Provision of prison dialysis

[Garry]

Hi All,

I would appreciate any feedback on experiences providing dialysis within a prison environment.  Any logistical hurdles to overcome as, without any previous experience, I'm assuming similar to a normal home installation apart from arranging maintenance visits.

thanks

Garry

[Ian Wilde]

The guys at Preston are well versed in this 👍🏻

[fraser gilmour]

that's a new one on me, HMP HHD
We have HMP Portland near our Dorchester unit, with prisoners transferred with two guards and 'secured' during treatment, in a side room when possible.
It's not that frequent for us, but I suppose if there are enough treatments to justify the setup and running in a prison it may be cheaper/easier/safer than transferring to a dialysis unit.
would be good to hear what transpires
     

[Garry]

I believe the prison is only allowed to release a set number of patients for treatment each day.  Currently dialysis patients are taking up the majority of the slots so alternatives are being looked at.

[Chris Pearson]

We put 2 chairs in a high security prison called Full Sutton near York and it was a bit of a nightmare because the guests are mainly ISIS terrorists and murderers .
They were very conscious of the risks to the nurses so anything that was anywhere near considered sharp even something as inocuous as a eyewear arm had to be soft,cushions had to be breathable so no smothering,and no hazardous chemicals.
I think Peter Jones was involved with providing the machine and disposables.
Main thing to watch is you need to document what tools you need to take in with you and NO phones or memory sticks otherwise you might find yourself invited to stay for a while.
If you are being asked to provide costings think of a number and double it to take into account the time it will take you to clear security goig in and back out.
I think the best option would be to transfer the inmates to a unit already set up and running if there is one close enough or they can't have visitors anyway.

[DrewB]

Hi Garry,

At Guys we used to have a machine in wormwood scrubs. Other than the occasional long wait while they counted all the inmates, it was fairly trouble free. Think they had to have a nurse working there willing to train and do the dialysis, otherwise it was exactly the same as a home machine.
From memory if there was a problem with the machine or RO we just swapped it out as taking tools into the prison involved extra security checks.

Costings wise would the Prison service not pick up the bill as it will save them money in guards and transport?

Drew

[Garry]

Thanks for all the pointers, I'll take on board.  Still early stages but will post the outcome.

[Chris Eaton]

We previously had a NxStage in Prison, one of the staff in the medical wing was an ex Heamo nurse, so we just needed to train her on the NxStage machine.
we used the prison maintenance department to connect up a drain, we made them a manifold to "t" into a feed in the room they were planning to use and supplied the NxStage saddle for the drain and water connector that attached to the 3/4 water outlet.
We may well be restarting this, as one of the other post alluded to, the prison he had a machine at has 3 escorts per day, this means if it takes 2/3 guards out for the day (breaks etc) to bring a patient to dialysis then NO other prisoners can leave the prison as lack of dialysis is seen as immediately life threatening. any other Prisoner will be knocked back, even if its cancer treatment etc as it isn't immediately life threatening. we currently have 1 prisoner attending our unit but there may be a new one.
Access to the prison is a nightmare, you are allowed 3 visits before having to go through the vetting procedure, which took months..
The use of conventional HD may be possible but the process of getting tools in and out of a prison will be fraught, virtually everything in your tool case will be on the banned items list, including your phone, for which it's a custodial offence to take one into a prison( nearly got caught out forgetting to remove that from my pocket).
but it is interesting, was given a walk round the last time I went, was an eye opener.
oh and like old peoples homes, prisons stink of piss, shit and biscuits.
sure this isn't a complete breakdown, just the highlights, feel free to contact me if i can offer any further advice.

[Chris Pearson]

I seem to remember one NHS Tec (Leeds ?)  was caught with a memory stick in his pocket and narrowly missed a conviction given the amount of money it was worth to an inmate.

[Chris Pearson]

It's just occured to me that a set up we did with Andy at Derby with extremely long custom made bloodlines for a research project dialysing in a Magnetic Resonance Scanner could work if the prison has an adjacent small room to put the machine and water treatment kit in with just a 2 cm hole in the wall to put the bloodlines through to the patient.

[Chris Eaton]

Think this could be even more of a nightmare, there was a porter guy in the prison we had the machine in and post dx he had to cut the lines down to 2 inch lengths that can't be knotted back together. would make excellent weapons in strangulation attacks apparently, i was wondering about them shinning down the wall hanging from them, but apparently strangulation is more common than attempted escapes.