Peritoneal Dialysis Exchange Checklist
Comprehensive peritoneal dialysis exchange documentation including aseptic technique verification, exchange parameters, and catheter care assessment.
- Industry: Healthcare
- Frequency: Every exchange
- Estimated Time: 30-45 minutes
- Role: PD Nurse/Patient
- Total Items: 31
- Compliance: ISPD Guidelines, KDOQI Guidelines, CDC Infection Prevention
Pre-Exchange Preparation
Preparation before exchange
- Hand hygiene performed (2 min scrub)?
- Mask worn during exchange?
- All supplies gathered and unexpired?
- Solution warmed to body temperature?
- Solution inspected (clear, no leaks)?
Drain Phase
Effluent drainage
- Drain time documented?
- Drain volume documented?
- Effluent clear (not cloudy)?
- Effluent color normal?
Fill Phase
Solution instillation
- Correct solution type?
- Correct fill volume?
- Fill time documented?
- Medications added per order (if any)?
Exit Site Care
Catheter exit site assessment
- Exit site assessed?
- No redness or swelling?
- No purulent drainage?
- Catheter properly secured?
- Dressing changed per protocol?
Ultrafiltration Calculation
Fluid balance
- Ultrafiltration calculated?
- UF within expected range?
- Fluid balance documented?
Pre-Assessment Information
Initial assessment documentation and patient/facility identification
- Assessor Name / Credentials
- Assessment Date
- Department / Unit
- Assessment Type (Routine/Annual/Complaint)
- Previous assessment findings reviewed?
Infection Prevention & Control
Verify infection control practices per CDC and Joint Commission standards
- Hand hygiene compliance observed?
- Appropriate PPE available and properly used?
- Isolation precautions properly implemented?
- Sharps containers available and not overfilled?
- High-touch surfaces properly disinfected?
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Why Use This Peritoneal Dialysis Exchange Checklist?
This peritoneal dialysis exchange checklist helps healthcare teams maintain compliance and operational excellence. Designed for pd nurse/patient professionals, this checklist covers 31 critical inspection points across 7 sections. Recommended frequency: every exchange.
Ensures compliance with ISPD Guidelines, KDOQI Guidelines, CDC Infection Prevention. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Peritoneal Dialysis Exchange Checklist cover?
This checklist covers 31 inspection items across 7 sections: Pre-Exchange Preparation, Drain Phase, Fill Phase, Exit Site Care, Ultrafiltration Calculation, Pre-Assessment Information, Infection Prevention & Control. It is designed for healthcare operations and compliance.
How often should this checklist be completed?
This checklist should be completed every exchange. Each completion takes approximately 30-45 minutes.
Who should use this Peritoneal Dialysis Exchange Checklist?
This checklist is designed for PD Nurse/Patient professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.