Access-related infections in two haemodialysis units: results of a nine-year intervention and surveillance program

Ittamar Gork,
Ilana Gross,
Matan J. Cohen,
Carmela Schwartz,
Allon E. Moses,
Michal Dranitzki Elhalel and
Shmuel BenensonEmail author View ORCID ID profile

Antimicrobial Resistance & Infection Control20198:105

https://doi.org/10.1186/s13756-019-0557-8

Received: 14 February 2019
Accepted: 10 June 2019
Published: 18 June 2019

Abstract

Background

Access-related infections are a major cause of morbidity and mortality in haemodialysis patients. Our goal was to decrease the rate of these infections by implementing an intervention and surveillance program.

Methods

This intervention took place in two haemodialysis units (Units A and B) and was a joint effort by the haemodialysis staff and the unit for infection prevention and control. It included reviewing the work methods and work space, observations on compliance with standard precautions and handling of the vascular access, creating a checklist and a designated kit for handling the vascular access and prospective surveillance of access-related infections.

Results

During a nine-year period, the haemodialysis units A and B treated 4471 and 7547 patients (mean number of patients per year: 497 (range 435–556) and 839 (range 777–1055), respectively). For most patients, the procedure was done through an arteriovenous fistula (66.7%, range 50.3–81.5%). The access-related infection rate decreased significantly in both haemodialysis units: from 3 to 0.9% (trend: p < 0.05, linear regression: p < 0.001) in Unit A and from 0.9 to 0.2% (trend: p < 0.05, linear regression: p = 0.01) in Unit B.

Conclusions

An intervention which included introduction of a checklist and designated kit, together with ongoing surveillance and feedback, resulted in a significant decrease in the access-related infection rates in both haemodialysis units.