As the Pink Floyd song goes, “all in all it’s just another brick in the wall”. That may be true for brick-and-mortar, but with Dialysis wall boxes, it’s a bit more complex. Dialysis wall boxes are recessed frames in the wall at each hemodialysis station that support connections for the dialysis machine to receive acid and base concentrates and treated water, and dispose of waste products. In a wet environment, these boxes pose a significant infection-control risk because they can become easily contaminated with microorganisms and subsequently transmit them to dialysis patients, who are vulnerable to infections. Our teams are finding dialysis wall boxes that are not being cleaned and disinfected during our surveys. Additionally, we are observing a buildup of sediment and residue that can harbor microorganisms. In one instance, we identified a persistent leak from a water connection in a wall box that, over time, had caused significant damage to the wall plaster beneath the dialysis hookup, creating an even greater infection-control risk. The area under the box was consistently wet. Furthermore, there was notable rust on the drainage pipe, which can harbor microorganisms and potentially cause blockages in the drain line.
These observations can present a significant finding during survey. The Centers for Disease Control and Prevention provides excellent guidance on managing dialysis wall boxes. (see https://www.cdc.gov/dialysis-safety/hcp/recommendations-resources/dialysis-wall-boxes-and-drains.html). Ensure that your dialysis team and infection prevention team collaboratively review your wall box cleaning and disinfection practices and frequently round on the condition of the wall boxes for opportunities. Make this routine for environment-of-care rounding. After all, it’s not just another brick in the wall.
Please contact us for questions or more information at 704-573-4535 or info@courtemanche-assocs.com.
Courtemanche & Associates specializes in Healthcare Accreditation and Regulatory Compliance Consulting Services. With over 30 years of being in business and 100+ years of healthcare experience amongst our consulting team, we are ready to assist with your accreditation and regulatory compliance needs.
