Transfer Set Change for Home Peritoneal Dialysis Patients

Important information for catheter procedures (PD patients):

Understanding procedures

• Know when and how to perform each procedure, especially after contamination.

• Pay attention if the clamps are open or if dialysis is happening during contamination. If so, antibiotics may be needed—your dialysis team will confirm.

• Contact your dialysis team to know which procedure is required.

Definitions

• Aseptic: Keeping things as clean as possible.

• Sterile: Germ-free.

Touch contamination

• Touch contamination happens when a sterile item (transfer set, catheter, or mini cap) touches something non-sterile, like your hands.

• This increases the risk of peritonitis.

• Be sure to know which cycler supplies are sterile.

Transfer set change

• Should be done every 6 months with your dialysis team.

• Also needed if the transfer set falls off or has a hole.

Titanium adapter change

• Performed at home if there's a hole or split in the catheter that can’t be fixed by changing the transfer set.

• Also needed if the titanium adapter disconnects from the catheter.

You'll get emergency procedure supply bags when starting home PD. Keep these bags stocked and in an easy-to-find place at home. Check expiration dates and let your dialysis center know when supplies need updating.

Instructions for transfer set change:

• Before starting, if transfer set becomes disconnected from the titanium adapter, be sure beta cap clamp is in place and apply sterile syringe to the exposed titanium adapter while preparing for the procedure.

• You may need a second set of hands to help with this procedure.

Prepare for the procedure 

1. Wash your hands before touching any of your supplies:

   • Turn on the water.

   • Wet your hands and wrists.

   • Use liquid soap from a pump dispenser. Work up a lather.

   • Scrub your hands thoroughly for at least 20 seconds.

   • Rinse your hands, keeping your fingers pointed downward toward the drain.

   • Dry your hands with a clean paper towel. Use this paper towel to turn off the faucet.

   • Once you have washed your hands, be careful only to touch your supplies. You must wash your hands again if you touch anything else, such as furniture or your clothes.

   • If you prefer, clean your hands using an alcohol-based hand sanitizer.

   • If you prefer, clean your hands using an alcohol-based hand sanitizer.

2. Gather supplies. Check expiration dates of supplies prior to using.

   • Minicap™

   • New transfer set

   • 4x4 sterile gauze

   • PVP prep solution (10% povidone iodine solution)

   • Sterile specimen container

   • Sterile syringe

   • Mask

   • Clean exam gloves

   • Blue chuck pad

3. Clean your work area

   • Keep pets and other children out of your work area.

   • Don't work in the bathroom. There are too many germs.

   • Clean washable surfaces with soap and water. Dry with a paper towel.

   • Wipe down non-washable surfaces (such as fabric or wood) to remove dust.

   • Spread a clean cloth, paper towel or blue chuck over your work surface.

   • Place your supplies on the clean, dry, covered work surface.

   • Put on a mask and wash your hands again, using step 1 above.

   • If you feel the need to sneeze or cough, turn away from your work surface.

Perform procedure

1. Carefully remove the cap from the sterile container and set it aside.

2. Pour the PVP (povidone-iodine) solution into the sterile container until the container is at least halfway full.

3. Open the sterile 4x4 gauze, Minicap, sterile syringe, and new transfer set packages. Do not remove these items from their packages to keep them clean.

4. Wash your hands again and put on clean gloves.

5. If a sterile syringe is attached to the end of the titanium adapter, remove it. If the transfer set is still connected to the titanium adapter, remove it.

6. Titanium adapter in PVP solution

   Titanium adaptor between gauze

   Carefully place the end of the titanium adapter into the sterile container with the PVP solution. Do not touch the titanium adapter.

7. Allow the titanium adapter to soak in the PVP solution for 2 minutes.

8. After 2 minutes, remove the titanium adapter from the sterile container.

9. Attach a new sterile syringe to the end of the titanium adapter.

10. Place the titanium adapter with the syringe attached between the sterile 4x4 gauze in its package and pat gently to remove excess PVP solution.

11. Carefully remove the new transfer set from its package, then remove the blue pull ring from the end. While holding the new transfer set in one hand, use the other hand to remove the sterile syringe from the titanium adapter. Be careful not to touch the end of the transfer set.

12. Attach the new transfer set to the titanium adapter by twisting it securely onto the adapter. Make sure it is tight.

13. Close the white twist clamp on the transfer set.

14. Remove the clear cap from the end of the new transfer set and replace it with the new Minicap.

Contact your CHOP dialysis team with questions or concerns.

• 8:30 a.m.-4:30 p.m., Monday-Friday call 215-590-2449.

• Outside of those hours, and on holidays, call 215-590-1000, ask the hospital operator for the nephrology fellow or PD dialysis RN.

Reviewed December 2024 by Rebecca Deady RN, BSN, CDN