CCHT Quality Control 2

Question 1

What is the purpose of conducting monthly water quality testing in a hemodialysis facility?

Accepted Answer

To ensure treated water meets AAMI chemical and microbiological standards and prevent patient harm from contaminated dialysate

Answer

To determine water billing costs

Answer

To test for heavy metals only once per year

Answer

To verify municipal water supply compliance

Question 2

What does the term residual chloramine testing refer to and why must it be performed before every dialysis run?

Accepted Answer

Testing for chloramines remaining in dialysate water that could cause hemolysis if present above 0.1 mg/L

Answer

Testing for chemical residue left by dialyzer reprocessing agents

Answer

Testing for calcium and magnesium residue from previous sessions

Answer

Testing for residual heparin in the blood lines

Question 3

In dialyzer reprocessing, what does the fiber bundle volume (FBV) test assess and what is the minimum acceptable result?

Accepted Answer

The volume of the hollow fiber compartment, with a minimum of 80% of original volume required for reuse

Answer

The amount of sterilant remaining in the dialyzer after processing

Answer

The number of times a dialyzer has been reprocessed

Answer

The membrane permeability for large molecules

Question 4

What is the significance of dialysis adequacy targets (Kt/V 1.4 or greater) from a quality perspective, and how does this metric drive facility performance?

Accepted Answer

Kt/V measures dialysis dose delivery; facilities must achieve 1.4 or greater for 65% or more of patients as a CMS performance standard

Answer

Kt/V is a billing metric only and has no clinical significance

Answer

Kt/V is measured only for research purposes

Answer

Facilities must achieve Kt/V of 2.0 or greater for all patients

Question 5

What action is required when a hemodialysis machine fails its required disinfection process verification test?

Accepted Answer

Take the machine out of service immediately, notify biomedical engineering, and document the failure

Answer

Continue using the machine for stable patients only

Answer

Repeat the disinfection cycle once and proceed if the repeat passes

Answer

Use the machine for the next session and schedule maintenance for the following day

Question 6

What is the purpose of a root cause analysis (RCA) following a serious patient safety event in a dialysis unit?

Accepted Answer

To systematically identify contributing factors and implement system-level changes to prevent recurrence

Answer

To identify and punish the staff member responsible

Answer

To satisfy insurance requirements for documentation only

Answer

To determine if the facility needs additional staff