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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 *revised*
30.10.03 Initiation and termination of Treatment using the Fresenius 5008 ONLINEplus™ System
30.10.05 Providing a bolus using the Fresenius 5008 ONLINEplus ™ System
30.10.06 Fresenius 5008 ISO Ultrafiltration (Sequential Therapy)
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
30.10.12 Single Needle (Click-Clack) Hemodialysis for Fresenius 5008 Dialysis Delivery System
30.10.13 Providing Hemodialysis without Heparinization
30.10.14 Intradialytic Blood Product Administration
30.10.14b Appendix B: Notification Card Sample
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
30.10.19 Changing Dialysate Concentrate During Hemodialysis Treatment
30.10.20 Providing Heparin Bolus During Hemodialysis Treatment
30.10.21 Manually Opening Arterial Pressure Measurement Unit
30.10.22 Emergency Reinfusion Procedure using the Fresenius 5008
30.10.23 Manual Reinfusion Procedure in the Event of Power Failure and Empty Battery/System Failure
30.20.01 Venipuncture of Arteriovenous Fistula/Graft
30.20.02a Anticoagulant/ Thrombolytic/Antibiotic Lock Solutions for Hemodialysis
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
30.20.05a Statlock Application Procedure
30.20.06 AVF/AVG Vascular Access Assessment
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 *revised*
30.20.10 Alteplase for Hemodialysis Central Venous Catheter (Dwell procedure)
30.20.11a Anticoagulant/ Thrombolytic/Antibiotic Lock Solutions for Hemodialysis
30.20.12 Use of BARD Dialysis Catheter Repair Kit
30.20.13 Use of Covidien™ Acute and Chronic Catheter Repair Kit: Palindrome™ Chronic Care and All Mahurkar™ Acute and Chronic Care Catheters
30.20.14 Use of the HEMOdialert™ device with hemodialysis
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
40.10.01 Attachment of Minicap Extended Life PD Transfer Set to Peritoneal Catheter
40.10.02 Changing Titanium Adapter in a Peritoneal Catheter
40.10.03 Installation of Medications into Peritoneal Dialysis Solution
40.10.03a Instillation of Medication into Peritoneal Dialysis Solution (IP Drugs Manual)
40.10.04 Application of Locking Cap to Peritoneal Catheter
40.10.05 Peritoneal Catheter Flush
40.10.06 Peritoneal Exit Site Care *revised*
40.10.06a Physician Management of Exit Site Infection Algorithm
40.10.06b Peritoneal Catheter Exit Site Care Resource
40.10.06c Peritoneal Dialysis Exit Site Images
40.10.07 Intraperitoneal tPA for Obstructed Peritoneal Dialysis Catheters
40.10.08 Peritoneal Dialysis Bag Exchange Utilizing Twin Bag System
40.10.08a Continuous Ambulatory Peritoneal Dialysis Record (W-00353)
40.10.09d Automated Peritoneal Dialysis Record (W-00354)
40.10.10 Peritoneal Catheter Irrigation
40.10.11 Silver Nitrate Application *revised*
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
40.10.14a Site Specific Requisitions for Peritonitis Investigation
40.10.14b Decision Tree for obtaining Peritoneal Effluent Sample
40.10.14c Sending PD effluent sample poster *revised*
40.10.15 Peritoneal Equilibration Test (PET) *revised*
40.10.15a PET (Peritoneal Equilibration Test) Collection Sheet W-00714 *revised*
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
50.10.02 Ordering Dialysis Supplies: NxStage & Fresenius 5008S Home Hemodialysis Patients
50.10.02a Health Science Centre Winnipeg NxStage Order Form
50.10.02a Seven Oaks Hospital NxStage Order Form *New*
50.10.02a Health Science Centre Winnipeg 5008S Order Form *New*
50.10.02a Seven Oaks Hospital 5008S Order Form *New*
50.10.02b Manitoba Renal Program Home Hemodialysis Script order form *revised*
50.20.02 Nxstage Installing PAK
50.20.03 NxStage Adjusting the Temp of the PAK
50.20.04 NxStage Changing SAK Type
50.20.05 NxStage Draining a SAK
50.20.06 NxStage Initiation and Discontinuation of Dialysis
50.20.07 NxStage Instillation of New Dialysate SAK
50.20.08 NxStage Setup of Cycler
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*
60.20.01 Hemodialysis Treatment Record Standard (For Fresenius 5008 Delivery System)
60.20.01a Hemodialysis Treatment Record for Fresenius 5008 (#1592)
60.20.02 Hemodialysis Flow Sheet Standard (for Fresenius 5008)
60.20.02a Hemodialysis Flow Sheet (SAP #295046 Form #W-1593)
60.20.04 Hemodialysis Treatment Record Standard HSC
60.20.04a Hemodialysis Treatment Record (HSC ) (W-00497)
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)
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
70.10.04b Patient Transfer Letter
70.10.04d Permanent Transfer of Renal Patients to a Home Dialysis Unit
70.10.04e Appendix E : Permanent Transfer of Stage V Renal Health Patients to a Hemodialysis Unit
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
70.20.02 Management of HBsAg Positive Hemodialysis Patients
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
70.20.04a Dialysis Panel HSC and LRHU
70.20.04d Dialysis Panel Brandon
70.20.04e MRP HIV Testing Letter *revised*
70.30.03 Peritonitis Protocol *revised*
70.30.03a Peritonitis informational letter
70.30.05 Peritoneal Dialysis Contamination Protocol
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*
70.30.05g Decision Tree for Managing Contamination
70.30.06 Initial and Monthly Lab Tests Protocol for patients receiving Chronic Peritoneal Dialysis
70.30.06a SOH PD bloodwork panel *revised*
70.30.06b SBH PD bloodwork panel *revised*
70.30.06c BRH PD bloodwork Panel *under review*
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
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
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
80.20.06b Guidelines for the Treatment of Post Hemodialysis Hypotension
80.20.07a HSC Guidelines On-Call (80.280.002)
80.20.09 Hemodialysis Performed in Urgent Care at Seven Oaks Hospital *revised*
80.20.12 Guideline for Sustained Low-Efficiency Dialysis *new*
80.30.01 Guideline for care of the In-Centre Peritoneal Dialysis Patient
80.30.01a Checklist for managing a hospitalized Peritoneal Dialysis patient
80.30.02 Care of the patient on Continuous Ambulatory Peritoneal Dialysis guideline
80.30.02a Fluid Management Guidelines
80.30.02b Continuous Ambulatory Peritoneal Dialysis Record (W-00353)
80.30.03 Care of the patient on Continuous Cycling Peritoneal Dialysis Guideline
80.30.03a Fluid Management Guidelines
80.30.03b Automated Peritoneal Dialysis Record (W-00354)
80.30.04 Care of the patient on Home Peritoneal Dialysis Guideline
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.
