520
Detailed Needs and Requirements: Hemodialysis Unit
2. Organization
There are two systems of supplying dialysate solution to the individual
patient dialyzers:
a. The single patient system in which the dialysate supply unit and the
dialyzer are both located at the patient bedside. The supply unit
prepares and controls the fluid for the individual dialyzer.
b. The multiple patient system consists of a central dialysate
preparation unit, which supplies prepared solution to several
bedside control stations and dialyzers.
Space and facilities should be provided for both systems in the
hemodialysis unit. Most treatments will utilize the central dialysate
supply unit; however, some patients may require special dialysate
solutions which could be prepared and supplied from individual
bedside units. The inclusion of both systems also allows for
emergency coverage at times when the central unit may be out of
operation.
Before treatment, the patient and equipment must be prepared and
following treatment, the dialyzer must be disconnected, the patients
cannula reapplied, and the reassembled prior to its next use.
Due to unpredictable complications or delays the scheduling of
treatments will remain somewhat flexible. Normally, the unit will be
operated on a twenty-four hour, seven-day a week basis in order to
accommodate these delays.
During treatments, the patient's well-being depends on the proper
functioning of the equipment. Any breakdown or malfunction may be
harmful or dangerous to the patient. For this reason the staff should
be constantly aware of equipment function and of the patient's
condition. This may be accomplished through monitors built into the
equipment and by physiological monitoring of the patient, but provision
should also be made for constant visual observation by the nursing
staff.
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