View from the Chair: A Pictorial Guide to Managing Supplies and Setting Up a Room for PD
In the Home Dialysis Central Facebook Discussion Group (a closed group for our 6,800 members), newbies often ask, “Help! How do I set up a room for home dialysis?” This month, we will learn what folks have done for PD and next month for home HD. We’ll divide the content up into three sections: Supply Delivery, Supply Storage, and Room Organization.
PD Supply Delivery
The first delivery or two of PD supplies can be a shocker. Some have gotten as many as 50 heavy boxes! Later deliveries are not as large. Someone will need to be home to accept the delivery in a “window” of time that may be a range of hours, and the driver may be late, which can be frustrating. Who delivers the supplies matters, too:
If the boxes are brought by Baxter or Fresenius, the driver may bring them into the house and put them in the storage room, even if it is up or down stairs. For later deliveries, a driver can rearrange the boxes so the oldest ones will be used first.
If the boxes are brought by a “common carrier” such as UPS, the boxes may be left outdoors—even in the rain. This can pose a major challenge. If a large pile of boxes need to be moved, family, neighbors, or members of your faith community may step up. As a last resort, open the boxes and move one or two bags at a time to lighten the load. Keep the same type of bag together—they are color-coded.
A PD training nurse home visit will help sort out which room will work best to store supplies. Most likely, with a cycler, treatments will be done in a bedroom. Manual exchanges can be done in any room.
PD Supply Storage
In a home with large, spacious rooms, rooms that are not used, and/or empty closets, supply storage can be straightforward. Most boxes are the same size, so they stack nicely in a closet or against a wall. Some of the boxes can be in the PD treatment room, with the rest in a garage or basement, as long as it doesn’t freeze.
Not blessed with lots of space or closets? It’s time to get creative. Stack boxes in a closed cupboard. Take bags out of the boxes, so they take up much less room, and can go in bins or on shelves, keeping the same strength of solution together. The cupboard below makes use of a nook between two rooms.
No room for cupboards, either? Use space under the bed or in a dresser. Bags can go into rolling bins under bed bins. A heating pad placed in a bin can even keep bags warm and ready to use. Some have supply delivery every 2 weeks instead of once a month. This means more time waiting for a driver—but fewer supplies to store at a time. Or, line up the boxes neatly against a wall or two and cover them with a tablecloth or pretty sheet or hide them behind a screen.
PD Room Organization
The set-up for PD exchanges is a bit different. Most people use a cycler at night. A cycler needs to be next to a bed, with small supplies that will need to be handy. A nightstand or cart on wheels can make this easier. The height of the cycler may need to be adjusted up or down relative to the bed.
For manual exchanges, pop an IV pole somewhere that is convenient to a chair, sofa, or bed.
Comments
Jenn
Sep 26, 2023 2:45 PM
I'm not sure which cycler you're on, but yes, they do all have a STOP/PAUSE feature. It's really there for if you have to make a temporary disconnection-- to go to the bathroom, or get a snack, or something quick like that. You should run through how to do this without contamination with your nurse. Some PD systems have more than one sterile connector on the cassette so you can disconnect/reconnect to a fresh one every time. Some systems have additional connectors you can add on to the patient line for this same purpose. Other systems have a specific sterile and individually wrapped cap just to keep the patient line sterile during a STOP/PAUSE. The reason I say to check with your nurse to make sure that you're taught how to do this on your specific system is because making a mistake on a disconnect/reconnection pause would absolutely be a wet contamination and probably cause a peritonitis. Make sure you're super comfortable with your equipment and on/off technique first. There is usually an alarm that will sound if the cycler is in pause for more than a half-hour. :)
Patrick
Sep 24, 2023 4:17 AM