Infection Control
How long is handwashing performed?
Cover hands (palms, back of hands, between fingers) and wrists with lather and wash vigorously for a minimum of 20 seconds.
What is considered abnormal BP findings pre-dialysis? When to notify RN?
Systolic greater than 180 mm/Hg or less than 90 mm/Hg
Diastolic greater than or equal to 100 mm/Hg
When is water chlorine monitoring performed? Frequency
Performed prior to the first patient shift then every four (4) hours
When are your unavailable days/ schedule preferences due to your FA for the schedule?
Each 5th of the month, for the following month.
For visible blood or gross blood spills? Type of bleach solution?
Routine disinfection: machine / chairs
1:10 (one to ten) bleach solution must be utilized.
Use an appropriate disinfectant such as 1:100 (one to one hundred) bleach solution for routine disinfection of environmental surfaces.
What is considered abnormal BP findings post dialysis tx? When to notify RN before discharge.
Systolic BP greater than 140/90 mm/Hg and 90/50 and less.
What is normal chloramine levels?
Less than or equal to 0.1.
True of False: Float teammates are able to schedule themselves with a different Region prior to the float schedule being released.
False
Dialysis station must be completely vacated by the previous patient before teammates can begin to bring disinfection supplies to the station, clean or disinfect the station and set up for the next patient.
True or False
True
What is considered abnormal BP findings during tx (Intradialytic).
Difference of 20 mm/Hg increase or decrease from patient’s last intradialytic treatment BP reading
Independent pH is required to be performed prior to each treatment.
The acceptable range for final dialysate pH is ___-___.
pH is 6.9-7.6.
Per the travel and entertainment policy, mileage should be submitted in how many days?
30
All expenses, including mileage, must be submitted in Concur within 30 days following completion of travel. Expenses more than 60 days old may not be reimbursed.
Dressing changes such as a small wound dressing is allowed? True or False
False
Dressing changes should not be performed in the treatment area with the exception of vascular access care.
Abnormal HR- when to notify RN
Heart or Pulse Rate Pre/Intra/Post: • Less than 60 beats per minute or greater than 100 beats per minute and/or an irregular heart beat
Conductivity
The acceptable range for machine dialysate conductivity is ___ - ____.
13 - 15.5 conductivity
Describe the difference between your home clinic for travel / mileage and your home clinic via Work Day.
Your home clinic for travel / mileage is the Davita Dialysis location closest to your home, used for travel time calculation and mileage if applicable.
Your home clinic is your FA's clinic and Work Address in Work Day - Davita Rancho San Bernardino.
Vascular Clamps:
Do you need an MD order: Yes or No
How long can you leave clamps on a pt?
Yes
Vascular access clamps should not be used routinely. However, if a patient is unable to hold his/her own sites, it is recommended that only one (1) clamp is used at a time and should not be left on longer than 20 minutes.
The prescription components are confirmed by a licensed nurse within one ___ (time) of treatment initiation along with the nursing assessment.
Prescription components include but are not necessarily limited to: Name at least 4
1 hour
Dialyzer make and model b. Treatment time c. Target weight d. UFR and Max UFR e. UF Profiling f. Blood flow rate g. Dialysate flow rate h. All accesses evaluated i. Correct dialysate composition (potassium, calcium, base sodium and bicarb) and settings, including upper and lower conductivity alarm limit settings if utilizing a Fresenius 2008 series dialysis delivery system j. Heparinization (intradialytic infusion setting)
If result for water testing is more than 0.1 what do you do?
Immediately Perform Total Chlorine Test on Secondary Carbon Tank.
On "Routine Total Chlorine Testing" Log document Primary Carbon Breakthrough. Initiated Breakthrough Log.
If result is abnormal more than 0.1ppm. DO NOT DIALYZE PLACE ALL MACHINES IN BYPASS by placing dialysis delivery system in bypass, discontinue treatment and do not rinse patent ‘s blood back.
Notify Facility Medical Director, FA, MCS, Biomed.
Joe's normal commute to work is 30 miles round trip. He agrees to support a clinic that is 100 miles round trip. How much mileage does Joe submit that is able to be reimbursed per our Reimbursement Policy?
Joe can submit 70 miles to be reimbursed in Concur per our Reimbursement Policy.
12.1. Appendix A – Local Mileage Reimbursement Policy The DaVita policy allows reimbursement for business use of personal automobiles.
1. Definitions: a. Reimbursable Mileage is defined as the number of business miles driven in excess of a Normal Daily Commute.
b. A Normal Daily Commute is defined as follows:
i. Teammates based in a facility or business Office = Roundtrip mileage from personal residence to primary facility
Normal Daily Commutes are not reimbursable.