Inadequate infection control practices remain the single largest preventable source of dialysis related complications by many reports. Sadly, the culture of overlooking basic hand washing and changing gloves is prevalent among many dialysis units. The lessons learned from hospital Intensive Care Units (ICUs) across the nation is that preventing blood born and healthcare associated infections (HAI) can be essentially eliminated. This can become the model of care in dialysis units.
While this is not complicated, the busy environment in the dialysis unit presents a challenge. For example, as soon as one patient leaves, another is coming to occupy the vacant chair. In the rush, staff could potentially miss critical steps such as ensuring the chair is completely clean or the machine is sanitized. However, if the patient is educated about the risks involved they are more likely to hold the staff accountable to not skip steps in their hurry to get to the next patient. Dialysis safety efforts include alcohol based Chlorhexidine for catheter care, vascular access care, and hand and glove hygiene. Patients should diligently observe and insist that there be NO exceptions to standard normal care.
With respect to hand hygiene, below are examples of situations when you should be observing hand hygiene for adherence to standards according to Centers for Disease Control (CDC):
- Before and after direct patient contact.
- After completing task at one patient station, and before moving to another.
- Before and after contact with vascular access.
- Before and after dressing changes such as to catheter.
- Before procedures such as intravenous medications.
The CDC guidelines also give recommendations on staff glove use. For example, they state that gloves should be worn prior to contact with patients at the treatment station, and potentially contaminated surfaces. Additionally, the guidelines state that gloves should be changed:
- After contact with blood and other body fluids.
- After completing tasks at one station, and before moving to another.
- After contacting a potentially contaminated site, and before touching a clean site.
KidneyBuzz.com believes that it is possible to significantly reduce the infections among dialysis patients if dialysis facilities' staff were to follow the CDC's protocols. If all staff in your dialysis facility were using the same interventions prescribed by CDC, we could see dramatic reductions in infections and adverse outcomes in dialysis patients. It is time for the dialysis patients themselves to put these life saving strategies to work. You must insist that your direct care providers (nurses, patient care technicians, and doctors) follow CDC's protocols without exception.
"CDC Protocols Prevent Dialysis Bloodstream Infections." Renal Urology News.
"HemoDoc, From Doctor to Patient." 'HemoDoc, From Doctor to Patient'