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 the consumables, equipment, medical environment, and medical skills of health care personnel.
The water used for dialysis is directly related to the quality of dialysis.
Quality control of dialysis equipment is the main link of hemodialysis, an important means of preventing acute and chronic dialysis complications in patients, and a measure of dialysis comfort and dialysis adequacy in patients. The quality control of dialysis water, dialysate and dialysis machine is the focus of the whole work.
The adequacy and comfort of dialysis are closely related to dialysis water. Each patient requires 120-150 liters of impermeable water for a single dialysis session and will receive 15,000-26,000 liters of dialysis water a year. Most dialysis water is used from the tap, but tap water is not pure, but contains impurities such as calcium, magnesium, iron, chlorine, silica, and organic matter. It varies greatly from one water source to another. Direct use of untreated tap water can change the composition of the dialysis solution. If the chemical pollutants or heavy metal ions in the dialysis water are excessive, they can cause acute and chronic dialysis complications such as nausea, vomiting, hemolysis, and anemia. The effect of some trace elements is not obvious 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 the water treatment process and equipment has gone through three main stages:
In the first stage, Aishen realized that excess calcium and magnesium ions would lead to "hard water syndrome" in patients. This stage of the equipment in the original simple crude filtration based on the emphasis on the softening process to remove calcium and magnesium ions. The corresponding water treatment equipment overall process is relatively simple, mainly including a variety of precision filtration devices, resin softening tanks or anion and cation removal beds;
The second stage, with the increase in water pollution around the world, the addition of a variety of disinfectants, in particular chlorine, chloramines and other substances that may have an adverse effect on the patient, the water quality requirements began to pure water development. At the same time to ensure softening, emphasized the function of activated carbon adsorption of organic toxins, the use of reverse osmosis membrane as the main technical components of desalination sterilization.
The third stage of love for the kidney with the deepening of clinical research on the impact of various pollutants on dialysis, people began to realize the serious danger of microbial contamination. At this time, the equipment formed a reverse osmosis as the core, set pretreatment, fine treatment, post-treatment, disinfection in one of the integrated water treatment equipment, and put forward the concept of ultrapure dialysis water. Some single-stage reverse osmosis devices were canceled and bipolar reverse osmosis devices were adopted. As a dialysis patient, for your own rights, you need to know the brand of the water treatment equipment, whether it is single-stage or bipolar, as well as information from the hemodialysis center about the conductivity of the water, the hardness of the water, the disinfection of the water, and maintenance. Failure to remove chlorine and chlorine from the water can exacerbate anemia and intractable itching of the skin in hemodialysis patients, creating a dialysis reaction.
Nurses and technicians need to further improve quality control.
Generally, hemodialysis machines are put into use and create benefits immediately after installation, commissioning, and sterilization. Few people study their in-depth application, quality assurance and quality control. The same type of equipment, in different hospitals, different users, different use of the environment, the use of the equipment is often very different. Many users are satisfied with simple application and operation, and some of them only use some of these functions
Nurses are the main users of dialysis machines, and the technicians in the blood purification centers are the guarantors of the normal and safe use of dialysis machines. Due to the special characteristics and importance of hemodialysis machines, it is often necessary to maintain, repair, calibrate and sterilize the equipment, and to repair the equipment and calibrate the parameters in time when there is a malfunction. Therefore, in order to make the hemodialysis machine work properly, it is necessary to strengthen the communication between nurses and hemodialysis machine maintenance technicians.
Meet the needs of patients with safety and application quality. Some alarms and simple malfunctions during the dialysis process also need to be handled urgently by nurses, otherwise they will seriously affect the normal use of the dialysis machine and bring discomfort to patients. In addition, effective communication can also improve the maintenance efficiency and provide maintenance technicians with information on fault phenomena and fault codes to solve problems in a timely and effective manner.
Therefore, through the communication and cooperation between nurses and maintenance technicians, nurses can be trained in the safe operation of dialysis machines, master the use of norms and safety features, improve the ability to respond to various alarms, reduce the additional stress caused by the complexity of machine use, reduce the misuse of machines, and improve nursing and operational skills. Maintenance technicians can learn clinical application knowledge, better perform machine maintenance, calibration and application quality analysis, and determine the level of operation and management of dialysis machines. Suggest improvement measures and eliminate defects, etc. It can further improve the quality of medical care, reduce the risk of dialysis, improve dialysis performance and patient comfort, and improve the respective efficiency and quality while ensuring medical safety.
Periodic examination 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 are receiving 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 adverse events during blood purification treatment, and provide dialysis patients with a safer and more comfortable therapeutic environment and adequate dialysis, the quality assurance and quality control of medical instrumentation and equipment should be strengthened, and the ultrafiltration and conductivity of the dialysis machine should be regularly inspected and calibrated, which are the important parameters and performances that are related to patients' life and health.
At present, most of the hospitals in China only pay lip service to quality control and quality assurance of medical instruments and equipment and do not implement them. Medical staff is difficult to unilaterally complete the safe and normal operation of medical equipment. Only the implementation of the relevant standards and norms, in order to allow patients to truly rest assured.