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Like anyone undergoing medical treatment, dialysis patients must take all the steps they can to reduce their risk of infection. In fact, preventing infection is especially important for people on dialysis because their medical condition can make them more susceptible to illness. Also, dialysis treatments require patients to have either an open catheter or a vascular access point, both of which provide an opportunity for bacteria to enter the body and cause infection. However, there are practical and easy ways to significantly reduce the chances of getting an infection. These include thorough hand-washing, effective cleaning methods and safe disposal of used supplies.
Home dialysis allows people the benefit of taking greater control of their care, which also means taking greater responsibility for their own health and safety during their treatments. With proper training and guidance, people on home dialysis can learn to create a safe and clean home environment for their treatments, particularly to reduce the risk of infection. While your doctor is the best person to talk to about proper ways to avoid infection once you begin your dialysis treatments, here are some basic tips to help keep you safe and healthy while performing your treatments:
One of the most important ways of preventing infection is to keep the area in your home where you perform dialysis as clean as possible. This means keeping the area free of microorganisms, including bacteria, fungus, viruses and other germs. Any one of these microorganisms can "contaminate" your treatment area and make you sick.
Use household disinfectant to clean all surfaces in your area as well as your dialysis equipment, including your blood pressure cuff, tourniquets, clamps and other items. It is particulary important to do this immediately if or when you are exposed to any other potentially infectious material to keep germs from spreading. A very powerful disinfectant can be made simply by mixing 1 part household bleach to 100 parts water for cleaning surfaces and non-treatment items and 1 part bleach to10 parts water for cleaning equipment.
It may seem obvious, but washing your hands thoroughly is the single most important thing you can do to prevent infection. And believe it or not, many people who understand how important this is still don't wash their hands thoroughly. Using a liquid antibacterial soap to wash your hands before beginning your treatments can help reduce the likelihood of infection.
Thoroughly washing your hands at home before beginning treatments is as important as doing so at a dialysis center. Lather the antibacterial soap on your hands and wrists and wash vigorously for at least 15 seconds. Rinse well with warm water and pat-dry your skin completely with a paper towel to prevent chapping. Once your hands are dried, use another paper towel to turn the faucet off. Also, remember to avoid touching the faucet handles after you have washed your hands. Putting on a pair of disposable medical gloves is recommended before preparing your access or catheter for use during treatment.
Taking proper care of your access or catheter can significantly help reduce the chances of getting an infection. It is important for people on home hemodialysis to clean their access site thoroughly with antibacterial soap before dialysis needles are inserted and not to touch the cleaned puncture site with their bare hands. Again, putting on a pair of medical gloves is recommended. People with a vascular access should also avoid wearing clothing, jewelry, lotions or other items that come in direct contact with their access because this could affect its cleanliness or cause irritation and sensitivity around the area. Also try not to carry or lift heavy items to avoid causing discomfort or pain in the arm. Be careful when sleeping that you don't rest on top of your arm that has the access. Watch for early signs of infection such as fever, redness, swelling, pain, tenderness or if the skin becomes warm to the touch around the access. Call your doctor right away if any of these symptoms occur.
If you are a peritoneal dialysis patient, washing your hands thoroughly with antiseptic before handling your catheter will make an infection less likely. However, cleaning your catheter before each and every treatment offers the greatest protection against the risk of infection. Also, using a medical antiseptic solution such as ExSept Plus® when preparing your access or catheter for treatment offers a higher degree of prevention against infection and helps keep germs from spreading.
Most patients on PD will be asked to apply a topical antibiotic to their exit site on a daily basis. This is usually done using a clean cotton swab, applying a small amount of antibiotic around the catheter exit each day after washing the exit site. Patients on HHD who dialyze through a catheter may also need to do this if there is evidence of inflammation or infection. Make sure to watch for early signs of infection during your regular treatments, looking for signs of cloudiness in drained fluids, flu-like symptoms or fever. Again, call your doctor right away if you notice these things happening.
It is very important to take care of your access or catheter regardless of the type of home dialysis treatment you choose. Make sure to keep your access or catheter and the area around it clean and dry at all times. You might also want to lubricate this area with a skin-softening cream to keep it healthy and avoid chapping.
People on home dialysis use a variety of prepackaged, sterile medical supplies specific to their treatment needs. To make sure your supplies remain sterile, inspect every package before you open it. Look at the expiration date and inspect the physical condition of the packaging. Your supplies must remain sealed in order to stay sterile and ready for use. If the expiration date has passed or the packaging looks torn, ripped or wet, discard the supplies and do not use them for your treatment. After a supply package is opened, the contents can easily become contaminated with bacteria, dust and other potentially harmful germs. Therefore, it's important that you only open medical supplies when you are ready to use them.
Home hemodialysis patients should always wipe the tops of medical vials as well as their skin before inserting a needle. Peritoneal dialysis patients should always wipe the tops of Epogen vials before they self administer. Additionally, try not to cough or sneeze on needles, bloodlines or syringes, and never touch them with your bare hands. Always use medical gloves when handling equipment. If any of your supplies become contaminated accidentally, throw the affected materials away. In the long run, it's cheaper to replace these items than risk infection. And, after each treatment, make sure to properly discard used supplies.
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