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Post by kendec65 on Jul 14, 2022 17:41:24 GMT
Can someone refresh my mind why the Braun machine does not need bleaching for hepatitis?
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Post by Chuck Weddle on Jul 14, 2022 18:05:01 GMT
Because citric/thermal is as good or better than bleach. Contact Braun, they have the data they can share.
Remember, just because Fresenius says to do something doesn't mean it is the only way, or even the best way to do it.
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Post by kendec65 on Jul 14, 2022 18:12:57 GMT
I agree, Chuck. I have the DOH standing here wanting full documentation why we don't bleach. SMH
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Post by Admin on Jul 14, 2022 18:24:07 GMT
As chuck said - because heat and citric is effective enough. Also - bleach will destroy the DF Filters.
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Post by kendec65 on Jul 14, 2022 18:26:10 GMT
Not disagreeing with either of you, but what do you think the DOH will say when I tell them, well Chuck and Admin told me..... LOL It's all good Braun hooked me up with documentation.
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Post by Admin on Jul 14, 2022 18:45:41 GMT
Tell DOH exactly that and if they don’t like the answer they can shove it.
Glad you’re all set up.
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Post by Chuck Weddle on Jul 14, 2022 18:54:56 GMT
As far as I know, there is no regulation that a disinfection is required after each patient even for hepatitis. However, if a machine is used for a hepatitis B patient, it has to be dedicated as strictly a hepatitis machine as long as that patient is on census. After that, it has to be "terminally disinfected" (whatever that means) before it can be used on a non-hepatitis B patient. This exactly the regulation for COVID+ also.
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Post by Chuck Weddle on Jul 14, 2022 19:08:18 GMT
Refer the inspector to V122 which states.....
Staff must appropriately clean and disinfect the internal circuits of the dialysis machines. Single-pass machines may be rinsed and disinfected at the beginning or end of each day, while batch recirculating machines must be drained, rinsed and disinfected after each use. If a blood leak occurs, the manufacturer’s recommendations for additional disinfection should be followed.
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Post by bcjammerx on Jul 15, 2022 0:11:54 GMT
Keep in mind to be in line with state and federal laws, if your company (like mine) has it written into their policies that a bleach disinfect must occur after a hep pos patient then you should do both; do the bleach to be in line with state, do the citric after to make sure the hep is taken care of. the machine WILL log if both were done and state WILL ask to see the disinfect log.
A company can always require a policy that is more strict but not less...so you have to do both.
Also after a bleach, if you have the filter on the back, you'll HAVE to replace it.
At my company we've given the paper work from BBRAUN proving the citric heat is superior to bleach in dealing with hep (and everything else too) but they still require we do a bleach...the admins refuse to listen to biomed on ANYTHING...it's come up a lot.
Always follow factory AND company policy...just fyi...if you don't, you will get fired if state notices...and they will.
Every state and company is different so just follow all the policies no matter what you think about them, if you want to keep your job that is
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Post by Chuck Weddle on Jul 15, 2022 16:30:05 GMT
If higher ups won't take the bleaching out of the policy then yes, you're stuck doing it. That said, when you do have to bleach the machine, do the citric/thermal first. If you bleach first and there is any dialysate left in the machine, it will precipitate.
The bleach will take care of the hepatitis just fine, it's just hard on the machine and an extra unnecessary step.
We don't use the filters so I don't know....The Fresenius filters are good for I think they say 13 bleachings....The Braun filters don't tolerate it at all?
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Post by kendec65 on Jul 15, 2022 16:44:28 GMT
Chuck,
This has nothing to do with Fresenius vs Braun or the higher ups not changing a policy, our policy is to
citric thermal the Braun. I was simply looking for documentation why the Braun does not need to be bleached for Hep positive patients. I asked here as well B Braun themselves to see who would answer first. I showed the DOH the documentation and all is good.
Thanks
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Post by Chuck Weddle on Jul 15, 2022 16:54:07 GMT
Chuck, This has nothing to do with Fresenius vs Braun or the higher ups not changing a policy, our policy is to citric thermal the Braun. I was simply looking for documentation why the Braun does not need to be bleached for Hep positive patients. I asked here as well B Braun themselves to see who would answer first. I showed the DOH the documentation and all is good. Thanks I was addressing bcjammerx's post but forgot to quote it. |
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Post by Admin on Jul 15, 2022 22:28:12 GMT
The BBraun DF filters do not tolerate it at all, no.
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Post by bimitiri on Jul 16, 2022 10:07:12 GMT
I based in Australia which we deal with both Fresenius and Nipro dialysis machines.
We used hot disinfection with citric acid as advised by both manufacturers and states' health departments that it is effective on Hepatitis B , Hepatitis C , HIV, as well as the SARS-CoV-2 viruses.
Please checked with Bbraun and your state health department.
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Post by SrCusEngr on Aug 8, 2022 3:20:53 GMT
For anyone who would like to know. The actual disinfection action of the B Braun Dialog machine is heat. We can add citric to the water to act as an activated cleaning agent for the internal plumbing. This will clean out any organics and descale the machine while at the same time disinfecting the machine. (Study done by Baxter Health International and Nepier Hospital, France to determine the best disinfection and cleaning solution.) As for killing viruses, most are destroyed at a sustained temperature of about 50 deg.C. The parvovirus, however, is the most difficult to destroy. B Braun had an independent lab in Germany test the Dialog machine on its ability to kill even the parvovirus with its Citric Thermal disinfection. The testing results prove that our machine provides a disinfection that is above and beyond what is needed.
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