cdc resources to help reduce dialysis related infections
DESCRIPTION
CDC Resources to Help Reduce Dialysis Related Infections . !. Intermountain ESRD – Network 15 Karen Strott, RN Linda Pleiman, RN. Objectives. Identify 5 evidence based resources proven to reduce HAI’s in the dialysis setting Review how to implement the use of audits in your QAPI program - PowerPoint PPT PresentationTRANSCRIPT
CDC RESOURCES TO HELP REDUCE
DIALYSIS RELATED INFECTIONS
Intermountain ESRD – Network 15
Karen Strott, RNLinda Pleiman, RN
!
OBJECTIVES
Identify 5 evidence based resources proven to reduce HAI’s in the dialysis setting
Review how to implement the use of audits in your QAPI program
Review Wyoming infection data-How does your dialysis unit stack up?
WHY ARE DIALYSIS PATIENTS AT RISK FOR INFECTION?
Patients who undergo hemodialysis have a higher risk of infection, due to the following factors:
Frequent use of catheters or insertion of needles to access the bloodstream
Weakened immune systemsFrequent hospital stays and surgery
WHY? About 410,000 people receive
hemodialysis (HD) at any given time in the United States
About 8 in 10 of these patients start treatment through a central line (a major risk factor for BSI)
Infections are one of the leading causes of hospitalization and death for patients on hemodialysis
WHY?
For hemodialysis patients, the rate of infection is now 43% greater than it was in 1993!
Hospitalization rates for BSIs have increased by 47% and by 87% for vascular access infections!
WHAT PUTS PATIENTS AT RISK?NOTICE PROJECT 2011
Outcome Predictor % Increase in Risk**
P-value
ICD-9 HD VAR Infection Rates
-Overall hand hygiene* -Hand Hygiene After -Supplies 1c2-Insert Needle 1c8-Injection port 2a9
80%79%60%46%49%
0.0160.0050.0050.0420.007
NHSN Bacteremia
-Dressing 1b7-Injection port 2a9
50%54%
0.0240.007
NHSN VAI -Hand hygiene --Injection port 2a9
51%43%
0.0010.023
WHAT DO WE NEED TO DO? CLABSI prevention in
dialysis facilities will require: Increased adherence to current inpatient CLABSI prevention recommendations
The development and implementation of additional prevention strategies specific to the dialysis environment
Collection and analysis of data
CDC Guidance
http://www.cdc.gov/dialysis/collaborative/
Tools website: http://www.cdc.gov/
dialysis/prevention-tools/index.html
CDC CORE INTERVENTIONS
Surveillance and feedback using NHSN Hand hygiene observations Catheter/vascular access observations Staff education and competency Patient education/engagement Catheter reduction Chlorhexidine for skin asepsis Catheter hub disinfection Antimicrobial ointment
HAND HYGIENE OBSERVATIONS
CATHETER CARE
Use chlorhexidine for skin antisepsis during insertion/dressing change (allow to dry)
Catheter hub cleansing (scrub-the-hub) after cap removed and before accessing
Use antimicrobial ointment or chlorhexidine-impregnated sponge dressings
VASCULAR ACCESS CARE
KEY INFECTION PREVENTION PRACTICES
Perform hand hygiene frequently/change gloves
Maintain separate clean areas for supplies and medications and separate contaminated areas for used items
Practice safe injection practices Perform proper environmental cleaning Dedicate supplies to a single patient
Use aseptic technique every time!
USING AUDITS IN QAPI Perform audits on a regular basis Involve all staff in audit process Share results with staff Review audit findings monthly in QAPI Use results to identify areas for
improvement Perform follow up audits of problem staff
or areas identified for improvement Review and celebrate improvements
USE NHSN
Know your data Share your data Compare your data to other facilities Use your data to improve outcomes Use NHSN to improve communication
between patients, staff and other facilities
REVIEW WYOMING INFECTION DATA-HOW DOES YOUR DIALYSIS
UNIT STACK UP?
CONTACTINGNETWORK 15
Karen Strott, RNQuality Improvement
Director303.831.8818
Linda Pleiman, RNQuality Improvement
Coordinator303.831.8818
Lori ChaseQI Data Specialist