2.  Risks of working in a dialysis clinic  Needle sticks  Blood splash or exposure  Blood spills  Needle dislodging  Chemical splash or exposure  Exposure to infectious diseases SAFETY !!

3. Use PPE appropriately  Face shield  Fluid resistant gown – keep snapped up!  Gloves Properly activate safety device on needles – at the time needle is pulled Don’t take general use items to the chairside – tape, Except, excessive 4x4’s or 2x2’s Use needle boxes properly  Dispose of when ¾ full  Cover needle with safety device Protection

4.  Hand hygiene  Every time gloves are removed  Between patients  Before going to patient  Before going from machine back to patient  Before preparing Heparin or other meds  After using the bathroom  Before and after eating  When gloves or hands soiled, even if same patient  If visibly soiled – must wash hands  If C difficile or norovirus – wash hands not sanitizer Protection

5. Technique with soap and water Warm running water, wet hands Use soap from dispenser (dime size) > 15 seconds period of friction Rub backs of hands, between fingers, thumbs and fingernails. Pat hands dry with paper towel Toweling used to turn off water Alcohol gel used as a hand wash substitute >15 second period of friction (hands must be thoroughly wet) Rub until thoroughly dry Hand Hygiene

6.  Only Hepatitis B antigen positive patients!  Dedicated machine and supplies  What goes in – stays in  Dedicated gown, stethoscope  Double bag any trash  Hepatitis B can live on a surface for up to 7 days  Patients near Iso must have Hep B antibodies.  Staff caring for iso patients should have antibodies Isolation Room Practices

7.  Wipe down patient station 2 times  Clean machine, BP cuff, TV, open the chair, Bicarts or any dialysate containers if not thrown away  First cleaning removes organic waste, dirt and grime especially if visibly dirty and can be done with patient in chair  Biological dirt or grime can actually protect the germs  Disinfect AFTER the patient has gone Cleaning the Patient Station

8. 15%–25% of people with chronic Hepatitis B develop serious liver conditions, such as cirrhosis (scarring of the liver) or liver cancer. May take 20- 30 years to develop. Chronic Hepatitis C can result in long-term health problems, including liver damage, liver failure, liver cancer, or even death. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. Approximately 15,000 people die every year from Hepatitis C related liver disease Hepatitis C can live up to 4 days outside the body Hepatitis