Providing for a Safe Environment for Peritoneal Dialysis

Prevention of exit-site infections and peritonitis requires that both clinicians and patients understand and practice aseptic technique. In the course of daily practice, staff must demonstrate and teach patients how to recognize the potential sources of contamination and to practice measures that will decrease the risk of infection. These preventative measures will reduce complications and promote positive patient outcomes.

Recommendations for a Safe and Clean Environment:

  • Prior to each exchange, clean the work area
  • The exchange area must:
    • Be well-lit and private
    • Have no open windows or doors
    • Have fans and air conditioners turned off
    • Be free of pets
  • For handwashing, use soap and/or alcohol-based products, followed by thorough drying with paper towels
  • The patient and partner or nurse must wear a face mask when performing exit-site care and dialysis exchange procedures
  • Do not touch STERILE areas of the PD system including:
    • Open solution port of the new bag
    • Tip of the exposed transfer set
    • Connections of the twin bag/“Y” set/cycler set
    • Interior of the MINICAP disconnect cap or connection shield and TWIN BAG system
  • Encourage the patient to practice good hygiene
  • Perform connections of PD/APD sets to solution bags and transfer sets using aseptic technique each time an exchange is performed
  • Use only clean and dry port clamps. Wash clamps with soap and water. Let outlet port clamps dry with open end facing downward

References used in this Appendix section

  1. Bender FH, Bernardini J, Piraino B. Prevention of infectious complications in peritoneal dialysis: best demonstrated practices. Kidney Int 2006:[Suppl 103]:S44-S54.
  2. Firanek C, Guest S. Hand hygiene in peritoneal dialysis. Perit Dial Int 2011;31:399-408.
  3. Ponferrada LP, Prowant BF, Satalowich RJ. Peritoneal dialysis complications. Core curriculum for nephrology nursing. In: Counts CS, ed. Pitman, NJ: American Nephrology Nurses' Association; 2008:824-47.