Hand Hygiene
Before initial contact
Moment 1
Initiates code and activates code blue
1st responder
Recommendations from coroners inquest
Patient access MUST be visible at all times
How to access necessary patient information during downtime
Downtime computer
Circuit tubing falls to floor during priming
Discard and start with new setup
Immediately after risk of body fluid exposure
Moment 3
Remains until end of code
The recorder
ABF blood flow decreased by 20%
Repeat to confirm and then report to Renal Nurse Navigator
Frequency downtime boxes are to be checked
Monthly
Patient is no show for treatment
Review consent for missed appointments, follow accordingly and document
Immediately before aseptic procedure
Moment 2
Provides information to code team/EMS upon arrival
Assigned nurse/nurse caring for patient
Prolonged bleeding
Notify Nurse Navigator and recommend further assessment +/- intervention
Where to locate BCA downtime forms
Downtime box (additional forms can be printed from BCA Downtime sharepoint.com)
Patient request extra fluid removal
Follow "Fluid Assessments in Dialysis" policy and procedure
After patient environment contact
Moment 4
Applies AED
Second responder
Red exit site
Assess for infection and report to Neph/NP
If downtime is less than 4 hours
Manually transcribe all information into EPIC
Check to see if there is documented consent to share information with son
After touching the garbage
Moment 2
Where to document
Adult resuscitation record (paper - out patients does not document on the code narrator)
Dynamic venous pressure increased 20%
Check trends and report to renal nurse navigator
Reports available for downtime
MAR, HD therapy plan and HD therapy plan overview
Code Green is initiated
Follow "Discontinuing Hemodialysis for Evacuation" policy and procedure