1. Effective prevention bundle to eliminate catheter-related bloodstream infections in ambulatory hemodialysis patients.
- Author
-
Hamid, Hoda A., Bouanane, Hicham, Ibrahim, Athar, Ismail, Sahar, El Sayed, Aisha, Mahmoud, Khaled M., Hamad, Abdulla, and Al Ali, Fadwa
- Subjects
PREVENTION of bloodborne infections ,CATHETER-related infections ,ALLIED health personnel ,CLINICS ,PREVENTION of communicable diseases ,HEALTH care teams ,HEMODIALYSIS facilities ,MEDICAL care costs ,MEDICAL protocols ,NURSES ,PATIENT safety ,QUALITY assurance ,EVALUATION of human services programs ,DESCRIPTIVE statistics ,INFECTION prevention - Abstract
Background: Hamad General Hospital (HGH) is the principal provider of dialysis in the state of Qatar, comprising a total of four facilities in different cities. Infection rates in dialysis patients are increasingly used as a surrogate marker for measuring patient safety and quality of healthcare. These infections are associated with substantial morbidity, mortality, and excess healthcare costs. We observed an elevated rate of hemodialysis catheter-related bloodstream infections (HD-CRBSI) in our outpatient dialysis facilities (1.4/1,000 Central Venous Catheter [CVC] days) in 2011. Our goal was to reduce our HD-CRBSI rate by 80% within a period of four years in HGH ambulatory dialysis facilities. Methods: HD-CRBSIs are defined as the presence of positive blood cultures in a febrile catheter-dependent patient in the absence of alternative sources of infection upon clinical evaluation. The project was led by the HGH quality improvement program director in coordination with a multidisciplinary team (nephrologists, nurses, vascular coordinators, a patient educator, and an infection control team) after implementation of a bundle of infection prevention measures. Results: The rate of HD-CRBSI was reduced from 1.4/1,000 CVC days in 2011 to 0.014 in 2017, achieving a 99% reduction rate (p < 0.001). Conclusions: Strict implementation of our new infection prevention measures bundle is sufficient to significantly reduce HD-CRBSIs. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF