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Infection Control in Dialysis Access

Infection Control in Dialysis Access. Epidemiology of Infections among Hemodialysis Patients . • Infections are the 2 nd leading cause of death (15% of deaths) • Site of infection - 57% vascular access - 23% wound - 15% lung - 5% urinary tract

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Infection Control in Dialysis Access

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  1. Infection Control in Dialysis Access

  2. Epidemiology of Infections among Hemodialysis Patients • Infections are the 2nd leading cause of death (15% of deaths) • Site of infection -57% vascular access -23% wound - 15% lung - 5% urinary tract USRDS 2005 Annual Data Report Tokars, Miller, Stein. AJIC 2002;30:288-295

  3. Rate of Access-Related Bloodstream Infection by Vascular Access Type Non Cuffed Catheter Cuffed Catheter Graft Fistula Dialysis Surveillance Network 1999-2005

  4. Non-Cuffed Catheter

  5. Guidelines for the Prevention of Intravascular Catheter-Related Infections Dressing changes or skin prep: • 2 % chlorhexidine (preferred) • 10 % povidone-iodine • 70 % alcohol Guidelines for the Prevention of Dialysis Access, 2002

  6. KDOQI Clinical Practice Guidelines, Catheter Care • Catheter access & cleansing exit site : - Chlorhexidine 2% is preferred • Use aseptic technique: - Correct hand hygiene - Masks for patient & staff - Sterile gloves , Gown,Cap , eye shield, a sterile drape . KDOQI Clinical 2006 Catheter Care Practice Guidelines

  7. Change catheter dressing : Transparent dressing changed every 7 days , inGauze and tape Change it every 48 hours .

  8. Fistula / Graft Care • Wash site using antibacterial soap or Scrub and water • Cleanse with: • 2% chlorhexidine • 70% alcohol • 10% povidone iodine • Wear new Sterile gloves • Follow proper infection control procedures KDOQI Clinical Practice Guidelines, 2006 - Fistula / Graft Care

  9. Skin Antisepsis

  10. Partner with your patients • Fact: - Dialysis patients share in the responsibility for preventing access-related infections. • Actions: - Educate patients about proper access care and infection control measures - Re-educate regularly

  11. Access Care • Patient Education - Proper access care - Signs of access infection - Encourage patients to report any changes in access site or discomfort • Gloves & Hand Hygiene

  12. catheter has been inserted through asmall cut (incision) near the catheter exit site.Sterile strips (small adhesive strips) are placedover the incision. Do not remove these strips.Let them fall off. Check this site for bleeding,redness, warmth or drainage until it is completelyhealed. Call your doctor if you haveany of these symptoms. Catheter care at home University of Pittsburgh Medical center 2005.www.upmn.com

  13. Patient Education Before you leave the hospital, your nurse will show you how to change the dressing. He or she will allow time for you to become familiar with catheter care and will answer your questions. University of Pittsburgh Medical center 2005.www.upmn.com

  14. Guidelines for dialysis access care •Do not let the catheter exit site get wet until it is well healed. •Do not bathe or shower, sooner than 72 hours after the catheter has been inserted. •Do not submerge the catheter site or caps below the level of water in a bathtub, hot tub, or swimming pool. • •When you bathe or shower, you must cover the site with transparent dressing. • Always clean your work area with alcohol and let it to dry completely . • Use only sterile supplies. Open all packages carefully without touching the contents. Handle dressings only at the edges. •Never touch the open end of the catheter when the cap has been removed. •Never touch the end of the needleless cannula or the end of the open syringe. •Never use scissors, pins, or sharp objects near the catheter or other tubing. The catheter could be damaged easily.

  15. Remember to wash your hands thoroughly before and after working with thecatheter

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