|
|
Post by H2Otech2 on Apr 12, 2022 15:47:56 GMT
How do you schedule your disinfections for Acute machines? I have been reading the new Acute Dialysis Survey Readiness Handbook by AAMI and I found a blurb that states Machines need disinfected daily if in constant use and before patient treatment if idle for more than 4 hours. We are currently disinfecting daily but I have never heard of this 4 hour if idle business. I have referred to AAMI standards but I'm not finding it anywhere.
ANSI/AAMI/ISO 23500-1:2019 Annex G
|
|
|
|
Post by Chuck Weddle on Apr 12, 2022 15:53:44 GMT
It sounds like it is referring to dialysis machines not RO's. That said, I've never heard of the 4 hour thing either. What AAMI standard is that from?
|
|
|
|
Post by H2Otech2 on Apr 12, 2022 17:42:31 GMT
It sounds like it is referring to dialysis machines not RO's. That said, I've never heard of the 4 hour thing either. What AAMI standard is that from? I found it in the Acute Dialysis Survey Readiness Handbook by AAMI. It refers to ANSI/AAMI/ISO 23500-1:2019 Annex G. The hand book says I too, have never heard this. |
|
|
|
Post by h2otech on Apr 13, 2022 10:11:08 GMT
I have been thinking about this all last evening. I see the rationale but in the grand scheme of things, it isn't realistic. I came into work this morning and read it again. The word "should" stuck out.
|
|
|
|
Post by Chuck Weddle on Apr 13, 2022 11:51:42 GMT
That word is a problem. Surveyors read it as "WILL" saying that since it is recommended, it is considered "best practice" I've had discussions about the word "should" with members of the AAMI committee regarding things in RD52. Their position is: They (AAMI) make recommendations. The regulations are made by CMS off of their interpretations.
|
|
|
|
Post by h2otech on Apr 13, 2022 14:12:49 GMT
It is very problematic. It creates grey area surrounding the standards. I have had surveyors go both ways when challenging their interpretation on this. You can find documents from CMS with - "Shall" denotes a mandatory requirement, and "should" denotes an optional requirement. The words Optional and Requirement together seem completely contradictory.
|
|
|
|
Post by dave74 on Apr 15, 2022 19:10:50 GMT
The trouble is that there can be unexpected delays in acute treatments. Suppose a nurse is supposed to dialyze a patient in the morning and a second patient in the afternoon. The second treatment gets delayed when the patient has to undergo a procedure. AAMI needed to come up with a recommendation as to how long the machine could sit idle. I think we would all agree that 24 hours would be too long. It sticks in my mind that we use 4 hours for a lot of things. A machine is set up, but the patient is unable to be dialyzed. How long can the setup sit before you have to tear it down? 2 hours? 4 hours? The 4 hours is not based on science, but they had to come up with something.
|
|
cane
New Member
Posts: 17
|
Post by cane on Apr 21, 2022 14:55:31 GMT
There is a big difference between best practice and what is enforceable according to CMS. How a surveyor interprets that can vary but here is what I would go with for my rationale. IMO, this falls under V-Tag 403 "Staff must operate and maintain the equipment in accordance with manufacturer’s instructions."
According to current operator's manual for the 2008T pg. 180 reads "If the machine is not in use for more than 48 hours, it should be disinfected before the next use...".
Unless your organization sets a tighter window, which would include your own policy, I would go with these two items to justify my practice.
|
|
|
|
Post by dave74 on Apr 21, 2022 15:08:14 GMT
I think Cane and I may be talking about two different situations. In this case, AAMI is referring to a machine that has been in use for at least one treatment and has not been disinfected. How long can the machine sit idle before you either use it or disinfect it?
|
|
cane
New Member
Posts: 17
|
Post by cane on Apr 25, 2022 13:29:18 GMT
Now I understand your situation a little better, and that's a good question. I can't think of any regulation or IFU that would cover this scenario. Definitely a good question to consider.
|
|
stuff
Full Member
Posts: 136
|
Post by stuff on Apr 27, 2022 8:47:26 GMT
just a stupid 2cent thought. The scenario above about a patient in the morning and a delayed treatment in the afternoon. What is stopping them from just keeping the machine running in just acid so there is continuous flow through the machine, or hell a rinse with the hanson door up. (assuming fresenius machine).
Use the AAMI words against them; ie: "Provided that there is a continuous flow of dialysis fluid through the machine". Then comes the argument what constitutes dialysis fluid? Because RO water IS technically a dialysis fluid
|
|
|
|
Post by dave74 on Apr 27, 2022 12:57:53 GMT
If treatments are performed at the bedside, there may be no place to rinse the machine.
|
|
