Keywords Water test
IFU
ifu indicates instructions for use
MICRONS
microns are the unit of measure for filter pores. filters with high micron sizes trap large particles and allow smaller particles and allow smaller particles to flow through a submicron filter may be required to capture very small particles
REJECT WATER
reject water is the waste or reject stream that is sent to the drain along with the solutes removed by reverse osmosis
EMPTY BED CONTACT TIME
Empty bed contact time is the time period during which feed water must remain in contract with the charcoal bed in a carbon tank during water treatment. feed water must remain in contact with the charcoal long enough to allow adequate removal of chlorine and chloramines. aami standard for carbon tanks is 10 minutes total ebct
MEMBRANE FILTERS
Membrane filters are water treatment cartridges containing thin membranes with pores of specified size. Membrane filters remove small particles and some solutes
FILL VOLUME
fill volume is the quantity of treated water plus the number of bags of acid base powder required to produce the total volume of acid base concentrate as stated by the manufacturer.
FILTERS
filters are devices that remove particles, solutes and other substances of a given size by passing them through holes of various sizes.
TOTAL CHLORINE
free chlorine hypochlorite ion aka bleach combined chlorine chloramines free chlorine is unbound and combined chlorine is bound chlorine plus ammonia chloramines the safe level of total chlorine is 0.00-0.09 ppm an unsafe level of total chlorine is at or above 0.10ppm
SEDIMENT FILTER MULTIMEDIA
sediment filters are one of the most common means of removing particles
THE PRE TREATMENT OF THE RO SYSTEM
sediment filters are used prior to the carbon filters.
PRECIPITATE
see scale
TEMPORARY LABLELING
temporary labeling is labeling to mix tanks that will need to be changed as the contents of the mix tanks change unattended mix tanks containing solutions must have a sign displayed that identifies the solution in the tank and the label must be conspicuous and noticeable
BREAKTHROUGH
test results after the first carbon filter that indicate a level at or above the action level 0.0. these results are documented on tcl1 long only once a line i p[laced through all unused documentatiion sites on the tcl 1 log and tcl log is then started
DIRECT FEED
A water system design in the facility that does not have a holding storage tank. examples of direct feed are acute dialysis settings and home hemodialysis
ADSORPTION
Adsorb means to attract and hold on a surface. Adsorption is the binding of chlorine and chloramine molecules to the granulated activated carbon surface. The gac attracts chlorine and chloramines to the surface of carbon like a magnet
BRINE TANK
Brine is concentrated saline solution. water softeners require brine tanks. the brine tank holdz salt pellets and water. the salt and water create the solution to regenerate the softener exchange the magnesium and calcium ions for sodium ions
CONDUCTIVITY
Conductivity is the ability of a fluid to transfer electrical charge it is a measure of ions in solution. A conductivity meter measures the electrolyte composition of dialysate to be sure it is within safe limits
DEIONIZATION TANK DI
DI is usually an emergency backup to the RO system and is rarely used as the primary water treatment , A deionizer uses beds of resin beads to remove unwanted ions from water, the unwanted ions are exchanged for hydrogen and hydroxide ions to form water. water used for dialysis will be free of ions that could affect the conductivity of dialysate
FEED WATER
Feed water is water before it passes through a water treatment system feed water must pass through the various components of water treatment system before being used for dialysis
GRANUFLO
Granuflo is powered acid concentrate or the liquid acid concentrate after reconstitution
GAC
Granulated Activated Carbon gas filters are the primary method used in hemodialysis water purification systems to remove total chlorine gac removes total chlorine through adsorption. these filters must be maintained and monitored
HMIS
Hazard materials identification system. this permanent labeling required on sds equipment uses colored bars numbers and symbols to alert staff of hazards of chemicals
HEAD TANKS
In gravity feed solution delivery systems, concentrates acid and bicarb are pumped into this equipment for delivery to patient stations
PRODUCT WATER
Product water is water that has been forced through a reverse osmosis membrane
HEMODIALYSIS CONCENTRATED DISSOLUTION UNIT
See granuflo mixer
MICROBIOLOGICAL TESTING
Testing to determine if microorganisms are present at a specific site. testing is used as a means of monitoring for compliance with fmcna and aami standards . microbiological testing helps ensure patients safety ensure aami quality water and dialyisate in regard to endotoxins and bacteria
FREQUENCY OF ROUTINE CHLORINE TESTING
The frequency of total chlorine testing for routine documentation is prior to the beginning of the first patient treatment and not to exceed every four hours
LOW RANGE LR
The hach colormeter should always be set in low range lr always verify the low range setting before using the hach meter to check total chlorine
ALTERNATIVE WATER SUPPLY
This plan is approved by the medical director, and provides instructions for the facility should the municipal water supply be interrupted, the plan also ensures that the facility always provides water that meets AAMI standards for dialysis, even if one or more components of the locations water treatment system should fail. this plan should be posted in the water treatment area
0.00-0.09 parts per million ppm
Total chlorine levels that are within the safe range for our patients
HYDROMETER
a device used to measure specific gravity of acid concentrate after mixing. the specific gravity must be +/-2% of expected range after mixing acid concentrate
WATER SOFTNER
a water softener is used in water treatment to reduce the concentration of the calcium and magnesium that form scale soften hard water water softeners work by a process called ion exchange ions of calcium and magnesium are removed from the water by a bed of electrically charged resin beads and traded for sodium ions which form sodium chloride
INDIRECT FEED WATER
a water system design in the facility that has a holding storage tank
ACTION LEVEL
an action level is a level that necessitates taking corrective measures. the action level for total chlorine is 0.10ppm which necessitates corrective measures to be taken to restore water to a safe range 0.00-0.09ppm
ULTRAFILTER
an ultra filter is used to control and remove particulate bacteria endotoxins pyrogens and other microorganisms it controls and removes particulates and microorganisms that may be present in the water system and harmful to our patients
DEPTH FILTERS
are a type of sediment filter that may contain one or more layers of fibrous material or mesh each layer finer than the one before, to trap smaller and smaller particles. These filters can remove nearly all floating particle from the feed water
SEDIMENT FILTERS
are components of dialysis water treatment systems that trap undissolved particles such as sand and mud before that can reach the reverse osmosis membrane and damage it
AAMI
association for the advancement of medical instrumentation. AMMI developes voluntary standards for various aspects of dialysis treatment, including maximum levels of water contamination
BACKWASHING
backwashing means forcing water backwards through a filter this technique can be used to remove accumulated particles from clogged sediment filters in a water treatment system.
BICARBONATE MIXER
bicarbonate is a buffer. in the body it is used to neutralize acids that form when the body breaks down protein and other foods. it is reabsorbed by healthy kidneys. Dialysis patients often have low levels of bicarbonate because their kidneys do not reabsorb enough bicarb is used in dialysate to help restore levels of bicarbonate in the body
CARBON TANK
carbon tanks are water treatment devices that contain granular activated carbon that adsorbs low molecular weight particles from water carbon tanks are used primarily to remove chlorine, chloramines pesticides and industrial solvents, and some trace organic substances from water used in dialysis
THE FILTER BED
contains multiple layers with each layer retaining progressively smaller particles, Particles as small as 10 microns in size can be removed . these are not required at all facilities
INITIAL VOLUME
initial volume is quantity of treated water in the mix tank prior to the addition of bicarbonate concentrate powder.
ION EXCHANGE
ion exchange is a process that occurs inside a deionizer for water treatment. unwanted ions are traded for hydrogen and hydroxyl ions to create pure water
15 minutes
length of time the reverse osmosis RO has to be running before water samples can be obtained for RO sample and total chlorine testing.
PERCENT REJECTION
percent rejection will provide an indication of how effective the ro machine is at removing contaminants from the incoming water. percent rejection must be 95% at the time of installation and whenever membranes are replaced action must occur if there is a radical change in the ro percent rejection as well as unscheduled aami chemical analysis taken when the ro percent rejection reaches 95% 90% 85% and 80%
PERMANENT LABELING
permanent labeling is labeling that is intended to remain on the equipment at all times
DELTA PREESSURE -PRESSURE
pressure gauges on different pieces if water treatment equipment must be monitored by measuring the delta pressure. the standard delta pressure is established by taking the pre-filter pressure of a new filter and subtracting the post-filter pressure. the allowable limit will be the filters standard delta pressure + 10psi OR + manufacturer limit whichever is less. Action should be taken on any parameter that is exceeded according to manufacturers guidelines and FMC guidelines to insure our water system is providing quality water for our patients at all times
RPC ULTRA LOW TOTAL CHLORINE STRIPS
rpc strips are another method of testing for total chlorine in water. these strips are used as a backup if the hach colorimeter is out of service in certain circumstances it may also be used at some facilities as the primary method of testing
SCALE
scale or precipitate is solid particles that settle out of a solution such as water dialysate and can clog pipes or damage components of the water treatment system hard water which contains more minerals and salts can form scale
SEDIMENT FILTER CARTRIDGE TYPE
the cartridge type sediment filter consists of a cylindrical cartridge of filter medium wit ta central drainage core. they filter out particles from the feed water and also catch carbon finds the water softener resin
HACH POCKET COLORIMETER
the hach colorimeter is a type of meter that is used to test for total chlorine. it is the primary means of testing total chlorine. the hach colorimeter is important because the water used to prepare dialysate must be maintained between 0.00-0.09 of total chlorine
COLONY FORMING UNITS CFU
the number of colony forming units in a water ore dialysate sample is a measure of the number of living bacteria
REVERSE OSMOSIS
the ro machine removes dissolved inorganic solutes larger organic solutes molecular weight greater than 200 microbiological contaminants such as endotoxins viruses and bacteria and particles from the feed water. because of the broad spectrum of solute rejection ro is an important process in the purification of water in hemodialysis in the ro machine, pressure is applied to the incoming water when the pressure that is applied to the semi permeable membrane overcomes the osmotic pressure of the solution the water then travels across the membrane in reverse of the natural occurrence of osmosis
SPEC SPEC CHECK COLOR STANDARD KIT
the sample cells vials in this kit are used to validate the hach colorimeter daily to ensure total chlorine is within the safe range 0.00-0.09ppm
SDS
the solution delivery system is a device used to mix and or deliver dialysate concentrate solutions to single patient dialysis machines. sds consists of the bicarbonate mixt tank, bicarbonate and acid head tank and distribution loop acid and bicarbonate the sds is a gravity feed or pressurized concentrate delivery system
TEMPERATURE BLENDING VALVE
the temperature b lending valve mixes hot and cold water to an ideal temperature of 77 degrees farenhieght the temperature should stay at this level. a decrease in temperature will decrease the efficiency of a reverse osmosis membrane a temperature gauge thermometer is placed downstream from the temperature blending valve as a monitor
TOTAL VOLUME
the total volume is defined as the quantity of treated water plus the contents of bags or cartons of natural lyte label for the 4000 series 1 carton=8l, 1 bag=96l
VALVE PANEL
the valve panel is a panel or wall box where bicarb concentrate acid concentrate and ro water are centrally delivered for use by hemodialysis machines
WATER STORAGE TANKS
the water storage tank holds product water and sends it to the product water loop for use
BOOSTER PUMP
the water treatment system needs constant water flow and pressure. if flow or pressure drop from a centers water source. a booster pump may be used to increase them
TANK TYPE MULTIMEDIA
these are sediment filters that are also known as sand, depth, or bed filters, They are important in removing large particulate matter from incoming water
TOTAL CHLORINE TESTING ALGORITHM
this algorithm is a tool that can be used by staff in guiding them through routine testing and what to do when total chlorine results are at or above 0.10ppm
TCL-2 TOTAL CHLORINE LOG
this log is used for breakthrough documentation when total chlorine levels are 0.10ppm or greater after the first carbon tank
TCL-1 TOTAL CHLORINE LOG
this log is used for routine daily total chlorine documentation of safe ranges between 0.00ppm-0.09ppm
BACKFLOW PREVENTIVE DEVICE
to keep water from flowing backward into the incoming water supply, most cities require that the back flow device must be installed at the start of the water treatment system. this in turn keeps any contaminants taken out by the water treatment system from getting into the feed water
UV LIGHT
uv light administers a lethal dose of radiation to eradicate bacteria as a method of controlling bacterial proliferations in processed water., the uv light is located on the sds it is generally followed by an ultra filter to catch killed bacteria