The only criterion for kidney to evaluate the quality of dialysis machine is the safety and effectiveness of diagnosis and treatment, which not only depends on the quality of the equipment itself, but also is closely related to consumables, equipment, medical environment and medical skills of medical staff.
Dialysis water is directly related to dialysis quality.
The quality control of dialysis equipment is the main link of hemodialysis, an important means to prevent patients from acute and chronic dialysis complications, and also a standard for patients to measure dialysis comfort and dialysis adequacy. The quality control of dialysis water, dialysate and dialyzer is the focus of the whole work.
The adequacy and comfort of dialysis are closely related to dialysis water. Each patient needs 120- 150 liters of anti-seepage water once for dialysis, and will receive 15000-26000 liters of dialysis water a year. Most dialysis water uses tap water, but tap water is not pure water, and contains impurities such as calcium, magnesium, iron, chlorine, silicon dioxide and organic matter. Different water sources vary greatly. Directly using untreated tap water will change the composition of dialysate. If the chemical pollutants or heavy metal ions in dialysis water exceed the standard, it will cause acute and chronic dialysis complications such as nausea, vomiting, hemolysis and anemia. Some trace elements have no obvious effect in a short time, and long-term dialysis may cause organ dysfunction, so there should be certain standards and requirements for dialysis water.
The control of water treatment technology and equipment mainly goes through three stages:
In the first stage, Aishen realized that too much calcium and magnesium ions would lead to "hard water syndrome" in patients. On the basis of the original simple coarse filtration, the equipment at this stage emphasizes the removal of calcium and magnesium ions by softening process. The overall process of the corresponding water treatment equipment is relatively simple, mainly including various precision filtration devices, resin softening tanks or anion and cation removal beds;
In the second stage, with the aggravation of water pollution in various places and the addition of various disinfectants, especially chlorine, chloramine and other substances that may have adverse effects on patients, the water quality requirements began to develop into pure water. While ensuring softening, the function of activated carbon to absorb organic toxins is emphasized, and reverse osmosis membrane is used as the main technical component of desalination and sterilization.
With the deepening of clinical research on the influence of various pollutants on dialysis, people began to realize the serious harm of microbial pollution. At this time, the equipment has formed a comprehensive water treatment equipment with reverse osmosis as the core, integrating pretreatment, fine treatment, post-treatment and disinfection, and put forward the concept of ultra-pure dialysis water. Cancel some single-stage reverse osmosis devices and adopt bipolar reverse osmosis devices. As dialysis patients, for their own rights and interests, they need to know the brand of water treatment equipment, whether it is single-stage or bipolar, and get information about water conductivity, water hardness, water disinfection and maintenance from hemodialysis center. If chlorine and chlorine in water are not removed, it will aggravate anemia and intractable itching of skin in patients with hematological diseases and produce dialysis reaction.
Nurses and technicians need to further improve the quality control level.
Generally speaking, hemodialysis machines are put into use immediately after installation, debugging and disinfection, and create benefits. Few people have studied their deep application, quality assurance and quality control. The same type of equipment, in different hospitals, different users and different use environments, often has great differences in use. Many users are only satisfied with simple applications and operations, and some users only use some of them.
Nurses are the main users of dialysis machines, and technicians in blood purification center are the guarantee personnel for the normal and safe use of dialysis machines. Because of the particularity and importance of hemodialysis machine, it is often necessary to maintain, repair, correct and disinfect the equipment, and repair the equipment and correct the parameters in time when there is a fault. Therefore, in order to make the hemodialysis machine work normally, it is necessary to strengthen the communication between nurses and maintenance technicians of the hemodialysis machine.
Meet patients' requirements for safety and application quality. Some alarms and simple faults during dialysis also need urgent treatment by nurses, otherwise it will seriously affect the normal use of dialysis machines and bring discomfort to patients. In addition, effective communication can also improve maintenance efficiency, provide maintenance technicians with information such as fault phenomena and fault codes, and solve problems timely and effectively.
Therefore, through the communication and cooperation between nurses and maintenance technicians, nurses can receive training on the safe operation of dialysis machines, master the use specifications and safety features, improve their ability to deal with various alarms, reduce the extra pressure caused by the complexity of machine use, reduce the misoperation of machines, and improve their nursing and operation skills. Maintenance technicians can learn clinical application knowledge, better carry out machine maintenance, calibration and application quality analysis, and judge the operation level and management status of dialysis machine. Put forward improvement measures and eliminate defects, etc. It can further improve medical quality, reduce dialysis risk, improve dialysis performance and patient comfort, and improve their respective efficiency and quality while ensuring medical safety.
Regular inspection of important parameters
With the development of modern medical technology and the improvement of social medical security, more and more patients with chronic renal failure receive blood purification treatment, and more and more medical institutions have set up blood purification rooms. In order to improve the quality of blood purification treatment, reduce the adverse events in the process of blood purification treatment, and provide a safer and more comfortable treatment environment and adequate dialysis for dialysis patients, we should strengthen the quality assurance and quality control of medical instruments and equipment, and regularly check and correct the ultrafiltration and conductance of dialysis machines and other important parameters and performance related to patients' life and health.
At present, most hospitals in China only pay lip service to the quality control and quality assurance of medical instruments and equipment, but do not implement them. It is difficult for medical staff to complete the safe and normal operation of medical equipment unilaterally. Only by implementing relevant standards and norms can patients be truly reassured.