Targeting Zero Infections in Hemodialysis

Kliger, Alan S.; Garrick, R.

doi:10.1053/j.ajkd.2019.05.015

“…However, they may be harmful for people with CKD due to ingredients that are only partly scrutinized by regulatory agencies. [1][2][3] Supplements may be inaccurately labeled, interact with each other and/or prescription medications, or contain nephrotoxic substances. Renally eliminated supplements and metabolites may accumulate in CKD, leading to adverse outcomes.…”

Section: Research Letter Supplement Use By Us Adults With Ckd: a Popumentioning

confidence: 99%

“…Renally eliminated supplements and metabolites may accumulate in CKD, leading to adverse outcomes. Earlier studies examined select supplement use by people with CKD, 4 but without conclusive safety data for most supplements, a broader examination of supplement use in CKD is needed to inform interventions in this population. Furthermore, whether CKD awareness translates to caution in supplement use is unknown.…”

Section: Research Letter Supplement Use By Us Adults With Ckd: a Popumentioning

confidence: 99%

“…2018;13(9):1381-1388. 4 We appreciate Dr Brown's call 1 for industry-wide improvements in hemodialysis catheter care and general infection prevention. Monitoring bloodstream infection rates, overall and by factors such as vascular access and pathogen type, can provide valuable insight to facilities as they strive to reduce infections.…”

mentioning

confidence: 99%

“…Through human factors evaluations, the Centers for Disease Control and Prevention (CDC) and Nephrologists Transforming Dialysis Safety are working to define the issues that interfere with best infection prevention practices. 4 It will be incumbent on the dialysis provider community and other stakeholders to help solve these problems. Ensuring that dialysis technicians are not spreading infections due to insufficient time to change gloves and perform hand hygiene while responding to multiple patient events and determining how to disinfect wall boxes daily when they are barely accessible (eg, hidden behind dialysis machines) are just 2 issues facing the dialysis community.…”

mentioning

confidence: 99%

See 2 more Smart Citations

In Reply to ‘Bloodstream Infections in Hemodialysis Patients: The Role of Dialysis Providers’

Novosad

¹

,

Patel

²

2019

American Journal of Kidney Diseases

0

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Novosad et al 1 have alerted hemodialysis facilities to the wall boxes as an unsuspected source of Gram-negative bloodstream infections (BSIs), occurring largely in patients with catheter vascular accesses. However, they and the accompanying editorial 2 also stressed deficiencies in infection control techniques, largely gaps in staff hand hygiene, that served to transfer these bacteria to and between patients. During the same 2015 to 2016 period of those findings, our study 3 of BSI rates of patients with and without catheters in all 179 Medicare facilities in New England showed that 4 of the 5 dialysis provider groups had significantly higher BSI rates in their patients with catheters than the best-performing dialysis provider group (adjusted risk ratios of 1.44-1.91; P ≤ 0.001). Because BSI rates in patients without catheters, constituting 80% to 90% of most facilities, were similar among the 5 provider groups, overall reported BSI rates often give a false sense of infection control adequacy. 3 Therefore, if we are to "target zero infections in hemodialysis," 2 each facility should calculate its BSI rate in patients with catheters separately, and if greater than average (w2.15 per 100 patientmonths 3), look for gaps in infection control techniques and retrain dialysis staff to correct deficiencies. 4 However, my attempts to engage the large dialysis provider groups in New England has met with only partial success, although all have joined the Making Dialysis Safer for Patients Coalition. 5 In the interest of dialysis patient safety, some dialysis provider groups need to step up and educate their staff to perform best infection prevention practices regularly.

show abstract

A cluster of gram-negative bloodstream infections in Connecticut hemodialysis patients associated with contaminated wall boxes and prime buckets

Backman

¹

,

Dumigan

²

,

Oleksiw

³

et al. 2023

American Journal of Infection Control

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Bloodstream Infections in Hemodialysis Patients: The Role of Dialysis Providers

Brown

¹

2019

American Journal of Kidney Diseases

1

0

View full text Add to dashboard Cite

Novosad et al 1 have alerted hemodialysis facilities to the wall boxes as an unsuspected source of Gram-negative bloodstream infections (BSIs), occurring largely in patients with catheter vascular accesses. However, they and the accompanying editorial 2 also stressed deficiencies in infection control techniques, largely gaps in staff hand hygiene, that served to transfer these bacteria to and between patients. During the same 2015 to 2016 period of those findings, our study 3 of BSI rates of patients with and without catheters in all 179 Medicare facilities in New England showed that 4 of the 5 dialysis provider groups had significantly higher BSI rates in their patients with catheters than the best-performing dialysis provider group (adjusted risk ratios of 1.44-1.91; P ≤ 0.001). Because BSI rates in patients without catheters, constituting 80% to 90% of most facilities, were similar among the 5 provider groups, overall reported BSI rates often give a false sense of infection control adequacy. 3 Therefore, if we are to "target zero infections in hemodialysis," 2 each facility should calculate its BSI rate in patients with catheters separately, and if greater than average (w2.15 per 100 patientmonths 3), look for gaps in infection control techniques and retrain dialysis staff to correct deficiencies. 4 However, my attempts to engage the large dialysis provider groups in New England has met with only partial success, although all have joined the Making Dialysis Safer for Patients Coalition. 5 In the interest of dialysis patient safety, some dialysis provider groups need to step up and educate their staff to perform best infection prevention practices regularly.

show abstract

Targeting Zero Infections in Hemodialysis

Cited by 4 publications

References 12 publications

In Reply to ‘Bloodstream Infections in Hemodialysis Patients: The Role of Dialysis Providers’

In Reply to ‘Bloodstream Infections in Hemodialysis Patients: The Role of Dialysis Providers’

A cluster of gram-negative bloodstream infections in Connecticut hemodialysis patients associated with contaminated wall boxes and prime buckets

Bloodstream Infections in Hemodialysis Patients: The Role of Dialysis Providers

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