Dialysis Safety Series Clinical Safety Resources
Dialysis is not safe. Accidents will happen unexpectedly.
The nurse is the last line of defense. These pages are your preparation.
Vigilance — Critical Thinking — Rapid Action
Dialysis Water Treatment Log – Excel Download

Dialysis Water Treatment Log

Complete Every Shift — MOH Compliant
✅ All parameters within limits Carbon #2 Cl OUT MUST be 0.0 — SHUTDOWN if > 0.0
Date Shift Time Tech Supervisor WATER TREATMENT PARAMETERS Actions Tech Sig Super Sig
Feed PSI Cl IN Hard C1 ΔP C1 Cl C2 ΔP C2 Cl T1 EBCT T2 EBCT RO Feed RO Prod RO Rej Rec% Cond UV Loop 0.3µ ΔP
MOH LIMITS: >20 <2.0 <1 <15 <0.1 <15 0.0 ≥5 ≥5 35-50 <25 >16 >3.0 <25
(4000–8000 L)
Status: ✅ PASS
✍️ Author: Ahmed Mohmad Rashyd Musleh Registered Staff Nurse