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Policies & Procedures

30.10.01 Use of Fresenius 5008 Delivery System using 0.9% NaCl

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 

30.10.04 Converting to NaCl bolus or NaCl reinfusion using the Fresenius 5008 ONLINEplus™ System 

30.10.05 Providing a Fluid 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

30.10.09 Changing the Extracorporeal circuit during hemodialysis treatment for the Fresenius 5008 delivery system

30.10.10 Fresenius 5008 Recirculation of Extracorporeal Circuit with Normal Saline and with Blood (0.9% NaCl set up)

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

30.10.14a Appendix A: How to Order Blood

30.10.14b Appendix B: Notification Card Sample

30.10.15 Calcium Chloride Additive for Hemodialysis Patients

30.10.15a Appendix A: Guideline for Home Hemodialysis and Post Parathyroidectomy Patients

30.10.16 Administration of Intradialytic Parenteral Nutrition to the Hemodialysis Patient

30.10.16a Appendix A IPN 

30.10.17 Prevention and Treatment of Hypophosphatemia for Patients on Hemodialysis by utilizing phosphate additives

30.10.18 Cleaning and Disinfection of the Fresenius 5008 Hemodialysis System: Internal fluid pathways and External surfaces 

30.10.19 Changing Dialysate Concentrate During Hemodialysis Treatment 

30.10.20 Administering a Heparin Bolus during Hemodialysis Treatment using the Fresenius 5008 Heparin Pump 

30.10.21 Manually Opening Arterial Pressure Measurement Unit on the Fresenius 5008 

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

30.20.02 Accessing and Locking Dialysis Central Venous Catheter (Anticoagulant/ Thrombolytic/Antibiotic Locking)

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 Appendix A 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

30.20.09 Alteplase IV Infusion for Clearing Hemodialysis Catheter Thrombosis

30.20.10 Alteplase for Hemodialysis Central Venous Catheter (Dwell procedure)

30.20.11 Local Centres:  Antibiotic Lock Preparation Procedures for Hemodialysis Central Venous Catheters

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 Summary Poster Gold Standard Blood Cultures

30.20.17 Obtaining Blood Sample for International Normalized Ratio (INR) from Central Venous Catheters

30.20.18 Accessing and Locking of Hemodialysis CVC by Non-Hemodialysis Personnel for Urgent Situations

30.20.18a Appendix A CVC Tunneled

30.20.18b Appendix B CVC Non-Tunneled

40.10.01 Attachment of Minicap Extended Life PD Transfer Set to Peritoneal Catheter *revised*

40.10.02 Changing Titanium Adapter in a Peritoneal Catheter

40.10.03 Installation of Medications into Peritoneal Dialysis Solution

40.10.03a Appendix A: Instillation of Medication into Peritoneal Dialysis Solution (IP Drugs Manual)

40.10.03b Appendix B: IP KCl

40.10.04 Application of Locking Cap to Peritoneal Catheter

40.10.05 Peritoneal Catheter Flush

40.10.06 Peritoneal Exit Site Care

40.10.06a Appendix A: Physician Management of Exit Site Infection 

40.10.06b Appendix B: Peritoneal Catheter Exit Site Care

40.10.06c Appendix C: Peritoneal Dialysis Exit Site

40.10.07 Intraperitoneal tPA for Obstructed Peritoneal Dialysis Catheters

40.10.08 Peritoneal Dialysis Bag Exchange Utilizing Twin Bag System

40.10.08a Appendix A:  W00353 CAPD Flow Sheet

40.10.09 Home Choice Pro Cycler Set-Up: Initiation of Cycling and End of Treatment utilizing a luer lock cycler set (software version 10.4)

40.10.09a Appendix A: v W00354 Automated Peritoneal Dialysis Record

40.10.10 Peritoneal Catheter Irrigation

40.10.11 Silver Nitrate Application

40.10.12 Measuring Peritoneal Dialysis Adequacy:  KT/V Collection

40.10.12a Appendix A: Incremental PD Protocol

40.10.13 Ascites drainage utilizing a Peritoneal Catheter

40.10.14 Collection of Peritoneal Dialysis Effluent from a Peritoneal Dialysis Drain/Sample for Peritonitis Investigation

40.10.14a Appendix A: Site Specific Requisitions

40.10.14b Appendix B: Decision Tree for obtaining Peritoneal Effluent Sample

40.10.15 Peritoneal Equilibration Test (PET)

40.10.15a Appendix A:  PET (Peritoneal Equilibration Test) Collection Sheet W-00714

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 Appendix A:  Algorithm for Hepatitis B Vaccination and Monitoring in Susceptible Patients

70.10.02b Appendix B:  Schedule for Routine Blood Testing for Hepatitis B and Hepatitis C Virus Infections

70.10.02c Appendix C:  How to Switch a Patient from one product to the other

70.10.04 Protocol for the PERMANENT TRANSFER of Renal Patients between URBAN sites, units, and programs within the Manitoba Renal Program (MRP). *revised*

70.10.04 Appendix A: Permanent Transfer of Hemodialysis (HD) Patients to Another Winnipeg HD Site and Unit *revised*

70.10.04b Appendix B:  Patient Transfer Letter *revised*

70.10.04c Appendix C: Form #W-00226 Manitoba Renal Program Transfer of Patients Between Dialysis Units and or Sites within the Manitoba Renal Program Checklist *revised*

70.10.04d Appendix D: Permanent Transfer of Renal Patients to a Home Dialysis Unit *new*

70.10.04e Appendix E : Permanent Transfer of Stage V Renal Health Patients to a Hemodialysis Unit *new*

70.10.04f Appendix F: Staff Resources

70.10.06 Protocol for Temporary Transfer of Patients between Urban Hemodialysis Units within the Manitoba Renal Program

70.10.06a Appendix A: Checklist/Fax Cover Sheet for Temporary Patient Transfers due to Overcapacity

70.10.06b Appendix B: Algorithm: Temporary Hemodialysis Transfers due to Overcapacity

70.10.06c Appendix C: Overcapacity Directive

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.

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