External Cleaning and Disinfection Protocol for Hemodialysis Machines

The hemodialysis machine is essential equipment for hemodialysis treatment. As it is used frequently by multiple patients over long periods, it is highly susceptible to contamination from blood, dust, and other contaminants. Particularly during cannulation, patient blood may splash onto the machine, and patients experiencing hypotension may vomit. Various pathogens can colonize the machine, and airborne particles are generated when changing bed linens. Whether contamination is visible or not, the machine must undergo thorough cleaning and disinfection.

Areas prone to blood contamination: 

• Machine surfaces near the cannulation site 

• Machine control screen 

• Control buttons 

• Machine base

Frequently touched surfaces (high-contact areas): 

• Dialysate connectors 

• IV pole 

• Machine top

I. Purpose of Cleaning and Disinfection 

To ensure the external surfaces of hemodialysis machines are free from stains and blood, maintain bacterial counts below national Class III environmental standards, and standardize routine disinfection procedures for relevant personnel.

II. Pre-Disinfection Assessment

Check machine surface contamination for blood, dust, or stains

Verify proper concentration of disinfectant in disposable disinfectant wipes

III. Preparation

1. Environmental Preparation
   Clean and quiet environment with adequate lighting, fresh air, and proper ventilation and air disinfection systems.

2. Staff Preparation
   Proper attire, hand hygiene, mask, cap, and clean gloves.

3. Equipment Preparation
   Top tier of treatment cart:

• Clean cloth or disposable disinfectant wipes

• 500mg/L chlorine-based disinfectant solution

• 2000mg/L chlorine-based disinfectant solution (as needed based on contamination level)

• 3000-5000ml container

• Box of clean gloves

• Rapid hand sanitizer    

• Hemodialysis machine cleaning and disinfection log

   Bottom tier of treatment cart:

• Contaminated waste container

• Medical waste bin

• General waste bin

IV. Operating Procedures and Instructions 

Note: Procedures may vary by machine model. Follow specific instructions for each model.
(The following procedure is based on Gambro AK200U)

Operating Steps:

1. After completing hemodialysis treatment, remove tubing

2. Assess machine surface contamination and prepare necessary materials

3. Wipe with disinfectant cloth:

   Table 1: Hemodialysis Machine External Disinfection Protocol and Surface Cleaning Procedures

   Surface Type	Disinfectant	Sequence	Procedure
   Regular Surfaces (No visible contamination)	500mg/L	First Surface	Screen and control panel Right side of machine
   		Second Surface	IV pole (top to bottom) Machine top surface ("M" pattern) Left side and left bichamber holder
   		Third Surface	Front (blood pump, pressure sensors, substitution pump, safety valve, heparin pump holder) Dialysate bypass connector and tubing
   		Fourth Surface	Solution A and B ports and tubing Dialyzer clamp Machine base
   Blood-Contaminated Surfaces	2000mg/L then 500mg/L	Two-Step Process	1. Clean with 2000mg/L wipes 2. Disinfect with 500mg/L wipes
   Infection Zone Surfaces (HBV, HCV, syphilis, HIV)	2000mg/L	Single-Step Process	Clean with 2000mg/L chlorine-based disposable wipes
   Clean-up Procedures	500mg/L	Post-Cleaning Steps	1. Place used cloths in contaminated waste container 2. Wash thoroughly 3. Soak in 500mg/L chlorine solution (30 minutes) 4. Rinse and dry for reuse 5. Organize supplies and sort waste 6. Record time and operator's name

4. Disposable disinfectant wipes are recommended, following the same wiping method and sequence

5. For infection zones (including HBV, HCV, syphilis, HIV positive patients), use 2000mg/L chlorine-based disposable disinfectant wipes

6. Clean-up:

1. Place used cloths in contaminated waste container, wash thoroughly, soak in 500mg/L chlorine solution for 30 minutes, rinse clean, dry for reuse

2. Organize supplies, sort waste appropriately

3. Record disinfection time and operator's full name

Operating Key Points:

• Have 2000mg/L chlorine solution ready based on contamination level

• Fold cloth in four, following "M" pattern in same direction, use different surfaces for different areas, avoid overlap

• Use one cloth per machine per person

• Pay attention to knobs, corners, and buttons

• Open blood pump cover to clean inside of pump door and rotor

• Clean machine back weekly with 500mg/L chlorine solution

• Mark opening date on disposable wipes to monitor evaporation

• For display screens, after using 2000mg/L wipes, wait briefly then clean with clean gauze to reduce corrosion

• Use dedicated cloths for different zones

V. Important Notes

• Cleaning principles: One person, one machine, one cloth; clean from top to bottom, left to right, clean to contaminated areas.

• Two critical cleaning times: Immediately after establishing extracorporeal circulation. After removing tubing and dialyzer.

• Use different surfaces of cloth/wipes, avoid reuse, prevent hand contact with machine surfaces.

• Clean hard-to-reach areas (blood pump, pressure sensors, safety valve) weekly using soft brush or cotton swabs.

• Use hand sanitizer and clean gloves between machines.

• After each use, clean machine surface with disposable, microfiber disinfectant wipes that have adequate friction and moisture content.

About Us

Wipestar specializes in manufacturing high-quality lint-free wiping cloths specifically designed for professional medical equipment cleaning. Our product line includes both dry and pre-saturated options, engineered to meet the stringent cleanliness requirements of medical devices and critical healthcare environments.