Dialysis Treatment Flow Chart

Patient Care Technicians (PTs) function under the license, supervision, and direction of nurses (RN and/or LPN/LVN.)

The LPN/LVN functions under the license, supervision, and direction of the Registered Nurse.

Nurses direct the workflow of the clinic and delegate appropriate tasks based on employee role, training, competency, and state regulations.

1. Setup the dialysis machine for the day (turn on, run the rinse cycle, check for bleach)

2. Setup Machine for Patient

a. Verify the correct ordered dialyzer & dialysate concentrate match the orders

b.String blood lines

c. Prime the dialyzer with saline

d. Attach Heparin

e. Test machine

f. Respond to failed machine tests

g. Test & prime dialysate

h. Circulate saline

3. Pre-treatment Evaluation

a. Initial patient intake (pre-evaluation)

b. Take patient vital signs

c. Perform initial evaluation (Condition, Complaints, Changes)

d. RN assessment (ABCs)

e. Calculate patient UF goal and hourly UFR

f. Enter dialysis treatment prescription

g. Document the pre-treatment evaluation

h. Evaluate access

4. Treatment Initiation

a. Cannulate the patient

i. Select site

ii. Prepare the site

ill. Insert the needle

iv. Test patency

v. Tape the needle

b. Prepare labs

c. Administer Heparin (bolus)

d. Refresh the prime

e. Connect blood lines to patient access

f. Complete the Check 10 Checklist (Final Machine Verification)

g. Start the treatment (Adjust BFR)

h. Document the start of treatment (patient & machine)

5. Intra-treatment Monitoring & Evaluation (every 30 minutes)

a. Take vital signs

b. Collect and interpret machine and patient data

c. Check patient's mental & physical status

d. Check patient access

e. Document

6. Terminate Treatment

a. Collect post-treatment labs

b. Return blood from arterial segment and from venous segment

c. Collect & compare vital signs

d. Evaluate patient

e. Remove needles

f. Weigh patient & evaluate weight change

g. Document the treatment

h. Discharge patient

i. Post-treatment emptying (Drain lines)

j. Dispose of materials

k. Disinfect supplies & equipment externally