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Advisory Notice

Dear users,

  Safety First, Prevention First. Nationwide, there have been media reports that certain hospitals to carry out cross-infection incident in haemodialysis process. The occurrence of the event is great harm of the patient's and the hospital's reputation, the relevant person in charge has also been a certain amount of administrative penalties.The state Ministry of Health also strengthen efforts to control , we have to attract enough attention , according to the actual situation of the haemodialysis process, summed haemodialysis cross routes of infection and its preventive measures to strengthen the control of various aspects of each user, to prevent cross-infection occurred imperfections, also hope that the user give valuable advice.

  It is responsible for the dialysis department, hospital, leadership, patient ... also it is responsible for own!

  Haemodialysis cross infection routes and preventive measures

  I . Cross infection route:

  1) Infection in haemodialysis process:

  a. The infected patient’s blood contaminate arterial & venous pressure measurement connector → next dialysis → infection normal patients;

  b. The infected patient’s blood → operator has touched the contamination control panel or blood leak of membrane broken in dialysis →contamination the connector or dialysate tube → next time dialysis → infection normal patients;

  c. The infected patients with normal patient mix using haemodialysis machine together and haemodialysis machine can not be effective sterilization, then contamination the dialysate line to infection the normal patient;

  2) Infection in reprocessing:

  a. The residual blood in the dialyzer arterial & venous connector of the infection patient → pass the machine’s reprocessing connector → contaminate the normal patient’s dialyzer arterial & venous connector → infection normal patient;

  b. The dialyzer & reprocessing tube of infection patient, is mixing with normal patient’s → infection normal patient;

  c. Disinfectant concentration is not enough or failure can not be effectively sterilized → infection normal patient; ;

  d. Disinfectant failure or after perfusion the improper dialyzer storage environment caused disinfectant failure, can not be effectively sterilized (such as :High temperature caused peracetic acid failure);

  3) Other infection routes:

  a. Daily diet or exposure to infection;

  b. The abnormal acupuncture (such as: puncture, blood drawn, blood transfusion, infusion, etc.);

  II. Preventive measures

  1) Precautions in haemodialysis treatment

  a. Use the disposable blood line, do not reuse or share the hydrophobic filter of arterial & venous measurement joint.In one-time use, the hydrophobic filter can effectively prevent the occurrence of cross-infection in haemodialysis,but some hospitals re-use blood line, and did not note the importance of hydrophobic filters function to prevent cross-infection, sometimes in haemodialysis, there are not connected the hydrophobic filter or shared hydrophobic filter, resulting the occurrence of cross-infection, this phenomenon is also frequent in cross-infection, hospitals should be strengthened in this regard to prevent . And every day, clean and sanitize arterial & venous pressure measurement connector.

  b. Operator should take the disposable gloves when puncture or change dialyzer of blood leak. After, should promptly discard the gloves, and sanitize the machine which we touched, with alcohol or peracetic acid or sodium hypochlorite.

  c. Occurred blood leak when dialysis is finished, after should be promptly execute machine disinfection program, and dialysate return pipe’s connector also need be disinfected.

  d. After every work,we should use gauze soaked in alcohol or peracetic acid or sodium hypochlorite to wipe operating panel, surface.

  e. The infected patients used haemodialysis machine will distinguish isolated, separate with normal patient’s.

  f. Regularly extract liquid in haemodialysis machines pipeline to infection check.

  2) Reprocessing process precautions

  a.The infected patients used device will distinguish isolated, separate with normal patient’s.

  b.The weakest disinfection process is the blood screw joint of arterial and venous, this joint is the dead angle, is not easy to be thoroughly washed and disinfected, which pollute next dialyzer by the residual blood of the dialyzer blood screw joint, this is the most vulnerable aspect of cross-infection, precautions is the proper use of anti-cross-infection connector.

  Many hospitals have habits after the dialyzer finished dialysis treatment, before reprocessing in reprocessor, directly use the water rinse the dialyzer, but do not connect the anti-cross infection joint in dialyzer ‘s two ends, instead of using the rinse joint directly connect in the two ends of arterial and venous for rinsing,this approach is also the most easily pollute the next dialyzer by the residue bloodstains in the rinse joint, the correct approach is: after the dialyzer finished in dialysis treatment, directly connect the anti-cross infection joint which is disinfected or news in the two blood ends of arterial and venous,then go on rinse and affuse, after these steps, replace the used anti-cross infection joint with news,and check the two ends of dialyzer are closed well, and affuse enough disinfectant, no leaks.

  Anti cross-infection joint, dialyzer plug can throw at 3.5% Renalin or 0.5% peracetic acid for disinfectant soaking (soaking time, 20 ℃: Renalin shall not be less than 11hours, peracetic acid shall not be less than 6 hours) to be disinfected or sterilized with ethylene oxide sterilization.

  Soaking in disinfectant methods, we should pay attention to the disinfectant inefficacy by expire.The way is: before soaking the anti-cross infection join and blood chamber plug into the disinfectant, need use the test paper to test the disinfectant concentration, if the concentration meet the standard,then can use in soaking disinfection(this way can prevent the disinfectant inefficacy to lead the infection),reverse need re-disinfect.

  c. If there are residual blood or dirt external the dialyzer, need use the low concentration of disinfectant (0.5% peracetic acid) compatible with dialyzer external materials for soaking or cleaning.

  d.The affused dialyzer should be stored in the specified area, should be placed separately with the pending dialyzer to prevent confusion cause pollution or even misuse. And also separate from the dialyzer of infected patients and the dialyzer with normal patients to store in a suitable temperature environment.

  e. Before using the affused dialyzer for dialysis treatment, need test the disinfectant concentration, if concentration meet the standard then can use for dialysis.

  f. Hospital need regularly take the liquid sample of the normal patients and reprocessor pipeline for check infection.

  g Strictly in accordance with the user manual for operation the reprocessor.

  h. Strictly in accordance with the issued operating specifications from the Ministry of Health.

  i. Purchase reprocessor is not meet the inspection work, but take the responsibility for the patients.

  3) Other routes of infection precautions:

  Educate patients to pay attention to food hygiene, wash their hands before meals, bring health habits, do not go to illegal medical facility for treatment, law-abiding.

  III. Before use the reprocessor, pls note the before infection patients ! !

  China Chengdu Wesley Biotech Co.,Ltd

  Technical Services Department