Water Treatment for Hemodialysis: What You Must Know to Keep Patients Safe.

It is critical for all staff members to work together to keep patients safe. Nephrology nurses with responsibility for hemodialysis (HD) need to know and understand the clinical ramifications of water treatment and dialysate preparation. Although some HD programs may have full-time technical staff who operate and test the water treatment and dialysate preparation systems, many programs rely on nursing staff members for the dayto- day operation and testing of these systems. This article details the reasons safe water and dialysate are critical for patients on HD; and reviews components of water treatment systems, dialysate concentrate preparation, and the monitoring and testing necessary to assure that both water and dialysate are safe for patient use. Integrated HD systems (i.e., those that combine water treatment and dialysate preparation and delivery in an individual machine "package") are also described.