Policy and Procedure N0. 40 – Royal Hospital

PURPOSE

1.         To prevent infection

POLICY

1.         The procedure should be performed in the hospital by a physician or a C.A.P.D. trained Nurse

2.         A strict aseptic technique should be maintained

3.         The set should be changed every six (6) months or whenever it becomes contaminated

4.         Hand washing should be performed in accordance with the policy and procedure on hand washing

EQUIPMENT

1.         Trolley whased with soap and water with 70% spirit

2.         Frekasept

3.         Frekaderm

4.         Spirit

5.         Non-sterile clean gauze pieces

6.         New drainage bag

7.         New transfer set

8.         Sterile sheet / klinidrape

9.         Clean sheet / tray

10.       Surgical mask

11.       Small dustbin

PROCEDURE

1.         Explain the procedure to the patient to gain cooperation.

2.         Bring the prepared trolley beside the patient.

3.         Screen the patient to provide privacy.

4.         Wear surgical mask.

5.         Wash and dry hands.

6.         Clean top shelf of trolley with gauze soaked in spirit

7.         Open the transfer set pack gently using aseptic technique and place the opened pack with the tubing inside on a corner of top shelf (Place clear side of pack downwards).

8.         Open the new drainage bag pack and place the bag besides the transfer set pack, with the connecting site hanging freely not touching the edge of the trolley.

9.         Open sterile sheet pack and leave the sheet lying within the pack on the top shelf of the trolley.

10.       Place Frekasept and Frakaderm on the top shelf at one corner.

11.       Place clean tray below the level of the patient.

12.       Place the dustbin beside the patient.

13.       Disinfect hands properly with Frekasept (Turn aside, away from the trolley).

14.       Remove the cap of the new drainage bag and spray all around the exposed connecting site with Frekaderm (Avoid the lumen).

15.       Disinfect hands again properly with Frekasept.

16.       Taken one end of transfer set, remove cap and quickly connect it to the drainage bag and clamp the transfer set.

17.       Disinfect hands with Frekasept.

18.       Place sterile sheet underneath the Tenchkoff catheter and let the connecting site lie on the sheet.

19.       Spray all around the connecting site of the Tenchkoff catheter and old transfer set with Frekasept.

20.       Disinfect hands with Frekasept.

21.       Disconnect the old transfer set from the Tenchkoff catheter and discard it into the dustbin.

22.       Hold the Tenchkoff catheter end in between the 3^rd and 4^th finger of left hand and spray all around the exposed connecting site, avoiding the lumen.

23.       Pick up the other end of the new transfer set and hold it with the left thumb and forefingers.

24.       Remove the cap of the new transfer set and quickly connect it to the Tenchkoff catheter.

25.       Place the connected site on a dry area of the sterile sheet.

26.       Place the drainage bag on the clean tray below the level of the patient.

27.       Release clamps of the Tenchkoff catheter and transfer set. Allow about 100 mls of fluid to drain into the bag (Count 1-10). This is to flush out any bacteria present in the tube.

28.       Clamp both tubes.

29.       If due for exchange of fluid, patient can continue with his / her exchange otherwise, fold the bag with tubing coiled around the bag and secure it to patient’s abdomen.

30.       Document the procedure in the patient’s file.