The Making Dialysis Safer for Patients Coalition

Patel, Priti R.; Brinsley-Rainisch, Kristin

doi:10.2215/cjn.02730317

Cited by 23 publications

(5 citation statements)

References 24 publications

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“…This coalition was launched in 2016 and encourages adoption of a set of interventions that have been shown to sustainably reduce BSI. 8,22 This set of interventions includes a protocol for preparing catheter hubs before accessing the catheter for hemodialysis. Use of this approach has been shown to reduce BSI among patients with CVC vascular access, who are at highest risk of BSI.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Quality improvement initiatives, including the Centers for Disease Control and Prevention's (CDC) Making Dialysis Safer Coalition, established in 2016, encourage dialysis facilities to adopt evidence-based interventions to decrease the incidence of bloodstream infections (BSIs) in patients. 8 To monitor the effectiveness of infection prevention measures and to facilitate quality improvement, [9][10][11] the CDC conducts surveillance for BSI and related events in hemodialysis patients 12 through the National Healthcare Safety Network (NHSN). 13 To allow for a comparison of rates of BSI among populations, over time, and across facilities, NHSN calculates a risk-adjusted standardized infection ratio (SIR) for BSI events on the basis of a 2014 baseline.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Six-Year Follow-Up of Bloodstream Infections in Hemodialysis Facilities in the United States, National Healthcare Safety Network, 2020

Keenan,

Barbre,

Dollard

et al. 2024

CJASN

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The approximately 500,000 people in the US undergoing hemodialysis are at risk for bloodstream infections (BSIs). The Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) conducts surveillance for BSIs among outpatient hemodialysis facilities in the US. Quality improvement initiatives encourage these facilities to adopt evidence-based interventions to decrease the incidence of BSI in patients. We describe the incidence of BSI among patients at outpatient hemodialysis facilities in the US during 2020, stratified by state or territory. Methods Outpatient hemodialysis facilities report BSI events to NHSN. Pooled mean rates with 95% CI were calculated overall and for each type of vascular access (arteriovenous (AV) fistula, AV graft, or a central venous catheter (CVC)). Standardized infection ratios were calculated as observed BSI events divided by the predicted number of events based on national aggregate data. Median facility-level standardized infection ratios and 95% confidence intervals (CIs) were stratified by state and US territory. Results During 2020, 7,183 outpatient hemodialysis facilities reported data for 5,235,234 patient months with 15,181 BSI events. Pooled mean rates per 100 person-months were 0.29 (95% CI, 0.29-0.30) overall, 0.80 (95% CI, 0.78-0.82) for CVC, 0.12 (95% CI, 0.12-0.12) for AV fistula, 0.21 (95% CI, 0.20-0.22) for AV graft, and 0.28 (95% CI, 0.19-0.40) for other access types. The national standardized infection ratio was 0.40 (95% CI, 0.39-0.41). South Dakota had a standardized infection ratio significantly higher than one (1.34; 95% CI, 1.11 – 1.62). Fifty-one of 54 states and territories had BSI standardized infection ratio significantly lower than one. Conclusions In 2020, the median standardized infection ratio for BSI in US outpatient hemodialysis facilities was lower than predicted overall and in almost all states and territories. An elevated standardized infection ratio was identified in South Dakota.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Six-Year Follow-Up of Bloodstream Infections in Hemodialysis Facilities in the United States, National Healthcare Safety Network, 2020

Keenan,

Barbre,

Dollard

et al. 2024

CJASN

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“…Currently at the unit there is no written down protocol with regards to catheter care and infection prevention. Skin asepsis before the insertion of CVC is done with povidone iodine and 70% isopropyl alcohol but the standard of care however is use 2% aqueous chlorhexidine glucuronate and 70% isopropyl alcohol [ 29 ]. The use of 2% aqueous Chlorhexidine glucuronate plus 70% isopropyl alcohol has been shown to significantly inhibit growth of normal skin as compared to those with 10% povidone iodine plus 70% isopropyl alcohol [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Centre for Disease Control Dialysis Collaborative published a list of comprehensive dialysis management protocol in 2011 [ 32 ]. A study was carried out with this protocol in 17 outpatient dialysis units which reporting findings of a 54% reduction ( P <0.001) in catheter related blood stream infections [ 29 ]. Nasal Staphylococcus aureus decolonisation has been shown to reduce the risk of CRBSI [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Catheter-Related Bloodstream Infections among patients on maintenance haemodialysis: a cross-sectional study at a tertiary hospital in Ghana

Opoku-Asare,

Boima,

Ganu

et al. 2023

BMC Infect Dis

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Background Catheter-Related Bloodstream Infections (CRBSIs) are notable complications among patients receiving maintenance haemodialysis. However, data on the prevalence of CRBSIs is lacking. This study was conducted to determine the prevalence and factors associated with CRBSIs among patients receiving haemodialysis in the renal unit of the largest tertiary hospital in Ghana. Methods A hospital-based cross-sectional study was conducted on patients receiving maintenance haemodialysis via central venous catheters (CVC) between September 2021 and April 2022. Multivariate analysis using logistic regression was used to determine the risk factors that were predictive of CRBSI. Analysis was performed using SPSS version 23 and a p-value<0.05 was statistically significant. Results The prevalence of CRBSI was 34.2% (52/152). Of these, more than half of them (53.9%(28/52)) had Possible CRBSI while 11.5% (6/52) had Definite CRBSI. Among the positive cultures, 62% (21/34) were from catheter sites whilst the rest were from peripheral blood. Gram-negative cultures made up 53% (18/34) of positive cultures with the rest being Gram positive cultures. Acinetobacter baumannii (33.3% (6/18)) was the commonest organism isolated among Gram-negative cultures whilst Coagulase negative Staphylococci (43.7% (7/16)) was the commonest organism isolated among Gram-positve cultures. Gram-negative bacilli were more predominant in this study making up 52.9% of the total bacteria cultured. Sex, duration of maintenance dialysis, underlying cause of End-stage kidney disease, mean corpuscular haemoglobin (MCH), neutrophil count and lymphocyte count were significantly predictive of CRBSI status (p<0.05). Conclusion There was a high prevalence of CRBSI among patients undergoing haemodialysis. The commonest causative agent was Coagulase negative Staphylococci, however there was a predominance of Gram-negative bacilli as compared to Gram positive cocci. There is a need to set up infection surveillance unit in the renal unit to track CRBSI and put in place measures to reduce these CRBSI.

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“…To achieve this goal, NTDS and CDC have responded to the challenge in several ways. NTDS has reached out to a broad array of nephrologists, nurses, and other dialysis personnel through publications, [7][8][9][10][11][12][13][14] webinars, lectures, seminars, and focus groups to share the knowledge of best practices and to examine the barriers to performing best practices consistently. The NTDS website (https://www.asn-online.org/ntds/) includes evidence for best practices, as well as CDCdeveloped guidance and tools.…”

Section: Related Article P 610mentioning

confidence: 99%