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Routine Cleaning, Disinfection, Operation and Maintenance of the Gambro WRO 300 Portable RO (2.7)

Routine Cleaning, Disinfection, Operation and Maintenance of the Gambro WRO 300 Portable RO (2.7) - Policies, Clinical, UWHC Clinical, Department Specific, Hemodialysis

2.7

University of Wisconsin Hospital and Clinics
Inpatient Hemodialysis
Department 55400

TITLE: Routine Cleaning, Disinfection,
Operation and Maintenance of the
Gambro WRO 300 Portable RO

POLICY #:2.7
REVISED: October 2016
Page 1 of 6
Nurse Manager: Joan Watson, MS, RN
Director: Ann Malec, DNP, RN, NEA-BC
Medical Director: Alex Yevzlin, MD


I. PURPOSE

Control bacterial growth on the surfaces and internal fluid pathways of the Gambro WRO 300
Portable RO. Establish routine maintenance and operation procedures for the Gambro WRO 300
Portable RO and define safe operating parameters and documentation requirements.

II. POLICIES

A. Surface cleaning will be performed on the Portable RO equipment after each patient use
prior to leaving the patient bedside.
a. Cavi-wipes™ will be used for surface cleaning unless the patient is in isolation
for Clostridium Difficile, in that instance Clorax™ Bleach wipes will be used.
B. Routine cleaning, disinfection, and maintenance procedures will be performed on the
internal fluid pathways of the Portable RO machine in the Technician work room.
C. Check the RO Operation Log sheet prior to each use to insure disinfection and/or
maintenance procedures have been performed.

Procedure Name Frequency
“Flush” If not used every 2 days.
Minncare Disinfect Every 7-10 days
Particulate Filters Every 7-10 days
Carbon Filters Second carbon filter replaced and rotated each month
to primary carbon filter by Bio-Med tech.

D. Daily/routine cleaning, disinfection, operation and maintenance procedures performed on
the RO will be documented in the Log Book by the person(s) performing the procedures.
E. The RO Operation Log sheet will be completed prior to performing a hemodialysis
treatment after the machine is attached and running for at least three minutes. Normal
range values for measurements/test performed are listed at the top of the log sheet.
F. Do NOT use a portable RO with system parameter(s) outside the normal range. Notify
Dialysis Solutions Chief Technician at the phone number on top of the log sheet.





Page 2 of 6
III. GENERAL INFORMATION

A. Minncare™ is used for disinfect procedure is stored in the Tech room and expired one
year from the date of manufacturing.
B. Caviwipes™ or Clorox ™ Bleach wipes are used for cleaning equipment surfaces.
C. See Material Safety Data Sheet for more detailed information on these cleaning solutions.

IV. EQUIPMENT
Minncare Particulate Filter
Peracitic Acid Residual Reagent Strip Gloves
Safety Glasses/Face Shield and Mask. Filter Wrench
Dialysis Gooseneck Faucet Pipe Wrench
Water Pressure Regulator

V. PROCEDURES

A. Minncare Disinfect
1. Plug the RO in and LEAVE IN STANDBY.
2. Place a sign on the WRO 300 stating DO NOT USE on the front of the RO.
3. Attach the water supply to RO and turn on water.
4. Insert Minncare Wand into the chemical intake port. Press in firmly and turn the
connector downward to lock. Check that the connector is securely in place.












5. CHEM SELECT is shown on the display and the button starts to flash.
6. Insert the Minncare wand into the jug of Minncare.











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7. From CHEM SELECT press to enter the list of available disinfection
programs.
8. Select MINNCARE by using the arrow buttons. Start the Minncare intake
pressing the button until the light goes on.

Note: The display will show the present phase of the chemical disinfect
procedure.
If the container empties before this phase is complete an
INSUFFICIENT INTAKE error will appear and this
phase will need to be re-started.
9. REMOVE WAND is displayed, the
buzzer sounds and the button is flashing. Press the button to mute.
10. Disconnect the wand form the Minncare and rinse the wand with RO water. Hang
to dry.
11. The disinfect procedure will continue automatically. The time remaining will be
displayed as well.
12. When the disinfect procedure is complete the display will show PERFORM
RESIDUAL TEST. The button will remain steady lit and the button will
flash.

B. Residual Minncare™ Test
1. Press until the light goes on, to start the RO. The button will be lit and the
button will flash.
2. Install the short Fresenius connector line to the RO product port to collect a water
sample.








3. Press the button until the light goes out. The button remains steady lit.
4. Test the water for residual Minncare using Peracitic Acid Residual reagent strips.
If positive let the RO run and re-check every ten minutes.
Remember to compare the test strip with the bottle because even 0 ppm has a
slight color.
5. Remove the DO NOT USE tag when negative.
6. Document the Disinfect procedure on the RO Operation Log Sheet.




Page 4 of 6
C. WRO “Flush”
1. Plug the WRO 300 into an electrical outlet.
2. Place the drain hose into a drain.
3. Attach the WRO into an RO water source. This will extend the life of the Carbon
filter attached to the WRO. This can easily be done in the Tech Room
a. If not available you can use a non RO water hookup but this will deplete
the carbon filter faster and cold water should be used to avoid damage.
4. Turn the water supply on fully. Allow the RO to run for 1 minute prior to turning
the WRO on.
5. Press the WRO start button and hold while the display changes from STANDBY
to RUN. (approximately 3 seconds)
6. Let run for 15 minutes.
7. Document the Flush procedure on the RO Operation Log Sheet.

D. Change Particulate Filter
1. Using the filter housing wrench (see image below). Place the wrench at the top of
the blue plastic housing.

2. Remove the blue housing by turning the
wrench clockwise.
3. Wearing gloves remove the old filter and
discard.
4. Place a new particulate filter in the housing
and return the blue housing to the bracket and hand tighten.
5. Using the filter housing wrench turn the
wrench counter clockwise to tighten.




E. Set-up /Run Procedure
1. Review the RO Operation Log sheet prior to each use to determine if the WRO
unit has been properly disinfected and maintained.
2. Plug the WRO unit into a red outlet. Place the drain hose into the preferred drain
and secure. Attach the water source line using one of the following
configurations:
a. If the faucet in the room has a threaded spout, attach a pressure regulator
to the faucet spout then attach the RO water source line.
b.If the faucet does not have a threaded spout, turn off both water supply
lines below the sink and remove the faucet. Replace the room faucet with
the dialysis gooseneck faucet and pressure regulator assembly provided on
the RO cart. Turn on water supply lines below the sink and attach the RO
water supply line.
3. Turn on ONLY THE COLD incoming water and allow to run for one (1) minute
prior to starting the WRO unit or attaching the dialysis machine.

Page 5 of 6
4. Attach the RO connection tubing (water lines with quick release connectors) first
to the dialysis machine then to the WRO unit.
5. Press the button and hold for at least three seconds. The display on the WRO
unit will change from “Standby” to “Run”.
6. Complete the RO Operation Logsheet after the RO is running for at least 3
minutes and before intiating treatment.
a. Use the and keys to scroll thru the display on the front of the
machine to find and record the Product uS/cm, Feed uS/cm, % Reject and
Temp Feed measurements.
b.Pressure Guage 1, 2, 3 and the Chlorine/Chloramine test points are found
on the back of the RO chart. Record pressure guage readings whern the
needle is at the lowest point.
7. Troubleshoot alarms as needed using the Troubleshooting Guide found in the RO
Operation Log Book.

F. Disconnect Procedure
1. Turn off the dialysis machine and the WRO unit. Press the button and hold
for at least three seconds. The display on the WRO unit will change from to
“Run” to “Standby”.
2. Turn off the incoming water supply and reduce the internal water pressure in the
lines and WRO unit by opening the Chlorine/Chloramine test point valve and
drain line.
3. Disconnect the dialysis machine from the WRO and disconnect the RO
connection tubing and drain any residual water.
4. Turn off the water supply (under the sink) and remove the dialysis gooseneck
faucet and/or pressure regulator. Return these parts to the RO cart. Replace the
original faucet to the sink as needed.

VI. DOCUMENTATION

A. Record the date, time, and initials in the corresponding columns and record the
disinfect/flush procedure performed in the comments column. See Appendix A. UWHC
Portable WRO 300 Operation Log Sheet.

VII. RESOURCES

o WRO 300 Manual
o Appendix A. UWHC Portable WRO 300 Operation Log Sheet

REVIEWED: 12/1/2016
Jmw8/10/13

Page 6 of 6

Appendix A: