Policy and procedure No. 149 Royal Hospital
PURPOSE
1. To aid in the removal of toxic substances and metabolic wastes.
2. To assist in regulating body fluid and electrolyte balance.
3. To control blood pressure.
4. To remove excessive body fluid.
POLICY
1. All nursing staff working in the renal Unit should be trained in connecting a patient to peritoneal dialysis machine.
2. Tow (2) nurses of whom one should be an experienced dialysis nurse should carry out this procedure.
3. A strict aseptic technique should be maintained through out the procedure in accordance with the policy and procedure of aseptic technique.
4. Hand washing should be performed according to policy and procedure of hand washing.
EQUIPMENT
1. Trolley washed with soap and water and wiped with spirit 70%.
2. On & Off Pack.
3. Betadine should [antiseptic].
4. Surgical Mask.
5. Sterile gloves.
6. Disposable apron.
7. Sterile gauze.
8. Specimen Container.
9. Specimen bags.
10. Sterile Drape.
11. Peritoneal dialysis flow chart.
12. BP set & stethoscope.
13. Mepore dressing 9×15 cm
14. Frekaderm hand rub
15. Frekasept spray
16. Lab. investigation.
17. Culture swab stick
18. Thermometer.
PROCEDURE
| SN | Nursing Action | Rationale |
| 01 | Check the physicians order and previous dialysis records if any. | To perform the correct treatment |
| 02 | Explain the procedure the patient and provide privacy. | To release tears and to provide protection |
| 03 | Place the patient in a comfortable position. | To obtain co-operation |
| 04 | Take and record vital signs and weight. | If any variation inform to the physician. |
| 05 | Both nurses wear Disposable apron and surgical Mask. | To prevent cross- infection |
| 06 | Wash and dry hands wear gloves. (According to policy and procedure on infection control). | |
| 07 | Prepare trolley and set On & Off pack on the sterile field. Over the sterile drape as well as necessary things. | |
| 08 | One nurse will remove the PD catheter dressing. (Do not use SCISSORS). | To avoid damage to the catheter. |
| 09 | Inspect the PD catheter site or any unwanted leakage or infection and take swab if appropriate. | |
| 10 | First Nurse will clean the peritoneal dialysis catheter site, and surrounding area with Betadine solution then apply sterile dressing. | |
| 11 | Wrap the catheter with a piece of gauze soak the tip of the catheter and remove the Betadine gauze and dry the catheter will plain sterile gauze. | To detect early signs of infection. |
| 12 | Second Nurse will spray Frekasept over the PD line connector and give the line to the First Nurse. First Nurse connects the line to the catheter adaptor. | |
| 13 | Open the clamp on the patient line and on the catheter extension press the key Treatment is one. | To prevent infection. |
| SN | Nursing Action | Rationale |
| 14 | Secure the lines and the catheter will plaster. | To prevent accidental disconnection. |
| 15 | Leave the patient in a comfortable position. | |
| 16 | Check vital signs at this point and maintain hourly or more frequent checks depending in patients condition. | Any variation inform to the nurse in change and physician. |
| 17 | Maintain PD Night flow chart. | |
| 18 | Document the procedure in the nursing notes. |