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Myer kidney Care

Policies & Procedures 

Professional Advisory Committee & Policy & Procedures Committee

PAC Committee Terms of Reference

P&P Committee Terms of Reference

Committee Structures

Committee Distribution of Content

Working Group Membership List

30.00 Hemodialysis

30.10 Eqipment Procedures

30.10.01 Use of Fresenius 5008 Delivery System using 0.9% NaCl *revised*

30.10.02 Fresenius 5008 Preparation for Hemodialysis using the ONLINEplus ™ System *revised*

30.10.03 Initiation and termination of Treatment using the Fresenius 5008 ONLINEplus™ System

30.10.04 Converting to 0.9% NaCl bolus or NaCl reinfusion using the Fresenius 5008 ONLINEplus ™ System

30.10.05 Providing a bolus using the Fresenius 5008 ONLINEplus ™ System

30.10.06 Fresenius 5008 ISO Ultrafiltration (Sequential Therapy)

30.10.07 Fresenius 5008 Air Detected Below the Venous Bubble Catcher

30.10.08 Fresenius 5008 Blood Leak Alarms; responding to

30.10.09 Changing the Extracorporeal circuit during hemodialysis treatment for the Fresenius 5008 delivery system

30.10.10 Fresenius 5008 Recirculation of Extracorporeal Circuit with Normal Saline and with Blood (0.9% NaCl set up)

30.10.11 ONLINE Circulation of Bloodlines with Substituate After Blood Reinfusion

30.10.12 Single Needle (Click-Clack) Hemodialysis for Fresenius 5008 Dialysis Delivery System

30.10.13 Providing Hemodialysis without Heparinization

30.10.14 Intradialytic Blood Product Administration

30.10.14a How to Order Blood

30.10.14b Appendix B: Notification Card Sample

30.10.15 Calcium Chloride Additive for Hemodialysis Patients *revised*

30.10.16 Administration of Intradialytic Parenteral Nutrition to the Hemodialysis Patient

30.10.16a Intradialytic Parenternal Nutrition

30.10.18 Cleaning and Disinfection of the Fresenius 5008 Hemodialysis System; Internal Fluid Pathways and External Surfaces

30.10.19 Changing Dialysate Concentrate During Hemodialysis Treatment

30.10.20 Providing Heparin Bolus During Hemodialysis Treatment

30.10.21 Manually Opening Arterial Pressure Measurement Unit

30.10.22 Emergency Reinfusion Procedure using the Fresenius 5008

30.10.23 Manual Reinfusion Procedure in the Event of Power Failure and Empty Battery/System Failure

30.20 Vascular Access

30.20.01 Venipuncture of Arteriovenous Fistula/Graft

30.20.02 Accessing and Locking Dialysis Central Venous Catheter (Anticoagulant/ Thrombolytic/Antibiotic Locking)

30.20.02a Anticoagulant/ Thrombolytic/Antibiotic Lock Solutions for Hemodialysis

30.20.03 Establishing and Maintaining Buttonhole Venipuncture Sites

30.20.04 Use of Closed Needleless Access Device with Hemodialysis Central Venous Catheters (CVC)

30.20.05 Hemodialysis Central Venous Catheter Dressing and Care of Catheter

30.20.05a Statlock Application Procedure

30.20.06 AVF/AVG Vascular Access Assessment

30.20.07 Removal of Non-Tunneled Hemodialysis Central Venous Catheters

30.20.08 Alteplase for Clearing Hemodialysis Catheter Thrombosis using the Push (30 minute) Method *revised*

30.20.10 Alteplase for Hemodialysis Central Venous Catheter (Dwell procedure)

30.20.11 Local Centres:  Antibiotic Lock Preparation Procedures for Hemodialysis Central Venous Catheters

30.20.11a Anticoagulant/ Thrombolytic/Antibiotic Lock Solutions for Hemodialysis

30.20.12 Use of BARD Dialysis Catheter Repair Kit

30.20.13 Use of Covidien™ Acute and Chronic Catheter Repair Kit: Palindrome™ Chronic Care and All Mahurkar™ Acute and Chronic Care Catheters

30.20.14 Use of the HEMOdialert™ device with hemodialysis

30.20.15 Obtaining Blood Specimens Pre and Post Hemodialysis

30.20.16 Collection of Blood Culture Specimen from a Hemodialysis Access

30.20.16a Blood Cultures for Hemodialysis

30.20.17 Obtaining Blood Sample for International Normalized Ratio (INR) from Central Venous Catheters

30.20.18 Accessing and Locking of Hemodialysis CVC by Non-Hemodialysis Personnel for Urgent Situations

30.20.18a Central Venous Catheter Tunneled (image)

30.20.18b Central Venous Catheter Non-Tunneled (image)

30.30 Water Treatment

a30.30.01 Use of; Lauer Aquaboss EcoRO Dia II HT Reverse Osmosis System (RO).
Health Sciences Centre – Central Dialysis Unit, Sherbrook Dialysis Unit, St. Boniface Dialysis Unit, Seven Oaks Dialysis Unit, Boundary Trails Health Centre, Pine Falls Dialysis Unit, Dauphin Dialysis Unit; Portage Dialysis Unit, Ashern Lakeshore Hospital; and Selkirk Dialysis Unit

30.30.02 Fresenius AquaC UNO H Reverse Osmosis System; use of

30.30.03 Use of Lauer Aquaboss Eco RO Dia Reverse Osmosis System *revised*

30.30.04 Fresenius AquaUNO Reverse Osmosis System; use of *revised*

30.30.05 Use of Reverse Osmosis System via the Multi-Media Interface Nurse Remote Panel (Island Lake, Lake of the Woods District, and Swan Valley Health Centre)

30.30.06 Lauer Eco RO Dia IIC Operation (Thompson Dialysis Unit, The Pas Dialysis Unit, Gimli Dialysis Unit, Russell Dialysis Unit, Hodgson Dialysis Unit, Berens River Dialysis Unit *revised*

30.30.08 Floodstop, Use of

40.00 Peritoneal Dialysis

40.10 Procedures

40.10.01 Attachment of Minicap Extended Life PD Transfer Set to Peritoneal Catheter

40.10.02 Changing Titanium Adapter in a Peritoneal Catheter

40.10.03 Installation of Medications into Peritoneal Dialysis Solution

40.10.03a Instillation of Medication into Peritoneal Dialysis Solution (IP Drugs Manual)

40.10.04 Application of Locking Cap to Peritoneal Catheter

40.10.05 Peritoneal Catheter Flush

40.10.06 Peritoneal Exit Site Care *revised*

40.10.06a Physician Management of Exit Site Infection Algorithm

40.10.06b Peritoneal Catheter Exit Site Care Resource

40.10.06c Peritoneal Dialysis Exit Site Images

40.10.07 Intraperitoneal tPA for Obstructed Peritoneal Dialysis Catheters

40.10.08 Peritoneal Dialysis Bag Exchange Utilizing Twin Bag System

40.10.08a Continuous Ambulatory Peritoneal Dialysis Record (W-00353)

40.10.09 Home Choice Pro Cycler Set-Up: Initiation of Cycling and End of Treatment utilizing a luer lock cycler set (software version 10.4)

40.10.09a Changing Program

40.10.09b Making adjustments

40.10.09c Nurses’ menu

40.10.09d Automated Peritoneal Dialysis Record (W-00354)

40.10.10 Peritoneal Catheter Irrigation

40.10.11 Silver Nitrate Application *revised*

40.10.12 Measuring Peritoneal Dialysis Adequacy: KT/V Collection

40.10.12a Incremental PD Algorithm

40.10.13 Ascites drainage utilizing a Peritoneal Catheter

40.10.14 Collection of Peritoneal Dialysis Effluent from a Peritoneal Dialysis Drain/Sample for Peritonitis Investigation

40.10.14a Site Specific Requisitions for Peritonitis Investigation

40.10.14b Decision Tree for obtaining Peritoneal Effluent Sample

40.10.14c Sending PD effluent sample poster *revised*

40.10.15 Peritoneal Equilibration Test (PET) *revised*

40.10.15a PET (Peritoneal Equilibration Test) Collection Sheet W-00714 *revised*

40.20 Procedures - Fresenius

40.20.03 Instillation of Medication into Peritoneal Dialysis Solution using Fresenius Stay Safe Balance

40.20.04 Converting between Fresenius Extension and Baxter Transfer Sets

40.30 Procedures - Amia Cycler

40.30.01 Baxter Amia® Cycler Set-Up, Initiation of Cycling, and End of Treatment utilizing a luer lock cycler set (software version 10.4)

40.30.01a Amia Cycler Graph sheet (W-00832 & W-00837) *under development*

40.30.02 Measuring Peritoneal Dialysis Adequacy: KT/V Collection using Amia® Night Cycler

40.30.02a Incremental PD Algorithm *revised*

50.00 Home Hemodialysis

50.10 Procedures

50.10.01 Use of the Horizon Mini E Centrifuge

50.10.02 Ordering Dialysis Supplies: NxStage & Fresenius 5008S Home Hemodialysis Patients

50.10.02a Health Science Centre Winnipeg NxStage Order Form

50.10.02a Seven Oaks Hospital NxStage Order Form *New*

50.10.02a Health Science Centre Winnipeg 5008S Order Form *New*

50.10.02a Seven Oaks Hospital 5008S Order Form *New*

50.10.02b Manitoba Renal Program Home Hemodialysis Script order form *revised*

50.10.03 Prevention and Treatment of Hypophosphatemia for Patients on Hemodialysis by utilizing phosphate additives

50.20 NxStage

50.20.02 Nxstage Installing PAK

50.20.03 NxStage Adjusting the Temp of the PAK

50.20.04 NxStage Changing SAK Type

50.20.05 NxStage Draining a SAK

50.20.06 NxStage Initiation and Discontinuation of Dialysis

50.20.07 NxStage Instillation of New Dialysate SAK

50.20.08 NxStage Setup of Cycler

50.20.09 NxStage Testing Chloramines

50.20.10 NxStage Boil Water Advisory

50.30 Fresenius

50.30.01 Use of Fresenius 5008S Delivery System using 0.9% NaCl

50.30.02 Cleaning and Disinfection of the Fresenius 5008S Hemodialysis System; Internal Fluid Pathways and External Surfaces

Policy & Procedures PDF Table of Contents

60.00 Documentation Standard Forms

60.10 Myer Kidney Care Program

60.10.01 Renal Nursing Kardex Standard

60.10.01a Renal Patient Kardex (#W-00195A)

60.10.01b Hemodialysis Patient Kardex (#W-00195B)

60.10.01c Peritoneal Dialysis Kardex

60.10.01d Home Hemodialysis Kardex

60.10.02 Hemodialysis Renal Medication Flow Sheet Standard (eKHR)

60.10.02a eKHR reference guideline

60.10.02b Update eKHR medication (W-00581)

60.10.03 Hemodialysis Renal Medication Flow Sheet Standard (non eKHR)

60.10.03a Hemodialysis Renal Medication Flow Sheet (#NS01708)

60.10.04 Working Alone Standard for Manitoba Renal Program (MRP) Employees *renumbered and under review*

60.10.04a Manitoba Renal Program (MRP) Reporting form for missing employee *renumbered and under review*

60.10.04b Emergency Contact Information form *renumbered and under review*

60.10.05 MRP Signature

60.10.05a MRP Signature Sheet (NS 00714)

60.20 Hemodialysis

60.20.01 Hemodialysis Treatment Record Standard (For Fresenius 5008 Delivery System)

60.20.01a Hemodialysis Treatment Record for Fresenius 5008 (#1592)

60.20.02 Hemodialysis Flow Sheet Standard (for Fresenius 5008)

60.20.02a Hemodialysis Flow Sheet (SAP #295046 Form #W-1593)

60.20.04 Hemodialysis Treatment Record Standard HSC

60.20.04a Hemodialysis Treatment Record (HSC ) (W-00497)

60.20.06 Manitoba Renal Program & Long Term Care Communication Record Standard

60.20.06a Manitoba Renal Program & Long Term Care Communication Record (W-00273)

60.20.06b Riverview Health Centre Manitoba Renal Program & Long Term Care Communication Record (WR-16)

60.20.06c Deer Lodge Centre Manitoba Renal Program & Long Term Care Communication Record Form (# CL0065-5)

60.30 Peritoneal Dialysis

60.20.01 Hemodialysis Treatment Record Standard (For Fresenius 5008 Delivery System)

60.20.01a Hemodialysis Treatment Record for Fresenius 5008 (#1592)

60.20.02 Hemodialysis Flow Sheet Standard (for Fresenius 5008)

60.20.02a Hemodialysis Flow Sheet (SAP #295046 Form #W-1593)

60.20.04 Hemodialysis Treatment Record Standard HSC

60.20.04a Hemodialysis Treatment Record (HSC ) (W-00497)

60.20.06 Manitoba Renal Program & Long Term Care Communication Record Standard

60.20.06a Manitoba Renal Program & Long Term Care Communication Record (W-00273)

60.20.06b Riverview Health Centre Manitoba Renal Program & Long Term Care Communication Record (WR-16)

60.20.06c Deer Lodge Centre Manitoba Renal Program & Long Term Care Communication Record Form (# CL0065-5)

60.40 Home Hemodialysis

60.40.01 Nx Stage Home Hemodialysis Treatment Flowsheet W-00868

60.40.01a Nx Stage Home Hemodialysis Treatment Record W-00869

60.40.02 Fresenius 5008S Home Hemodialysis Treatment Flowsheet W-00866

60.40.02a Fresenius 5008S Home Hemodialysis Treatment Record W-00867

70.00 Protocols

70.10 MyerKidney Care Renal Program

70.10.01 Human Leukocyte Antigen Antibody Testing Routine and Post Transfusion Protocol

70.10.02 Adult Patient Screening and Vaccination Protocol for Hepatitis B and Hepatitis C

70.10.02a Algorithm for Hepatitis B Vaccination and Monitoring in Susceptible Patients

70.10.02b Schedule for Routine Blood Testing for Hepatitis B and Hepatitis C Virus Infections

70.10.02c How to Switch a Patient from one product to the other

70.10.04 Protocol for the PERMANENT TRANSFER of Renal Patients between URBAN sites, units, and programs within the Manitoba Renal Program (MRP).

70.10.04a Permanent Transfer of Hemodialysis (HD) Patients to Another Winnipeg HD Site and Unit

70.10.04b Patient Transfer Letter

70.10.04c Manitoba Renal Program Transfer of Patients Between Dialysis Units and or Sites within the Manitoba Renal Program Checklist (#W-00226)

70.10.04d Permanent Transfer of Renal Patients to a Home Dialysis Unit

70.10.04e Appendix E : Permanent Transfer of Stage V Renal Health Patients to a Hemodialysis Unit

70.10.04f Staff Resources

Staff Memo on Patient Transfer Communication
Transfer Information Process
Staff Script for Patient Transfer
Dialysis Care Transfer poster
70.10.06 Protocol for Temporary Transfer of Patients between Urban Hemodialysis Units within the Manitoba Renal Program

70.10.06a Checklist/Fax Cover Sheet for Temporary Patient Transfers due to Overcapacity

70.10.06b Algorithm: Temporary Hemodialysis Transfers due to Overcapacity

70.10.06c Overcapacity Directive

70.20 Hemodialysis

60.20.01 Hemodialysis Treatment Record Standard (For Fresenius 5008 Delivery System)

60.20.01a Hemodialysis Treatment Record for Fresenius 5008 (#1592)

60.20.02 Hemodialysis Flow Sheet Standard (for Fresenius 5008)

60.20.02a Hemodialysis Flow Sheet (SAP #295046 Form #W-1593)

60.20.04 Hemodialysis Treatment Record Standard HSC

60.20.04a Hemodialysis Treatment Record (HSC ) (W-00497)

60.20.06 Manitoba Renal Program & Long Term Care Communication Record Standard

60.20.06a Manitoba Renal Program & Long Term Care Communication Record (W-00273)

60.20.06b Riverview Health Centre Manitoba Renal Program & Long Term Care Communication Record (WR-16)

60.20.06c Deer Lodge Centre Manitoba Renal Program & Long Term Care Communication Record Form (# CL0065-5)

70.30 Peritoneal Dialysis

70.30.03 Peritonitis Protocol *revised*

70.30.03a Peritonitis informational letter

70.30.05 Peritoneal Dialysis Contamination Protocol

70.30.05a Physician Order Sheet Peritoneal Dialysis Empiric Treatment of Peritoneal Dialysis Related Peritonitis (W-00624)

70.30.05b Part 1 Determining Peritonitis in Rural Patients (W-00681) *under review*

70.30.05c Part 2 Collection of Peritoneal Effluent in Rural Settings (W-00682) *under review*

70.30.05d Part 3 Guideline for Empiric Antibiotic Treatment Guidelines for Rural Outpatients with Peritonitis (W-00680) *under review*

70.30.05e Physician’s Order Sheet Peritoneal Dialysis OUTPATIENTS Confirmed Pathogen Peritonitis (W-00543)

70.30.05f Physician’s Order Sheet Peritoneal Dialysis OUTPATIENTS Exit Site/Tunnel Infections and Wet Contamination (W-00542)

70.30.05g Decision Tree for Managing Contamination

70.30.06 Initial and Monthly Lab Tests Protocol for patients receiving Chronic Peritoneal Dialysis

70.30.06a SOH PD bloodwork panel *revised*

70.30.06b SBH PD bloodwork panel *revised*

70.30.06c BRH PD bloodwork Panel *under review*

70.30.06d Appendix D HIV Testing Letter *New*

70.40 Home Hemodialysis

70.40.02 Initial and Monthly Tests Protocol for Patients Receiving Home Hemodialysis

70.40.02a Home Hemodialysis Panel: Seven Oaks General Hospital (SOGH)

70.40.02b Home Hemodialysis Panel: Health Sciences Centre (HSC)

70.40.02c MRP HIV Testing Letter *revised*

80.00 Guidelines

80.10 Myer Kidney Care Renal Program General

80.10.01 Guidelines for Patient Identification of Outpatients receiving services or procedures from the Manitoba Renal Program Team

80.10.02 Guidelines for Medication Reconciliation

80.10.02a Medication Change Form *under review*

80.10.02b Medication Card *under review*

80.10.03 Guidelines for assessing, documenting and verbally reporting patient care at the time of transfer from one health-care provider to another

80.10.03a Manitoba Renal Program Health Information Transfer Tool *under review*

80.20 Hemodialysis

80.20.01 Guidelines for Heparinization during Hemodialysis

80.20.02 Ordering & Returning Dialysis Supplies for Local Centre Dialysis Units

80.20.02a LRHC ordering and returning supplies, forms and labels

80.20.03 Discharge Criteria for Hemodialysis Patients from the Dialysis Unit following Treatment

80.20.04 Contacting a Patient who does not Attend a Hemodialysis Treatment

80.20.05 Guidelines for Managing Hospitalized Hemodialysis Patients (#W-00346)

80.20.05a Important reminder caring for HD in ER (poster)

80.20.06 Guidelines for Assessing, Monitoring and Documenting Patient Care Pre, Post and During the Hemodialysis Treatment

80.20.06a Guidelines for the Treatment of Intradialytic Hypotension

80.20.06b Guidelines for the Treatment of Post Hemodialysis Hypotension

80.20.07 Providing Acute/Emergent Hemodialysis Treatments outside the Operating Hours of the Hemodialysis Units at the Health Sciences Centre

80.20.07a HSC Guidelines On-Call (80.280.002)

80.20.08 Providing Acute/Emergent Hemodialysis Treatments outside the Operating Hours of the Hemodialysis Units at SBH

80.20.09 Hemodialysis Performed in Urgent Care at Seven Oaks Hospital *revised*

80.20.12 Guideline for Sustained Low-Efficiency Dialysis *new*

80.30 Peritoneal Dialysis

80.30.01 Guideline for care of the In-Centre Peritoneal Dialysis Patient

80.30.01a Checklist for managing a hospitalized Peritoneal Dialysis patient

80.30.02 Care of the patient on Continuous Ambulatory Peritoneal Dialysis guideline

80.30.02a Fluid Management Guidelines

80.30.02b Continuous Ambulatory Peritoneal Dialysis Record (W-00353)

80.30.03 Care of the patient on Continuous Cycling Peritoneal Dialysis Guideline

80.30.03a Fluid Management Guidelines

80.30.03b Automated Peritoneal Dialysis Record (W-00354)

80.30.04 Care of the patient on Home Peritoneal Dialysis Guideline

80.40 Home Hemodialysis

0.40.02 Care of Patient on Home Hemodialysis Guideline

Clinical Resources

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Primary Services

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Electronic Kidney Health Record

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Pharmacotherapy

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MKC Order Sets

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Local Renal Health Centre Operating Manual

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Transfer Tools Poster

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MKC Indigenous Patien Liaison Coordinator

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MKC Indigenous Patien Liaison Coordinator

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WRHA Indigenous Health

Professional Resources

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Primary Services

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Careers

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Education Opportunities for Staff

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Ethics & Dialysis

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Meet Your MKC: Staff Profiles

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MNNC Site Led

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MRP Indigenous Patien Liaison Coordinator

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WRHA Indigenous Health

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