DE LA SALLE LIPA
COLLEGE OF NURSING
Nursing Care Management 118
Procedural Checklist in
Hemodialysis machine set up and Priming
Name: Year/Sec: Rating:
General Objective:
The student will be able to perform the complete and proper procedure of hemodialysis machine
priming and set up
Specific Objectives:
1. To identify safety checks and pre-dialysis patient evaluation before the procedure
2. To implement the correct techniques in setting up the dialysis machine
3. To set up and prime the blood lines correctly
CRITERIA:
Item Descriptors Verbal Interpretation
Weight
2.00 Excellent Performed the procedure with great ease and confidence,
observing work ethics (prudent, accepts criticisms and
suggestions), able to rationalize scientifically and shows
diligence in documenting observations at all times.
1.50 Very Good Performed the procedure with more confidence and requires
close supervision, observing work ethics (prudent, accepts
criticisms and suggestions), able to rationalize scientifically
and shows minimal diligence in documenting observations.
1.25 Good Performed the procedure with less confidence and requires
close supervision, observing work ethics (prudent, accepts
criticisms and suggestions), able to rationalize scientifically
and shows minimal diligence in documenting observations.
1.00 Needs Failed to perform the procedure, unable to function well and
Improvement needs repeated specific/ detailed guidance or direction.
I. Values Based 2.00 1.50 1.25 1.00 Remarks
1. Follow universal precautions: hand hygiene, donning of PPE.
Introduce self to the patient and perform pre-dialysis patient
evaluation:
-identity
-weight, VS, laboratory result/s
-access status: signs of infection, patency (bruit, thrill)
2. Check the doctor’s order. Explain the procedure to the patient
and place the patient in a comfortable position. Prepare all the
equipment needed:
- blood lines set (arterial, venous, saline/infusion lines)
- Plain Normal Saline Solution (PNSS)
- prescribed dialyzer and concentrate (if dialyzer is
reused: check labels)
- prefilled heparin syringe according to Doctor’s order
II. Knowledge Based
3. Turn the machine on and perform safety checks:
-machine safety
-integrity of extracorporeal circuit
4. Label the Acid and Bicarbonate mixtures correctly and place
them below the machine. Place the red conductivity port to the
Acid mixture and the blue conductivity port to the Bicarbonate
mixture.
5. Arterial line and Infusion line:
- Aseptically open the blood lines
- Clamp all the small white clamps
- Connect the infusion line to the arterial line port
- Find the longer line as a marker and connect the arterial
transducer cover to the nearest port
6. Clamp the big red clamp. Aseptically spike the saline line to the
Plain Normal Saline Solution. Position the arterial drip chamber
upside down to the arterial chamber holder then place the
Dialyzer end to the arterial dialyzer clamp holder.
7. Insert the blood pump segment to its housing and activate
the blood pump by long pressing the Prime Button. Insert the
transducer end to the corresponding port. Aseptically connect
the prefilled heparin syringe to the heparin line then secure
the syringe to the heparin chamber.
8. For the Venous line, clamp all the small clamps. Connect the
drainage bag to the patient’s end, finding the big blue clamp
as a marker.
9. Place the venous drip chamber upside down loosely to its
holder and attach the Dialyzer end to the venous dialyzer
clamp holder. Connect the venous transducer to the
corresponding port.
10. Prime the arterial line by pressing the Prime Button and stop
the priming process once filled with PNSS and no air bubble is
present.
11. Open the dialyzer caps while draining the contained solutions
to a receptacle. Connect the arterial dialyzer end and venous
dialyzer end to the dialyzer. Place the dialyzer to its holder
with the venous end up to easily expel air.
12. Prime the venous line while gently tapping the venous end of
the dialyzer to expel air bubbles. Once priming is done, clamp
both big clamps and disconnect the Patient’s venous end from
the drainage bag then connect the Patient’s Arterial and
Venous end to one another for recirculation.
III. Outcome Oriented
13. Unclamp both big clamps then turn on the bloodpump to start
recirculation. Once done, press the Test Button. Once testing
is complete, attach the couplings according to color codes:
blue to blue, red to red.
14. Place the drip chambers and the dialyzer to the correct
position and secure in place. Re-check the settings before
hooking the machine to the patient.
IV. Leadership and Governance
15. Reports in uniform with proper grooming and displays correct
decorum, observes work ethics and shows resourcefulness,
manifests great confidence in his/her work, shows diligence in
documenting observations
Comments / Strengths & Weaknesses:
Conforme: Evaluated by:
Margarita L. Mapalad RN, MAN
Student’s Signature Clinical Instructor’s Signature
Date: Date:
