DIALYSIS NURSE TRAINING LOGBOOK

TRAINING CENTER

TRAINEE NAME

MOBILE NUMBER

PRECEPTOR NAME

MOBILE NUMBER

DATES OF PLACEMENT
 AFRICA HEALTHCARE NETWORK
Africa Healthcare Network (AHN) is the first and largest dialysis chain across Sub-
Saharan Africa, providing high-quality dialysis at an affordable cost.

Our goal is to bring world-class technical expertise combined with developing world
practical operating experience to a region in dire need of quality dialysis treatment. This
is achieved by bringing together a strong and experienced team committed to bring
sustainable change to those affected by kidney disease in Africa.

Mission
We are committed to providing best-in-class renal care across sub-Saharan Africa using
state of the art technology and a highly skilled clinical and non-clinical team in order to
create an affordable cost setting and increase access for our patients

Vision
To establish the largest renal care provider in Africa pioneering high quality patient
centric care, increasing access to care and awareness for patients via decentralized
healthcare, and reducing the daily burden to patient lives.

Values
As an organization, these are the values we live by on a day – to - day basis and whole
each other accountable for.

Patient First Providing high quality care to our patients is our number 1 priority

We hold ourselves to the highest standards of ethics

Integrity
We believe transparency is essential to success, from sharing
Transparency
feedback to being open about how our operations work.

Achievers We are not afraid to push the boundaries and grow as a team

Data Driven We look to bring data to drive all key decisions and to assess
our progress and performance.
Teamwork We work together to achieve our goals
 Dialysis Nurse Training Practical objectives
This document highlights minimum objectives to be met by a nurse trainee during
practical training period at Muhimbili National Hospital (MNH).

The nurse trainee is responsible for accomplishing all the objectives and should
effectively collaborate with MNH staff to gain competency in all the fields.

• Properly performs RO System start up and shut down procedure

• Properly performs the water hardness test
• Properly performs the chlorine/chloramine test
WATER TREATMENT • Properly reads the total dissolved solutes meter (TDS Test)
PROCEDURES • Properly reads pressure drops and RO conductivity
• Properly records RO rejection and product flow rates
• Properly documents performance and operating parameters
• Properly performs bacterial culturing of water treatment system
(Water sample collection)
• Properly reports to the in-charge nurse/administrator and
technical water treatment deviations and abnormal quality test
results
• Proper change of 5- and 10-micron filters
• Salt addition in Brine Tank
• Troubleshooting RO alarms..; Example ;Water dry alarms, RO
pumps air-suck malfunction etc.
• Observe and participate in changing of RO Membrane
• Properly Monitoring water PH
• Participate in Checking water Conductivity
• Properly do RO reporting and shift handover process
• Properly perform RO tanks-Back wash

LOOP DISINFECTION • Perform loop disinfection procedure according to MNH Protocols

• Proper refiling RO water to the storage tank after procedure
• Perform recommended post loop disinfection tests according to
MNH Protocols

• Proper documentation in the medical record beginning at the

start of hemodialysis as per MNH protocols
• Understanding of release of information from patient medical
DOCUMENTATION record
• Proper arranging the patient`s file according to MNH protocols
• Proper Crash cart management
• Proper fridge medication documentation
 • TPC filling

• Proper assessing general condition of the patient prior to Rx

• Proper assessing edema and difficulty in breathing to CKD pt.
PHYSICAL ASSESSMENT
• Proper assessing pain by using pain scale to CKD patient
• Proper assessing pre weight and intra dialytic weight gain to CKD
• Proper removal of UF from CKD patient
• Proper applying methods of assessment e.g., inspection,
palpation, Auscultation & fluid assessment to CKD patient
• Properly perform pre and post dialysis patient assessment.

• Proper assessing vascular access by using three methods

inspection, palpation, auscultation
VASCULAR ACCESS CARE
• Properly cleans the site with appropriate disinfectant (spirit
&iodine)
• Properly cannulates fistula at 25 angle (may depend with AVF
depth)
• Proper assess for any signs of fistula failure
• Properly performs pre-dialysis CVC care (as per protocols
• Properly performs post dialysis vascular access care
• Properly uses appropriate needle gauge size
• Properly demonstrates butterfly taping
• Properly assesses access for function and cessation of bleeding
from the sites
• Proper education on fistula and catheter care

• Properly evaluates a clotted dialyzer & dialyzer blood leak

• Properly replaces a dialyzer
• Properly responds to arterial & venous pressure alarms
TECHNICAL PROBLEMS • Responds properly to blood flow problems
• Properly performs the emergency termination of dialysis
• Responds properly to hematoma formation or infiltration

• Properly labels specimens & properly fills out forms

• Good technique collecting blood sample from arterial blood line
port
LABORATORY • Properly obtains blood specimen for transfusion
PROCEDURES • Properly obtains specimen for blood cultures
• Properly packs and prepares specimens for transport
 • Appropriate use of barrier precautions
• Properly disposal of waste
INFECTION CONTROL & • Appropriate cleaning and disinfecting of surfaces and
MANAGEMENT equipment in the unit
• Properly performs body fluids spill disinfection procedure
• Properly Performing hand washing technique in the unit
• Properly performs isolation procedure for patient care during
dialysis
• Properly performs and/or verbalizes airborne precautions
• Performing aseptic technique
• Adequately manages a patient with catheter related infection
• Properly performs system start up procedure
• Proper lining and priming
• Properly performs alarm systems function test
OPERATION OF HD • Properly performs manual conductivity test
MACHINE DELIVERY • Properly performs basic operator troubleshooting
SYSTEM • Properly cleans and disinfects exterior of machine
• Proper initiating machine rinse and disinfection according to
MNH protocols
• Perform patient starting and closing of dialysis according to
MNH
• Proper preparation of disinfectants used in HD machine
according to MNH Protocols
• Proper setting machine parameters
• Proper setting UF AND Na+ profiling to HD machine

• Proper preparation of various types of heparinization

according to MNH protocols
HEPARIN PREPARATION
• Proper use of heparin administration methods
&CATHETER LOCK • Indications of using specific types of heparinization to CKD
patient
• Proper catheter lock according to MNH protocols

• Responds properly to hypotension

RISKS OF HEMODIALYSIS • Responds properly to hypertension
COMMON • Responds properly to patient cramps
COMPLICATIONS • Responds properly to patient complaints of chest pain
• Responds properly to patient complaints of nausea and vomiting,
• verbalizes disaster and emergency readiness
• Recalls and/or responds properly to hypoglycemia
 • Recalls and able to identify early dialysis line clotting
• Demonstrates emergency termination of dialysis and rationale
• Properly manages a patient with catheter related infections
• Recalls and/or responds properly to blood flow problems

MANAGING UNCOMMON • Recalls and/or responds properly to an air embolism

DIALYSIS COMPLICATIONS • Recalls and/or responds properly to anaphylactic reactions
• Recalls and/or responds properly to cardiac/resp. arrest
• Recalls and/or responds properly to hemolysis
• Recalls and/or responds properly to angina
• Recalls and/or responds properly to arrhythmias
• Recalls and/or responds properly to back pain
• Recalls and/or responds properly to a blood loss
• Recalls and/or responds properly to crenation
• Recalls and/or responds properly to difficulty with needle
insertion
• Recalls and/or responds properly to disequilibrium syndrome
• Recalls and/or responds properly to a seizure
• Recalls and/or performs blood transfusion during dialysis

ADMINISTRATION OF • Properly recalls the five rights of administering medications

MEDICATIONS • Properly reads and checks medication label three times
• Properly documents the administration of medications on flow
sheet
• proper aseptic technique preparing and administering
medications
• Properly verifies the medication prescription and patient
• Demonstrates understanding of Iron and EPO administration
protocols in the unit
• Performs administration of medications during dialysis
• Demonstrates understanding of drug dialyzability

CRASH CART • Understands all the drugs in the crash cart and how to use them
in an emergency
• Able to adequately monitor and document crash cart drugs
• Understands protocols for crash cart inventory.

NUTRITION • Properly performs and documents Malnutrition and Risk

Assessment for patients
• Demonstrates understanding of FFQ for protein
 • Demonstrates understanding and application of MIS and SNAQ
scores
• Demonstrates understanding and application of anthropometric
measurements

PATIENT EDUCATION • Performs patient education on therapy regimen and adherence

• Performs patient education on complications related to HD
• Performs patient education on diet and fluid intake
• Performs patient education on vascular access care

OTHER PROCEDURES • Care of critical ill patients in HD i. e. ICU patients.

• Care of special group; such as pregnant women in HD
• Dialysis unit set up.
• Properly endorses over patient assignment before leaving the
floor in a consistent manner.
• Completed handover of the shift when leaving the unit in a timely
manner.
• Completed all in-services and schedules
• Effectively communicates with patients, families, and
multidisciplinary team members.
• Refers problems/issues to appropriate multidisciplinary team
member.
• Demonstrate understanding and engagement in the inventory
meetings
• Demonstrate engagement in CNE webinar discussions
• Demonstrates understanding of principles of patient scheduling
and scheduling patients for treatment with lead nurses
• Understand the principles of patient file management and
documentation; demonstrates correct management of patient
documentation
 NOTE:It is the responsibility of the nurse trainee to ensure all
procedures and activities done are recorded and signed by the mentor
daily. Below is an example of how to record.

Date From To Hours Activities/Procedures Preceptor Name

& Signature

16/02/2024 7:00AM 3:00PM 8HRS AVF CANNULATION M. Maua

EDUCATION ON ACCESS CARE

RO MONITORING

MACHINE DISINFECTION

17/02/2024 7:00AM 3:00PM 8HRS LOOP DISINFECTION

ACCESS ASSESSMENT METHODS A. Kelakela

RO REPORT AND HANDOVER

MONITORING MACHINE ALARMS

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& Signature
 END OF TRAINING COMMENTS

Name:

Nurse Trainee Signature:

Date:

Name:

Preceptor Signature:

Date:

Name:

Training Manager Signature:

Date: