Instructions for Touch Contamination 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 touch contamination:

• Before starting, be sure to apply new MiniCap™ (small protective cap) to the end of the exposed transfer set so it is covered while preparing for 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.

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

   • MiniCap

   • 4x4 sterile gauze

   • Bottle of Alcavis® (sterile cleaning solution)

   • Sterile specimen container

   • Mask

   • Clean exam gloves

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. Transfer set in solution

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

2. Pour the Alcavis solution into the sterile container until the halfway mark.

3. Open the sterile 4x4 gauze but do not remove from package.

4. Open the new MiniCap, but do not remove from package.

5. Clean hands again and put on clean gloves, mask should remain on.

6. Remove the MiniCap from the end of the transfer set.

7. Carefully place the end of the transfer set into the sterile container with the Alcavis solution. Make sure the dark blue part is fully covered by the solution.

8. Allow the end of the transfer set to soak for 2 minutes.

9. After 2 minutes, remove the end of the transfer set from the sterile container.

10. Pat dry the end of the transfer set between the 2 sterile 4x4 gauze pads.

11. If not connecting to cycler, place new MiniCap on the end of the transfer set.

12. If starting dialysis treatment, connect patient to cycler tubing.

Tips to prevent touch contamination

• Wash hands thoroughly suing the protocol above

• Perform hand hygiene if you touched anything other than PD supplies during set up and disconnection

• Keep your cycler work area clean – clean the cycler with soap and water only

• Wear a mask for all bag and patient connections/disconnections

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 BSN, RN, CDN