Abstract Type : Oral presentation
Abstract Submission No.: A-1045
Abstract Topic : Dialysis
Standards for Facilities and Operations of Hemodialysis Units in Korea
Do Hyoung Kim1, Young-Ki Lee1, Myung-Gyu Kim2, Kyung Don Yoo3, Won Min Hwang4, Young Geon Ji5
1Department of Internal Medicine-Nephrology, Kangnam Sacred Heart Hospital, Korea, Republic of
2Department of Internal Medicine-Nephrology, Korea University Anam Hospita, Korea, Republic of
3Department of Internal Medicine-Nephrology, Ulsan University Hospital, Korea, Republic of
4Department of Internal Medicine-Nephrology, Konyang University Hospital, Korea, Republic of
5Department of Preventive Medicine, CHA Bundang Medical Center, Korea, Republic of
Objectives : The purpose of this study is to establish evidence-based standards for the facilities and operations of hemodialysis (HD) units in Korea, with a focus on patient safety, infection prevention, and quality assurance, given the limited national regulations regarding staffing, infrastructure, and operational requirements for HD units.
Methods : The standards were developed through a nationwide survey of HD units in Korea, a review of domestic evidence on facility standards and clinical outcomes, and an appraisal of international guidance on HD unit facilities and operations. The proposed standards were organized into three domains—personnel, facilities, and operations—and classified as mandatory or recommended according to clinical importance, feasibility, and expert consensus.
Results : A total of 211 HD units were included in the survey. Overall, the findings demonstrated substantial variability in infrastructure and operational preparedness across institutions, particularly in backup power systems, fire safety measures, and dialysis room space. Mandatory items included HD-trained physicians and dedicated nurses; a minimum treatment area of 6 m² per bed; handwashing facilities; backup power capability; emergency equipment, including a laryngoscope, oxygen supply, suction equipment, electrocardiogram monitor, and defibrillator; regular testing of dialysate quality; routine laboratory assessment, including dialysis adequacy; periodic quality evaluation; fire safety inspection and maintenance; and infection control measures for hepatitis B and other transmissible diseases. Recommended items included dedicated support spaces such as water treatment and medication preparation rooms, an independent dialysis unit with accessible emergency exits, a bed-to-bed distance of at least 0.8 m, universal masking and prohibition of eating or drinking in HD unit, and patient isolation or cohorting when transmission risk is suspected.
Conclusions : In Korea, national standards for HD unit staffing, facilities, and operations remain limited. Comprehensive standards are needed to improve the safety and quality of care for patients with end-stage kidney disease.
Methods : The standards were developed through a nationwide survey of HD units in Korea, a review of domestic evidence on facility standards and clinical outcomes, and an appraisal of international guidance on HD unit facilities and operations. The proposed standards were organized into three domains—personnel, facilities, and operations—and classified as mandatory or recommended according to clinical importance, feasibility, and expert consensus.
Results : A total of 211 HD units were included in the survey. Overall, the findings demonstrated substantial variability in infrastructure and operational preparedness across institutions, particularly in backup power systems, fire safety measures, and dialysis room space. Mandatory items included HD-trained physicians and dedicated nurses; a minimum treatment area of 6 m² per bed; handwashing facilities; backup power capability; emergency equipment, including a laryngoscope, oxygen supply, suction equipment, electrocardiogram monitor, and defibrillator; regular testing of dialysate quality; routine laboratory assessment, including dialysis adequacy; periodic quality evaluation; fire safety inspection and maintenance; and infection control measures for hepatitis B and other transmissible diseases. Recommended items included dedicated support spaces such as water treatment and medication preparation rooms, an independent dialysis unit with accessible emergency exits, a bed-to-bed distance of at least 0.8 m, universal masking and prohibition of eating or drinking in HD unit, and patient isolation or cohorting when transmission risk is suspected.
Conclusions : In Korea, national standards for HD unit staffing, facilities, and operations remain limited. Comprehensive standards are needed to improve the safety and quality of care for patients with end-stage kidney disease.