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Dialysis Facilities Infection Prevention Control

Dialysis Facilities Infection Prevention Control

Preventing Bloodstream Infections (BSIs) in Outpatient Hemodialysis Patients

The Centers for Disease Control and Prevention (CDC) has received an increased number of reports of acute hepatitis C virus (HCV) among patients undergoing hemodialysis. As your partner for delivering safe, accurate renal care, the Henry Schein Dialysis Division offers products and recommendations to prevent infections such as HCV in your patients, including:

Criterion Powder-free Nitrile Exam Gloves- Henry Schein Medical

Criterion N200 Powder-Free Nitrile Exam Gloves

  • Eliminates type-1 allergic reactions associated with natural latex
  • Innovative formulation emulates the fit and feel of latex with added strength and puncture resistance
BD ChloraPrep - Henry Schein Medical

BD ChloraPrep

Standardize your prep with ChloraPrep skin antiseptic. The entire line of ChloraPrep products is indicated for patient pre-operative skin preparation.

Hydroalcoholic Antiseptic Gel for Skin and Hands-Henry Schein Medical

Aniosgel 85 NPC Hydroalcoholic Antiseptic Gel for Skin and Hands

  • Gentle and compliant with CDC and OSHA guidelines
  • Reduces the risk of bacterial cross-contamination and infection
  • NPC (no perfume or coloring)
PDI Prevantics -Henry Schein Medical

PDI Prevantics

Prevent the spread of HAIs with the first and only 3.15% CHG/70% IPA formulation with up to 7 days of continued antimicrobial activity. (Swabstick and Maxi Swabstick only.)

Visit the CDC website to learn more about the CDC advisory.

Core Interventions

The CDC offers a wide range of infection prevention tools, including the following core interventions that have been proven to reduce dialysis bloodstream infections. Apply these interventions when using the Audit Tools and Checklists.

  1. Surveillance and feedback using NHSN
    Conduct monthly surveillance for BSIs and other dialysis events using National Healthcare Safety Network (NHSN). Calculate facility rates and compare to rates in other NHSN facilities. Actively share results with front-line clinical staff.
  2. Hand hygiene observations
    Perform observations of hand-hygiene opportunities monthly and share results with clinical staff.
  3. Catheter/vascular access care observations
    Perform observations of vascular access care and catheter accessing quarterly. Assess staff adherence to aseptic technique when connecting and disconnecting catheters and during dressing changes. Share results with clinical staff.
  4. Staff education and competency
    Train staff on infection control topics, including access care and aseptic technique. Perform competency evaluation for skills such as catheter care and accessing every 6 to 12 months.
  5. Patient education/engagement
    Provide standardized education to all patients on infection prevention topics including vascular access care, hand hygiene, risks related to catheter use, recognizing signs of infection, and instructions for access management when away from the dialysis unit.
  6. Catheter reduction
    Incorporate efforts (e.g., through patient education, vascular access coordinator) to reduce catheters by identifying and addressing barriers to permanent vascular access placement and catheter removal.
  7. Chlorhexidine for skin antisepsis
    Use an alcohol-based chlorhexidine (>0.5%) solution as the first line skin antiseptic agent for central line insertion and during dressing changes. Povidone-iodine (preferably with alcohol) or 70% alcohol are alternatives for patients with chlorhexidine intolerance.
  8. Catheter hub disinfection
    Scrub catheter hubs with an appropriate antiseptic after cap is removed and before accessing. Perform every time catheter is accessed or disconnected.
  9. Antimicrobial ointment
    Apply antibiotic ointment or povidone-iodine ointment to catheter exit sites during dressing change. See information on selecting an antimicrobial ointment for hemodialysis catheter exit sites (selecting an antimicrobial ointment). Use of chlorhexidine-impregnated sponge dressing might be an alternative.

Guide to Hand-Hygiene Opportunites in Hemodialysis

Hand-Hygiene Opportunity Category Specific Examples
 
1. Prior to touching a patient
  • Prior to entering station to provide care to patient
  • Prior to contact with vascular access site
  • Prior to adjusting or removing cannulation needles
2. Prior to aseptic procedures
  • Prior to cannulation or accessing catheter
  • Prior to performing catheter site care
  • Prior to parenteral medication preparation
  • Prior to administering IV medications or infusions
3. After body fluid exposure risk
  • After exposure to any blood or body fluids
  • After contact with other contaminated fluids (e.g., spent dialysate)
  • After handling used dialyzers, blood tubing, or prime buckets
  • After performing wound care or dressing changes
4. After touching a patient
  • When leaving station after performing patient care
  • After removing gloves
5. After touching patient surroundings
  • After touching dialysis machine
  • After touching other items within dialysis station
  • After using chair-side computers for charting
  • When leaving station
  • After removing gloves