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|Year : 2020 | Volume
| Issue : 7 | Page : 89-91
Record keeping, reporting and hemodialysis
|Date of Web Publication||15-Jul-2020|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Record keeping, reporting and hemodialysis. Indian J Nephrol 2020;30, Suppl S1:89-91
Record keeping in a dialysis unit involves many different facets and is important to ensure safe and appropriate delivery of dialysis to patients. This involves recording of each individual dialysis [Table 1], for an individual patient [Table 2], records of dialytic and medical care of the patient over the course of his treatments and the water quality and safety parameters for the whole unit [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]. In addition, dialysis units should evaluate their performance to assess their current performance with a goal for continuous quality improvement [Table 8].
Dialysis units that are reusing dialyzers need to have additional monitoring and recording to ensure that patients are receiving good quality and safe dialysis [Table 9].
- We recommend recording initial weight, final weight, dry weight, dialyzer, station number, initial BP and final BP, number of hours of dialysis, access used, BFR, dialysis flow rate, dialysate composition used (Na, K, calcium, bicarbonate), conductivity, temperature, anticoagulation, any other medications administered.
- We suggest recording BP during the treatment and UF rate.
- We suggest for HDF recording replacement rate and total UF.
- We SUGGEST recording online kT/V from machine for each treatment where available.
- We recommend HD consent for treatment at start of dialysis at that unit and then every 6 months.
- We suggest recording monthly labs, vaccination history, home medications
- We suggest Monthly assessments by physicians (nephrologists/dialysis physicians)
- We suggest addressing and recording the following issues every month:
- Vascular access
- Cardiac status
- HTN and volume assessment
- Possibility for transplant
- Bone mineral disease
- Functional status, occupation, activity
- Quality of life.
- We recommend recording all bacterial culture and endotoxin results done monthly, RO and membrane filter pressures. Dates and type of maintenance and dates of filter changes.
- We suggest recording and including as part of an annual audit.
- Mortality, cause of death
- Anemia status (Hb, EPO doses, IV iron administered),
- Bone mineral disease (calcium, phosphorus, iPTH, calcium bath prescribed and delivered, phosphate binders, cinacalcet).
- Access (fistula, catheter, fevers on dialysis, bacteremia)
- Adequacy (percentage with adequate dialysis and interventions for those not adequate)
- Nutritional status (albumin)
- Complications: Hypotension, fever, codes, admission to hospital, sentinel event (and its investigation)
- CRBSI and rate.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]