PERITONEAL DIALYSIS TRANSFER SET CHANGE

PERITONEAL DIALYSIS

Purpose

Safe, sterile transfer set change.

POLICY

 

Peritoneal dialysis transfer sets are changed per manufacturer’s guidelines, or in the event of contamination or damage to the transfer set. In the hospital, the transfer set may be changed in order to make the patient’s tubing compatible with the ____hospital system.

Protocol:

A. PD tubing change is sterile procedure.

B. PD procedure should be done in an area that is free from drafts and interruptions. Preferably, the supplies are brought into the patient’s rooms, and the procedure is done at the bedside behind the pulled curtain with both patient and nurse wearing mask.

C. To switch a patient from Baxter to Fresenius, a 4 inch convertible extension set will be needed to replace the Baxter tubing. NOTE: if the patient is using Baxter at home, transfer set will need to be changed back prior to discharge.

D. To switch a patient from Fresenius to Baxter, a universal connector may be placed directly on the transfer set without removing the patient’s transfer set.

 

PROCEDURE

A. Gather supplies. Place occluding clamp on catheter and place underpad beneath the patient and catheter.

B. Mask self and patient/family.

C. Perform 3-minute hand scrub.

D. Open sterile basins, maintaining sterility.

E. Open packages of 4x4s in sterile fashion and drop into one of the sterile basins, maintaining sterility.

F. Open new connector package and drop into second sterile container.

G. Pour povidone-iodine on the 4x4s and new transfer set, allow new transfer set to soak for 5 –minutes.

H. Don sterile gloves.

I. Wrap half of the pividone-iodine-soaked 4x4s around tubing/catheter connection and soak for 5 minutes.

J. Remove used 4 x 4’s from the tubing.

K. Use remaining half of the 4 x 4’s to scrub the tubingfor 5- minutes.

L. Remove gloves.

M. Don sterile gloves.

N. Close roller clamp on new transfer set and remove line-occluding clamp.

O. Wipe connection to remove excess povidone-iodine.

P. Dispose of dirty supplies according to standard precautions.

Nursing Implications:

A. Luer connection between transfer set and Tenckhoff catheter must be secure to prevent accidental disconnection

And contamination.

B. If holes are noted in the Tenckhoff Catheter, place a clamp above and below the hole(s) and notify the renal fellow

C. or pediatric nephrology attending physician.

 

Patient/Family Education:

A. Reinforce inspection of catheter with each procedure the patient performs at home.

B. Reinforce procedure to be followed in case of contamination, disconnect, and holes in tubing.

 

Documentation:

Document as a procedure on patient care flowsheet applicable to practice area. Document patient education in Notes or Teaching Record, as applicable to area.

 

EQUIPMENT

  • 2 packages sterile 4x4s
  • Line Occluding Clamp
  • New transfer Set
  • 2 Sterile Basins
  • Mask
    2 pairs sterile gloves
    Povidone-iodine solution (new, unopened bottle)
    1 underpad

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