Effort to cut hemodialysis infection works

Patients undergoing hemodialysis, removing waste and water from blood during kidney failure, are at risk for bloodstream infections, U.S. health officials say. A report published by the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report said an estimated 37,000 bloodstream infections related to central lines occurred among U.S. hemodialysis patients during 2008. In 2009, to decrease bloodstream infection incidence in a New Jersey outpatient hemodialysis center, a package of interventions was instituted including a prevention program, and augmented by a social and behavioral change process to enlist staff members in infection prevention. "The incidence of all access-related bloodstream infections decreased from 2.04 per 100 patient-months pre-intervention to 0.75 per 100 patient-months after initiating program interventions, and to 0.24 after adding a behavioral change intervention," the report said. "Only one access-related bloodstream infections occurred during the last 12 post-intervention months." The facility joined the program in September 2009 and during the next three months worked to implement the prevention program interventions, which included -- in addition to dialysis event surveillance -- observation of catheter care and vascular access care, use of chlorhexidine for skin antisepsis, auditing of hand hygiene adherence, patient education and engagement, catheter use reduction programs, and staff member education and competency testing. Program members participated in monthly telephone conferences and yearly in-person meetings that served as a forum for presenting infection prevention topics, sharing best practices and problem solving, the report said.