Title
Amendments to Dialysis Clinic Regulations
Law
Doh Administrative Order No. 2006-0037
Decision Date
Dec 19, 2006
The amendment to the regulations governing dialysis clinics mandates updated qualifications for dialysis nurses and technicians, enhances patient care standards, and specifies equipment and facility requirements to ensure safe and effective treatment.
A

Dialysis Technician Requirements

  • Dialysis technician position is now optional.

Dialysis Service Complex Requirements

  • Dialysis Station must provide adequate space and privacy.
  • Minimum dialysis station area changed to at least two (2) meters by three (3) meters (previously 8 m2), excluding passageways.
  • Accommodation must include a dialysis chair, machine, and emergency equipment.
  • Separate dialysis machines must be dedicated for Hepatitis B patients (exclusion of Hepatitis C machines).
  • Facilities must include water treatment area.

Water Supply Standards For Dialysis

  • Water supply must be adequate in volume and pressure.
  • Water for dialysis must be analyzed monthly for bacteria and every six months for chemicals.
  • Bacterial count must be less than 200 col/cc.
  • Chemicals to be tested include aluminum, chlorine, fluoride, and copper.
  • Water treatment must comply with acceptable dialysis techniques to ensure biological and chemical compatibility.

Equipment and Supplies for Dialysis Clinics

  • Stethoscopes and sphygmomanometers provided as needed.
  • E-cart stocked with:
    • IV fluids and lines, including Insyt/Abbocath.
    • Intubation set (endotracheal tubes, laryngoscope, ambubag).
    • Emergency drugs like Dopamine IV, Isosorbide dinitrate tablets, Diazepam (tablet and IV), Hydrocortisone IV, Diphenhydramine maleate, hypertonic saline, D 50 W, parenteral antihypertensives, Clonidine tablets, Calcium Gluconate, Epinephrine, Lidocaine, Salbutamol, Sodium Bicarbonate IV solution.
  • Others include goose neck lamp, standby rechargeable light, ECG machine, suction machine, defibrillator with cardiac monitor, stretcher, wheelchair.
  • Standby generator minimum 20 kva.
  • Fire extinguisher.
  • Ambulance or contract service for patient transport.
  • Water treatment equipment including multi-media filter, bulk filters, carbon filter, softener, reverse osmosis machine with storage tank.
  • Acceptable disinfectants such as formalin (4%) and paracetic acid.

Patient Care Documentation

  • Transfer/referral slip required for patients transferred or referred to other health facilities.

Incident and Accident Logbooks

  • Must record complications related to:
    • Dialysis procedures.
    • Vascular access.
    • Disease process.
  • Include dialysis adequacy for patients undergoing thrice-weekly treatments.
  • Document patient and staff hepatitis status.
  • Include outcomes of treatments.

Administrative Requirements

  • Maintain minutes of facility staff meetings.
  • Keep reports of Department of Health inspections.

Repealing Clause and Effectivity

  • The Order repeals and supersedes specified subsections of the prior Administrative Order No. 163 s. 2004 and other inconsistent issuances.
  • The amendment takes effect upon approval and publication in the Official Gazette or a newspaper of general circulation.

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