For patients with suspected or confirmed COVID-19 requiring intermittent hemodialysis in the acute care setting, dialysis should ideally be performed in the patient’s hospital room with the door closed. This serves to limit the patient’s movement within the hospital.
If the patient is to be dialyzed in the acute care dialysis unit, consider the following:
Transporting patient to the acute care dialysis unit
When a patient with suspected or confirmed COVID-19 is being transported to the acute care dialysis unit, ensure HCP adhere to recommended infection control practices. The patient should wear a facemask during transportation. Additional information about the personal protective equipment recommended for transport personnel is available here.
Dialyzing patient in an acute care dialysis unit isolation room
If the acute care dialysis unit has an isolation room, hemodialysis should be performed in the isolation room with the door closed. Hepatitis B isolation rooms should only be used for dialysis patients with confirmed or suspected COVID-19 if:
1) the patient is hepatitis B surface antigen positive or
2) the facility has no patients on the census with hepatitis B infection who would require treatment in the isolation room.
The isolation room should be terminally cleaned after the care of each patient with COVID-19. Please refer to Question 5 for cleaning and disinfection of dialysis machine, equipment, and supplies.
Dialyzing several patients with confirmed COVID-19 (cohorting) in a shared room in the acute care dialysis unit
In a situation where there are several patients with confirmed COVID-19 requiring hemodialysis (non-ICU), consider cohorting the patients on the same dialysis shift, preferably the last dialysis shift of the day to allow for terminal cleaning of the dialysis unit following treatment. If possible, patients without COVID-19 should not receive dialysis during the same shift (in the same room); if patients without COVID-19 are dialyzed at the same time in the unit, they should be kept at least 6 feet away from the COVID-19 patients at all times. Patients with confirmed or suspected COVID-19 should continue to wear their facemask during treatment and adhere to appropriate respiratory hygiene and cough etiquette. Please refer to Question 5 for cleaning and disinfection of dialysis machine, equipment, and supplies.