Certainly, here's a step-by-step SOP (Standard Operating Procedure) for managing commonly known

dialysis patients (PiKI – Pre-Identified Known Individuals) from their arrival to exit:

---

**Standard Operating Procedure: Dialysis Patient Management**

**Objective:**

To provide consistent and effective care for commonly known dialysis patients, ensuring their health,
safety, and overall well-being during the entire dialysis process.

**I. Pre-Arrival Preparation:**

a. Access the dialysis schedule to identify the scheduled patients for the day.

b. Cross-reference the schedule with the list of PiKI dialysis patients to ensure proper identification.

**II. Patient Arrival:**

a. Greet the patient upon arrival and verify their identity using two patient identifiers.

b. Confirm the patient's appointment details and ensure any necessary paperwork is completed.

**III. Pre-Dialysis Assessment:**

a. Review the patient's medical history and note any changes or developments since the last session.

b. Assess the vascular access site for cleanliness and functionality.

c. Confirm the dialysis prescription, including prescribed medications and target fluid removal.

**IV. Dialysis Station Assignment:**

 a. Assign the patient to a designated dialysis station.

b. Ensure the station is equipped with the necessary supplies and the dialysis machine is calibrated.

**V. Pre-Dialysis Education:**

a. Provide the patient with a brief overview of the upcoming dialysis session, including expected
procedures and duration.

b. Reinforce self-care instructions, emphasizing dietary restrictions and fluid intake guidelines.

**VI. Dialysis Machine Setup:**

a. Calibrate and set up the dialysis machine according to the patient's prescription.

b. Confirm that all disposables, filters, and tubing are properly connected and sterile.

**VII. Patient Monitoring During Dialysis:**

a. Continuously monitor vital signs, including blood pressure, heart rate, and oxygen saturation.

b. Regularly assess the patient's comfort level and address any concerns promptly.

c. Monitor fluid removal, adjusting the ultrafiltration rate as needed.

**VIII. Medication Administration:**

a. Administer prescribed medications, including anticoagulants and any additional medications

ordered by the nephrologist.

b. Document medication administration accurately.

**IX. Post-Dialysis Care:**

a. Monitor the patient post-dialysis for any adverse reactions or complications.

b. Confirm the patient's readiness to leave the dialysis area and provide any necessary post-care
instructions.
**X. Exit Process:**

a. Assist the patient in safely disconnecting from the dialysis machine.

b. Ensure the patient has all personal belongings.

c. Provide any additional post-care instructions or follow-up appointments.

**XI. Documentation:**

a. Maintain comprehensive and accurate records of each dialysis session.

b. Document any deviations from the standard procedure or unexpected events.

**XII. Collaborative Communication:**

a. Communicate effectively with the healthcare team, including nephrologists, nurses, and technicians.

b. Share relevant information about the patient's session and any observations during the process.

**XIII. Continuous Quality Improvement:**

a. Participate in ongoing training and education to stay updated on best practices in dialysis patient
care.

b. Provide feedback on the SOP to identify areas for improvement.

**XIV. Review and Revision:**

a. Periodically review and update this SOP based on changes in protocols, guidelines, or feedback from
staff.

--- Note: This SOP is a general guideline and should be adapted to the specific protocols and regulations
of the healthcare facility. Regular reviews and updates are essential to ensure alignment with the latest
standards and practices.
 SOP for managing commonly known dialysis patient (PIKI- pre identified
known individual) from arrival to exit
Process Input Output

a. Access the dialysis

b. Cross-reference the - Dialysis -Verified list

schedule with the list of schedule for of scheduled
Pre- arrival PIKI dialysis patients to the day. PiKI patients
ensure proper for the day
preparation - List of PiKI
identification.
dialysis
patients.

a. Greet the patient

upon arrival and
verify their identity
using two patient - Patient -Confirmed
identifiers identification patient
details. identity upon
Patient arrival b. confirm the
patient’s arrival.
-
appointment details Appointment
confirmation.

a. Note any change or

development since the last
- Patient
session
medical
a. Assess the vascular history. -Updated
Pre dialysis Patient
access site for cleanliness
assessment - Information Assessment:
functionality
on changes or Updated
C. Confirm the dialysis developments assessment of
prescription, including since the last the patient's
prescribed medications session. medical
and target fluid removal. history and
 any changes
or
developments.
since the last
session

a. Assign the patient to a

designated dialysis station
-Assign the
b. Ensure the station is patient to a
equipped with necessary -Patient designated
Dialysis station assignment
supplies and dialysis dialysis
assignment details.
machine is calibrated station that is
prepared and
equipped for
the session.

a. Provide the patient

with a brief overview
of the upcoming
dialysis session, -Educated the
including expected patient about
procedures and - Patient
the upcoming
duration awareness
dialysis
level.
Pre dialysis b. Provide education on session,
self-care, - Previous including
education expected
emphasizing education
adherence to dietary records. procedures,
restrictions and fluid duration, and
intake guidelines. adherence
instructions

a. Calibrate and set up

the dialysis machine
- Dialysis -Dialed in and
according to the patient's
prescription for set up the
prescription.
Dialysis the patient. dialysis
b. Confirm that all machine
machine setup - Specific
disposables, filters, and according to
requirements
tubing are properly the patient's
for the patient
connected and sterile prescription
 a. Continuously monitor -Continuous
vital signs, including blood records of
Patient pressure, heart rate, and vital signs,
oxygen saturation. - Initial vital patient
monitoring
signs. comfort level,
during dialysis b. Regularly assess the
and fluid
patient's comfort level and - Patient's removal
address any concerns comfort level. targets
promptly.
throughout
- Targeted
c. Monitor fluid removal, the dialysis
fluid removal.
adjusting the ultrafiltration session
rate as needed.

a. Administer
prescribed
medications, -Administered
including prescribed
- Prescribed
anticoagulants and medications,
medications.
any additional including
medications ordered - Additional anticoagulants
by the nephrologist. medication , and
Medication orders documented
administration b. Document the
medication medication
administration administration
accurately accurately

a. Be prepared to
respond to any
emergencies, including
cardiac events or -Develop and -Activate
complications related to maintain a emergency
dialysis. comprehensive services
Emergency
b. Familiarize staff with emergency
Response response plan
emergency protocols,
 including initiation of the specifically
code blue procedure tailored to
dialysis
facilities.

a. Monitor the patient

post-dialysis for any
adverse reactions or - Patient's post- -Assessed the
complications. dialysis patient post-
Post dialysis condition. dialysis for
b. Confirm the patient's any adverse
care - Any
readiness to leave the reactions or
dialysis area and provide complications complications
any necessary post-care observed , ensuring
instructions. readiness for
exit

a. Assist the patient in

safely disconnecting from
- Details of the -Assisted the
the dialysis machine.
patient patient in
b. Ensure the patient has disconnect safely
all personal belongings. process. disconnecting
Exit process from the
c. Provide any additional - Verification
dialysis
post-care instructions or of belongings
machine.
follow-up appointments

a. Maintain
comprehensive and
documentation accurate records of each
dialysis session. - Session Maintained
details. comprehensiv
b. Document any
deviations from the e and accurate
- Any
standard procedure or records of
deviations
unexpected events. each dialysis
from the
session,
standard
including any
procedure
deviations
from the
standard
procedure
 a. Communicate Communicate
effectively with the d effectively
healthcare team, including with the
nephrologists, nurses, and - Relevant healthcare
Collaborative technicians. information team, sharing
communication about the relevant
b. Participate in regular information
patient's
multidisciplinary meetings about the
session.
to discuss patient progress patient's
and address any concerns. - Effective session and
communicatio any
n with the observations
healthcare
team

a. Participate in
ongoing training and
Provided
education to stay
- Feedback feedback on
Continuous updated on best
on the SOP the SOP,
quality practices in dialysis
identifying
improvement patient care.
areas for
b. Provide feedback improveme
on the SOP to identify nt in the
areas for improvement. dialysis
patient
managemen
t process

a. Periodically -Actively
review and update this participated in
- Changes in
Review and SOP based on changes
ongoing
protocols,
revision training and
in protocols, guidelines, or education to
guidelines, or feedback staff feedback. stay updated
from staff. on best
practices in
dialysis
patient care
- Contributed
to the review
and revision
of the SOP
based on
changes in
protocols,
guidelines, or
feedback from
staff