Six Ways To Decrease Infections In Dialysis Clinics
Infections are second leading cause of death and leading cause of hospitalizations in ESRD patients costing about $15,000 per admission (USRDS, 2018). A dialysis catheter puts patient at 7-fold increase in risk of infection versus a permanent access. According to CDC, every fourth Blood Stream infection may result in death. As a result of the above, quality of life is drastically decreased for the patients and their families. Furthermore, Infection is costly to the clinic in the form of missed treatments, increased staff hours, and lower QIP score.
Why are Dialysis Patients At Risk For Infections?
- Dialysis process requiring the use of needles and catheters, provides direct access to blood and thereby increases the chance of infection.
- Weakened patient immunity and exposure to highly infectious places such as hospitals and clinics.
- The uremic state in ESRD patients may also increase risk for infections.
- The process of hemodialysis requires direct vascular access for prolonged periods. A single misstep in care can increase the chance of infection.
- Exposure to contaminated devices, equipment, supplies, environmental surfaces, or hands of personnel is higher in hemodialysis patients.
- Frequent hospitalizations and surgery increase their opportunities for exposure to nosocomial infections.
How can we prevent dialysis related infections?
- Annual audit of Staff mixing dialysate. Coordinate audits on random days, unannounced to ensure safe and sterile practice.
- Educate staff on infection control practices at a minimum of once a year. Arrange for a champion among the staff to present to motivate your patient care team.
- Promote selfcare practices with your patients to minimize cross contamination with staff
- Educate patients on infection control practices and what to expect from your staff
- Update policies on infection control regularly and inform staff and physicians on the updates
- Compare and contrast with other dialysis centers in your area to learn best practices
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