Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Carol E ChenowethJoseph M Messana

Abstract

OBJECTIVE To observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. SETTING AND PARTICIPANTS Thirty-four hemodialysis facilities were randomly selected from among 772 facilities in 4 end-stage renal disease participating networks. Facility selection was stratified on dialysis organization affiliation, size, socioeconomic status, and urban/rural status. MEASUREMENTS Trained infection control evaluators used an infection control worksheet to observe 73 distinct infection control practices at the hemodialysis facilities, from October 1, 2011, through January 31, 2012. RESULTS There was considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68% (range, 45%-92%) across all facilities. Overall adherence to expected hand hygiene practice was 72% (range, 10%-100%). Compliance to hand hygiene before and after procedures was high; however, during procedures hand hygiene compliance averaged 58%. Use of chlorhexidine as the specific agent for exit site care was 19...Continue Reading

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Citations

Nov 15, 2015·Clinical Journal of the American Society of Nephrology : CJASN·David T Gilbertson, James B Wetmore
Jun 28, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Amy D WatermanUNKNOWN American Society of Transplantation
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Jan 30, 2018·Seminars in Dialysis·Paul J Scheel
May 16, 2019·Nature Reviews. Nephrology·Tina Z WangDavid P Calfee

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