Carry out, and conclude, dialysis therapy for individuals with established access

This standard covers initiating, carrying out and concluding dialysis therapy, both haemodialysis and Continuous Ambulatory Peritoneal Dialysis, for chronic, stable, dialysis individuals who have established access. The therapy can occur in a number of settings including the individual's home, hospital or any other care setting.

This standard is not intended to cover acute cases and does not include inserting, connecting, monitoring and disconnecting cannulae and catheters.

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1. access and accurately interpret all relevant work instructions and information
2. work safely at all times and in accordance with all relevant legislation, guidelines, policies, procedures and protocols
3. deal promptly and effectively with any problems within your control and report those which cannot be solved
4. identify and minimise hazards and risk in the workplace
5. communicate with the individual and key people at a pace, in a manner and at a level appropriate to the individual's understanding, preferences and needs
6. respect the individual's rights and wishes relating to their privacy, beliefs, and dignity
7. provide support to the individual and ensure health and safety measures are implemented at all times
8. check the individual's identity and confirm the planned activity
9. gain valid, informed consent from the individual in accordance with specific procedures
10. confirm that dialysis equipment and material are appropriate to the procedure and fit for purpose
11. initiate dialysis correctly and safely according to the individual's plan of care
12. recognise any problems with the dialysis access site for dialysis promptly and take the appropriate action without delay
13. monitor the progress of dialysis effectively and adjust the process correctly in accordance with the individuals plan of care
14. take physiological measurements accurately using the correct technique and equipment at appropriate times according to the plan of care
15. seek immediate advice if any change or unexpected occurrence in the physiological readings are observed
16. interpret the measurements accurately, record them correctly using the required format and report them to the appropriate member of the care team
17. inform an appropriate member of the care team without delay if you are unable to obtain the measurement in the specified way
18. record any unexpected change in the individual's behaviour or condition or the equipment parameters accurately and report them to the appropriate person without delay
19. report any condition or behaviour which may signify an adverse reaction to dialysis without delay and take action appropriate to the individual's condition
20. conclude the dialysis safely and correctly when specified in the plan of care
21. disconnect the dialysis equipment from the individual safely and correctly, and in line with manufacturer's instructions and protocols
22. complete and store all relevant documentation in accordance with organisational requirements

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1. the current legislation, guidelines, policies, procedures and protocols which are relevant to your work practice and to which you must adhere
2. the scope and limitations of your own competence, responsibilities and accountability as it applies to your job role
3. how to access and interpret all relevant work instructions and information
4. specific procedures for reporting issues which are beyond your competence, responsibilities and accountability
5. the duty to report any acts or omissions that could be unsafe/detrimental to you or others
6. the hazards and risks which may arise during the execution of your work role and how you can minimise these
7. how to adapt communication styles in ways which are appropriate to the needs of the individual  
8. the correct use of any equipment and PPE to protect the health and safety of you and others
9. the principles, practice and procedures associated with informed consent
10. the needs of individuals including issues relating to dignity, confidentiality, and privacy
11. organisational management structures, roles, and responsibilities
12. the importance of applying standard precautions to carrying out and concluding dialysis therapy for individuals with established access and the potential consequences of poor practice
13. the normal anatomy of the kidney and physiology of blood filtration and urine formation
14. the principles of diffusion and osmosis in relation to dialysis
15. fluid and electrolyte balance
16. the reasons for undertaking dialysis
17. the information contained within the plan of care
18. how to recognise contra-indications which mean that you should seek advice before continuing with preparation of individuals
19. the types of emotional and physical support which different individuals may need during, and following, dialysis
20. the types of change which may happen to individuals - both physical and emotional - and why it is important to recognise and report any changes
21. what information needs to be recorded and reported in relation to preparing individuals for dialysis
22. what aspects of dialysis need to be monitored and adjusted
23. which physiological measurements need to be measured at which stage(s) of dialysis, why it is important to take the relevant physiological measurements, and why they need to be recorded at the times specified in the plan of care
24. the range of results which would be expected for different individuals, what constitutes an abnormal result
25. why unexpected or abnormal results should be reported immediately and how the measurements obtained can affect the therapy being undertaken
26. how individuals and relevant others could be involved in taking measurements and why it is important to encourage their involvement
27. the common adverse reactions to dialysis, how to recognise them and what action to take if they occur
28. the common concerns which individuals may have regarding dialysis and the way in which it affects their lives
29. the importance of timing for dialysis, and the reasons why the length of therapy may be altered in the plan of care
30. the nature and function of haemodialysis machines and related equipment, the different types of machine which are available and their advantages and disadvantages for different individuals' conditions and needs
31. the equipment used in peritoneal dialysis and how this method of dialysis works
32. the different types and sites of dialysis access* *which individuals may have and the advantages and disadvantages of each

33. the reasons why:

    • a safe, treated water supply is needed for haemodialysis
    • specific sterile fluids must be used for peritoneal dialysis
      

34. how to check whether the machines and related dialysis equipment are functioning properly

35. relevant procedures for reporting faults and other problems with equipment and materials
36. what parameters on haemodialysis machines have to be set according to each individual's care plan and methods of setting controls
37. the sorts of access problems which may occur, how to recognise them and what action to take
38. the techniques and equipment to use for taking the different physiological measurements
39. how to disconnect the individual from dialysis
40. how to clean and/or disinfect machines and equipment, including what materials and cleaning techniques to use
41. how to complete and safely store all relevant documentation in accordance with organisational requirements

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2

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2026

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Current

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Original

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Skills for Health

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SFHCHS26

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Health and Social Care, Health and Social Services Officers, Health Associate Professionals, Health Professionals, Health, Public Services and Care, Healthcare and Related Personal Services

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2259

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Dialysis, therapy, access, conclude

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