[The role of pharmacist in a telemedicine collaboration in hemodialysis: Water bacteriological quality monitoring].

OBJECTIVES: In French health centers, the pharmacist is responsible for the quality of hemodialysis fluids. In an insular hospital, it is difficult to make bacteriological controls because of the lack of an environmental laboratory. Alternative choices of methods must be seek to facilitate water control and ensure the security of hemodialysis for patients. Controlling the microbiological risk is an essential condition for the good operation of a telemedicine partnership in dialysis.

METHODS: A review of the different methods that has been tried is presented. The hospital has experienced since 2014 a microorganism detection test by ATPmetry. An overview of the results is discussed.

RESULTS: The usability of this technique allows quarterly controls on the water treated by reverse osmosis and on fluids after one and two ultrafiltrations from every generator. Cases of non-compliance were due to false positives, which were squashed by verification control in 50% of the cases, and the other non-compliances were fixed by corrective actions.

CONCLUSIONS: The ATPmetry technique permits the collection of rapid results and verification of the effectiveness of the corrective actions immediately after their implementation. This method has been undertaken in a routine use instead of the reference technique (bacteriological cultures). Assuming a constant vigilance in the quality of dialysis fluids that is a part of a quality approach, the pharmacist is at the heart of the telemedicine partnership developed in hemodialysis on the island.