Practical Strategies for Decreasing and Controlling Permi-Cath Infection in Patients on Hemodialysis

Abstract

Background: One of the methods for achieving vascular access in hemodialysis patients is using cuffed hemodialysis catheters (permicath), which has some risks such as infection. Staphylococcus is the most common microorganism that causes permi-cath infection, and has contaminated 90% of clinical staff. Objectives: This study aimed to determine some strategies to reduce the level of permi-cath infection in hemodialysis patients. Patients and Methods: This was an action research, conducted on 32 patients with permi-cath, 21 of whom had acquired this infection in the past six months. The subjects were selected through convenient sampling. The required data were collected by observations, interviews and using the data documented in the patients' medical files as well as a questionnaire. The etiological factors of permi-cath infection were investigated; the strategies were determined through staffs' participation and using a standard guideline. Economical strategies were administrated based on their priority and applicability. Results: Twenty-five (65 %) patients received antibiotics (vancomycin); this number decreased to one (4.6%) after the intervention. Fourteen (44 %) were hospitalized before the intervention; this also decreased to zero after the intervention. Therefore, there was a statistically significant difference between the number of patients taking antibiotics before and after the intervention. Conclusions: Action research is an appropriate method for changing and improving nurses' practice. Since staffs' viewpoints are considered in this method, it makes them accept the required changes more rapidly. In addition, the decisions that are made will be more stable.