CHBT Infection Control and Disinfection Procedures 2 — Questions and Answers
Question 1: What chemical is most commonly used for disinfecting the internal fluid pathways of a hemodialysis machine?
- Peracetic acid or bleach (sodium hypochlorite) per manufacturer protocol (Correct answer)
- Alcohol-based solution
- Glutaraldehyde
- Quaternary ammonium compounds
Correct answer: Peracetic acid or bleach (sodium hypochlorite) per manufacturer protocol
Peracetic acid and sodium hypochlorite are the most widely used chemical disinfectants for hemodialysis machine internal pathways due to their broad-spectrum efficacy and compatibility.
Question 2: After using heat disinfection on a dialysis machine, the technician must verify the machine is safe for the next patient by:
- Completing the cool-down rinse cycle and confirming readiness indicators before connecting the patient (Correct answer)
- Testing the dialysate conductivity only
- Replacing all blood tubing
- Waiting 30 minutes with no further verification
Correct answer: Completing the cool-down rinse cycle and confirming readiness indicators before connecting the patient
Heat disinfection must be followed by a complete rinse and cool-down cycle, and the machine must signal readiness before patient connection to ensure safe dialysate temperature and no residual disinfectant.
Question 3: Standard precautions in hemodialysis require that blood and body fluids from ALL patients be treated as:
- Potentially infectious regardless of diagnosis or perceived risk (Correct answer)
- Infectious only if the patient has a known bloodborne disease
- Non-infectious if the patient tested negative last month
- Infectious only during active bleeding
Correct answer: Potentially infectious regardless of diagnosis or perceived risk
Standard precautions treat all blood and body fluids as potentially infectious to protect staff and patients regardless of known infection status.
Question 4: What is the significance of endotoxins in dialysis water?
- They are lipopolysaccharide fragments from gram-negative bacteria that cause pyrogenic reactions and inflammation in dialysis patients (Correct answer)
- They cause hepatitis C transmission
- They lower dialysate conductivity
- They destroy the dialyzer membrane
Correct answer: They are lipopolysaccharide fragments from gram-negative bacteria that cause pyrogenic reactions and inflammation in dialysis patients
Endotoxins from gram-negative bacteria can pass through some membranes and trigger fever, chills, hypotension, and chronic inflammation in dialysis patients.
Question 5: Which personal protective equipment (PPE) is required when handling concentrate containers and priming blood lines in a dialysis unit?
- Gloves and protective eyewear or face shield (Correct answer)
- N95 respirator and gown only
- Gloves alone are sufficient
- No PPE required for concentrate handling
Correct answer: Gloves and protective eyewear or face shield
Gloves protect against skin exposure and face protection guards against splashes of concentrate or blood during priming and handling procedures.
Question 6: How should a dialysis technician handle a machine that has been used by an HCV-positive patient?
- Follow standard machine disinfection protocols — no special additional procedures are required beyond standard precautions (Correct answer)
- Quarantine the machine for 24 hours
- Use higher-concentration disinfectant only
- Remove the machine from service permanently
Correct answer: Follow standard machine disinfection protocols — no special additional procedures are required beyond standard precautions
HCV is not efficiently transmitted via the dialysate pathway, so standard disinfection protocols are sufficient; dedicated machines are required only for HBsAg-positive patients.
CHBT Infection Control and Disinfection Procedures 2
What chemical is most commonly used for disinfecting the internal fluid pathways of a hemodialysis machine?