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COVID 19 Rapid Guidelines: Dialysis Service Delivery

Objective: To communicate the commandments for dialysis units.

The objective of the National Institute for Health and Care Excellence (NICE) guidelines is to maximize the safety of dialysis patients as well as to protect the staff from Coronavirus Disease 2019 (COVID-19).

Key Recommendations

  • Communicate with patients. Ask them or their carers to report any COVID-19 related symptoms before leaving home for the dialysis units. Minimize face-to-face follow ups and encourage telecommunications, medicine home-deliveries to promote social distancing.
  • Encourage patients to travel alone to the unit and minimize time in the waiting area.
  • Follow guidance on prevention and control for patients with known or suspected COVID-19.
  • Follow guidance on investigation and initial clinical management for testing and isolation of patients with symptoms of COVID-19 at presentation.
  • Follow guidance for prevention and control including information on using personal protective equipment for healthcare workers involved in receiving, assessing, and caring for patients with known or suspected COVID-19.
  • Collaborate with transport providers to ensure patients transport to and from dialysis units to ensure continuity in patient care, and to minimize cross-infection in patients.
  • Screen and triage all patients for known or suspected COVID-19 infection. Prepare and review facilities for dialysis and treatment of patients in cohorts based on their COVID-19 status.
  • Establish a multi-professional operational team lead by an executive to support COVID-19 planning, contingency staffing, safe provision of dialysis, and senior team oversight. Develop regional networks with other local or regional providers and share limited resources and best practices.
  • Use telephone or video consultations for meetings, remote monitoring, and follow up of vulnerable patients when workforce capacity is reduced. Prioritize safe staffing for dialysis services.
  • Continue and maintain provision of home dialysis. Evaluate the possibility of increasing home dialysis for new patients.
  • Have agreed protocols in dialysis units outlining restrictions, treatment recommendations, and risk assessment. Encourage and support shared care with patients and explain them the importance of remaining with regular dialysis unit.

Reference: National Institute for Health and Care Excellence (NICE). COVID-19 rapid guideline: dialysis service delivery. 2020. Available from: www.nice.org.uk/guidance/ng160.