Delivery of effective dialysis treatment is paramount within dialysis units.Our protocols set a minimum standard for us to deliver care.
Working in a Satellite Renal Unit where we do not have Renal Residents working with us,places us in a position that allows us to be autonomous in the delivery of dialysis treatment.

We have to initiate changes to treatment regimes on a frequent basis.Altering Heparin doses,Dialysate strengths and administrating IV fluid boluses where clinically indicated is a common occurrence.
Despite having protocols from our parent unit,St.Vincents Hospital,the Pharmceutical Advisory Committee at Werribee Mercy Hospital( WMH ) deemed it necessary to have a standing order to coincide with hospital protocol.

The WMH generic format wasused to generate standing orders for Dialysate,Heparin and Normal Saline treatments initiated by Renal trained nurses.

Current practise and protocols were used as a basis for review and adapted as a tool for the Standing Orders.During the process,a Renal Treatment Order chart was reviewed and guidelines documented for dialysis treatments.
A Renal Replacement Therapy chart is completed with current treatment and altered with every change made to treatment,signed by nurses and countersigned by the Consultant Nephrologist during regular meetings within the unit.

In conclusion,for those working in a Satellite Unit,the use of Standing Orders is a useful tool.It allows us as Renal Nurses to optimise patient's dialysis treatments within set guidelines and endorses autonomy and safe practise.