Catheters *revised*
40.10.08 Peritoneal Dialysis Bag Exchange Utilizing Twin Bag System
40.10.08a Continuous Ambulatory Peritoneal Dialysis Record (W-00353)
40.10.09a Changing Program *new*
40.10.09b Making adjustments *new*
40.10.09c Nurses’ menu *new*
40.10.09d Automated Peritoneal Dialysis Record (W-00354)
40.10.10 Peritoneal Catheter Irrigation *revised*
40.10.11 Silver Nitrate Application
40.10.12 Measuring Peritoneal Dialysis Adequacy: KT/V Collection
40.10.12a Incremental PD Algorithm
40.10.13 Ascites drainage utilizing a Peritoneal Catheter *revised*
40.10.14a Site Specific Requisitions for Peritonitis Investigation
40.10.14b Decision Tree for obtaining Peritoneal Effluent Sample *revised*
40.10.14c Sending PD effluent sample poster
40.10.15 Peritoneal Equilibration Test (PET)
40.10.15a PET (Peritoneal Equilibration Test) Collection Sheet W-00714
40.30.01a Amia Cycler Graph sheet (W-00832 & W-00837) *under development*
40.30.02 Measuring Peritoneal Dialysis Adequacy: KT/V Collection using Amia® Night Cycler
40.30.02a Incremental PD Algorithm *revised*
50.10.01 Use of the Horizon Mini E Centrifuge *revised*
50.10.02 Ordering Dialysis Supplies: NxStage & Fresenius 5008S Home Hemodialysis Patients
50.10.02a Fresenius Order Form: HHD *under reivew*
50.10.02b Manitoba Renal Program Home Hemodialysis Script order form *under review*
50.10.03 Prevention and Treatment of Hypophosphatemia for Patients on Hemodialysis by utilizing phosphate additives *renumbered from 30.10.17*
50.20.02 Nxstage Installing PAK *revised*
50.20.03 NxStage Adjusting the Temp of the PAK *revised*
50.20.04 NxStage Changing SAK Type *revised*
50.20.05 NxStage Draining a SAK *revised*
50.20.06 NxStage Initiation and Discontinuation of Dialysis *revised*
50.20.07 NxStage Instillation of New Dialysate SAK *revised*
50.20.08 NxStage Setup of Cycler *revised*
50.20.09 NxStage Testing Chloramines *revised*
60.10.01 Renal Nursing Kardex Standard
60.10.01a Renal Patient Kardex (#W-00195A)
60.10.01b Hemodialysis Patient Kardex (#W-00195B)
60.10.01c Peritoneal Dialysis Kardex
60.10.02 Hemodialysis Renal Medication Flow Sheet Standard (eKHR)
60.10.02a eKHR reference guideline
60.10.02b Update eKHR medication (W-00581)
60.10.03 Hemodialysis Renal Medication Flow Sheet Standard (non eKHR)
60.10.03a Hemodialysis Renal Medication Flow Sheet (#NS01708)
60.10.04 Working Alone Standard for Manitoba Renal Program (MRP) Employees *renumbered and under review*
60.10.04a Manitoba Renal Program (MRP) Reporting form for missing employee *renumbered and under review*
60.10.04b Emergency Contact Information form *renumbered and under review*
60.10.05 MRP Signature *revised*
60.10.05a MRP Signature Sheet (NS 00714) (revised)
60.20.01 Hemodialysis Treatment Record Standard (For Fresenius 5008 Delivery System) *revised*
60.20.01a Hemodialysis Treatment Record for Fresenius 5008 (#1592) *revised*
60.20.02 Hemodialysis Flow Sheet Standard (for Fresenius 5008) *revised*
60.20.02a Hemodialysis Flow Sheet (SAP #295046 Form #W-1593) *revised*
60.20.04 Hemodialysis Treatment Record Standard HSC *renumbered/revised*
60.20.04a Hemodialysis Treatment Record (HSC ) (W-00497) *renumbered/revised*
60.20.06 Manitoba Renal Program & Long Term Care Communication Record Standard
60.20.06a Manitoba Renal Program & Long Term Care Communication Record (W-00273)
60.40.01 Fresenius 5008S flowsheet standard *under development*
60.40.01a Fresenius 5008S Treatment flowsheet (W-00866) *new*
60.40.02 Fresenius 5008s Treatment Record *under development*
60.40.02a Fresenius 5008S Treatment Record (W-00867) *new*
60.40.03 NxStage flowsheet *under development*
60.40.03a NxStage flowsheet (W-00868) *new*
60.40.04 NxStage Treatment Record *under development*
70.10.01 Human Leukocyte Antigen Antibody Testing Routine and Post Transfusion Protocol
70.10.02 Adult Patient Screening and Vaccination Protocol for Hepatitis B and Hepatitis C
70.10.02a Algorithm for Hepatitis B Vaccination and Monitoring in Susceptible Patients
70.10.02b Schedule for Routine Blood Testing for Hepatitis B and Hepatitis C Virus Infections
70.10.02c How to Switch a Patient from one product to the other
70.10.04a Permanent Transfer of Hemodialysis (HD) Patients to Another Winnipeg HD Site and Unit *revised*
70.10.04b Patient Transfer Letter
70.10.04d Permanent Transfer of Renal Patients to a Home Dialysis Unit *revised*
70.10.04e Appendix E : Permanent Transfer of Stage V Renal Health Patients to a Hemodialysis Unit *revised*
70.10.04f Staff Resources
- Staff Memo on Patient Transfer Communication
- Transfer Information Process
- Staff Script for Patient Transfer
- Dialysis Care Transfer poster
70.10.06a Checklist/Fax Cover Sheet for Temporary Patient Transfers due to Overcapacity
70.10.06b Algorithm: Temporary Hemodialysis Transfers due to Overcapacity
70.20.01 Management of Hemodialysis Patients with Infectious Diseases Protocol *revised*
70.20.02 Management of HBsAg Positive Hemodialysis Patients *revised*
70.20.03a MRSA Admission Screening Algorithm
70.20.03c Transient Patients Forms (Orders and Information) ENGLISH or FRENCH
70.20.04 Initial and Monthly Lab Tests Protocol for Chronic Hemodialysis Patients *revised*
70.20.04a Dialysis Panel HSC and LRHU *revised*
70.20.04b Dialysis Panel SOH *revised*
70.20.04c Dialysis Panel SBH *revised*
70.20.04d Dialysis Panel Brandon *revised*
70.20.04e MRP HIV Testing Letter *under review*
70.30.03a Peritonitis informational letter *new*
70.30.05 Peritoneal Dialysis Contamination Protocol *revised*
70.30.05b Part 1 Determining Peritonitis in Rural Patients (W-00681) *under review*
70.30.05c Part 2 Collection of Peritoneal Effluent in Rural Settings (W-00682) *under review*
70.30.05d Part 3 Guideline for Empiric Antibiotic Treatment Guidelines for Rural Outpatients with Peritonitis (W-00680) *under review*
70.30.05f Physician’s Order Sheet Peritoneal Dialysis OUTPATIENTS Exit Site/Tunnel Infections and Wet Contamination (W-00542)
70.30.05g Decision Tree for Managing Contamination *revised*
70.30.06 Initial and Monthly Lab Tests Protocol for patients receiving Chronic Peritoneal Dialysis *revised*
70.30.06a SOH PD bloodwork panel
80.10.02 Guidelines for Medication Reconciliation
80.10.02a Medication Change Form *under review*
80.10.02b Medication Card *under review*
80.10.03a Manitoba Renal Program Health Information Transfer Tool *under review*
80.20.01 Guidelines for Heparinization during Hemodialysis
80.20.02 Ordering & Returning Dialysis Supplies for Local Centre Dialysis Units
80.20.02a LRHC ordering and returning supplies, forms and labels *revised*
80.20.03 Discharge Criteria for Hemodialysis Patients from the Dialysis Unit following Treatment
80.20.04 Contacting a Patient who does not Attend a Hemodialysis Treatment *revised*
80.20.05 Guidelines for Managing Hospitalized Hemodialysis Patients (#W-00346)
80.20.05a Important reminder caring for HD in ER (poster)
80.20.06a Guidelines for the Treatment of Intradialytic Hypotension *revised*
80.20.06b Guidelines for the Treatment of Post Hemodialysis Hypotension *revised*
80.20.07a HSC Guidelines On-Call (80.280.002)
80.20.10 Guideline for Calcium chloride additives Home Hemodialysis and Post-parathyroidectomy Patients *renumbered*
80.20.12 Guideline for Sustained Low-Efficiency Dialysis *draft*
80.30.01 Guideline for care of the In-Centre Peritoneal Dialysis Patient *revised*
80.30.01a Checklist for managing a hospitalized Peritoneal Dialysis patient *revised*
80.30.02 Care of the patient on Continuous Ambulatory Peritoneal Dialysis guideline *renumbered/revised*
80.30.02a Fluid Management Guidelines *renumbered/revised*
80.30.02b Continuous Ambulatory Peritoneal Dialysis Record (W-00353) *renumbered/revised*
80.30.03 Care of the patient on Continuous Cycling Peritoneal Dialysis Guideline *renumbered/revised*
80.30.03a Fluid Management Guidelines *renumbered/revised*
80.30.03b Automated Peritoneal Dialysis Record (W-00354) *renumbered/revised*
80.30.04 Care of the patient on Home Peritoneal Dialysis Guideline *renumbered/revised*
Disclaimer: The information and data in this document (“Information”) is based on scientific evidence current as of the date issued and is subject to change without notice. The Information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Any person consulting or applying the Information is expected to use independent medical judgment and expertise in the context of individual clinical circumstances. Winnipeg Regional Health Authority and the Manitoba Renal Program make no representation or guarantees of any kind whatsoever regarding the content or use or application of the Information and specifically disclaim any responsibility for its application or use in any way.
