The policy and procedure manual is not only a legal requirement but also a very handy tool for dialysis staff to make certain that there is consistent patient management. Additionally, with the looming accreditation review that the hospital was facing our challenge was to bring the unit policies and procedures in to the 21st century. The aim of this poster is to explain the hardships of creating all the policies from scratch, dispelling any "that is what I was told" myth and also ensuring that we met the strict hospital guidelines on policy writing. Furthermore that each policy needed to have evidence based prastise and at least 2 reviewers.