Keeping Water Safe in Changing Times: What Nurses Need to Know

Area of Science:

• Nephrology
• Biomedical Engineering
• Public Health

Background:

• Hemodiafiltration (HDF) is increasingly adopted in the US.
• Dialysis water and dialysate safety are paramount for patient well-being.
• Limited dedicated technical staff necessitates broader team involvement in system operation.

Purpose of the Study:

• To underscore the critical importance of safe water and dialysate in hemodialysis (HD) and hemodiafiltration (HDF).
• To review essential components and processes for ensuring safe dialysis fluid preparation.
• To emphasize the collaborative role of the care team in maintaining patient safety.

Main Methods:

• Review of water treatment system components.
• Analysis of dialysate concentrate preparation protocols.
• Examination of integrated HD/HDF system considerations.
• Discussion of essential monitoring and testing procedures.

Main Results:

• Direct infusion of dialysate in HDF heightens the need for stringent water purification.
• Current staffing models often place water system operation on direct care staff.
• Comprehensive understanding and rigorous testing are vital for preventing patient harm.

Conclusions:

• Safe water and dialysate are non-negotiable for HD and HDF patient safety.
• A multidisciplinary approach to operating and monitoring dialysis fluid systems is essential.
• Continuous vigilance and adherence to best practices safeguard patients undergoing dialysis treatments.