Prevention of Infection in Patients With Chronic Kidney Disease Part Iii: Surveillance and Auditing in a Renal Care Environment

Abstract

This third paper, in a three-part CE series on the preventions of infection in patients with chronic kidney disease, focuses on surveillance and auditing of healthcare-associated infections within the renal care environment. The last decade has seen an increased awareness of the threat to patient safety from healthcare-associated infection (HCAI) and the emergence of multi-drug resistance organisms. Effective HCAI prevention strategies include adequate governance structures, access to expert advice, adherence to standard and transmission-based precautions, minimising the use of invasive medical devices, and surveillance. Surveillance data can be collected using outcome (e.g. infection) and/or process (e.g. hand hygiene compliance audit) measures. Establishing a surveillance programme requires: commitment from senior management and the multidisciplinary team, prompt feedback of the data to clinical managers resulting in action been taken if necessary, to address specific areas of concern. While many renal units have access to infection prevention and control expertise to assist in the development of such a programme, units without such expertise should also have a surveillance programme in place.

Vascular access and infection prevention and control: a national survey of routine practices in Irish haemodialysis units

“…Surveillance is an essential component of infection prevention and control programmes, aimed at preventing and controlling HCA CRBSI [35]. In order to improve the quality and safety of patient care local monitoring of these infections is advocated [12]; dialysis units are expected to put in place surveillance programmes, to determine rates and trends of HCA CRBSI [13].…”

Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

“…Patients with end-stage renal disease (ESRD) undergoing hemodialysis are especially prone to acquiring healthcare-associated infections (HAI). 1 This is due to both the dialysis procedure and to the immune compromising effects of the underlying disease. 2 However, like all HAI, those happening in hemodialysis patients can be prevented with the implementation of infection control protocols.…”

Clinical Audit Improves Hypertension Control in Hemodialysis Patients

“…Hypertension in HD patients is a topic tailored to the audit scope for its clinical relevance, high prevalence, and the reduction in cardiovascular risk that is associated with its successful management (14–15). As yet, only a few audits have been reported in patients with chronic renal disease or undergoing HD (16–17). Based on this premise, the primary aim of this study was to test whether the clinical audit improves BP control in the HD setting.…”