Standards › Standard 26 › Forms
Form · DIA-FRM-005 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 26.7
Purpose
Records the check of each dialysis machine before use, against the written checklist, and any fault found.
How to complete
- Check the machine against the checklist before each session.
- Record any fault found.
- Withdraw the machine until repaired, and record it.
Checks
| Check | Entry |
|---|---|
| Machine ID and session date | Yes |
| Checklist completed (yes or no) | Yes |
| Fault found (yes or no) and details | Yes |
| Machine withdrawn until repaired (date) | Yes |
| Checked by | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on ISO 23500:2019 (fluids for haemodialysis) and the KDIGO Clinical Practice Guideline for Hemodialysis Adequacy (2015 update). |
| E-006 | ASF Policy Framework v1.2. Adapted. |
| E-009 | ASF Expert Committee consensus. |
Change history
| Version | Date | What changed | Approval |
|---|---|---|---|
| 1.0 | the date of approval | First version | set Expert Committee approval |
E-learning for this document
- Dialysis & Renal Replacement Therapy (AMB-12)
References
- Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
- Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)