Variation in Infection Prevention Practices in Dialysis Facilities: Results From the National Opportunity to Improve Infection Control in ESRD (End-Stage Renal Disease) Project. (16th March 2015)

• Record Type: Journal Article
• Authors: Chenoweth, Carol E.; Hines, Stephen C.; Hall, Kendall K.; Saran, Rajiv; Kalbfleisch, John D.; Spencer, Teri; Frank, Kelly M.; Carlson, Diane; Deane, Jan; Roys, Erik; Scholz, Natalie; Parrotte, Casey; Messana, Joseph M.
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 7(2015)
• Page Start: 802
• Page End: 806
• Publication Date: 2015-03-16
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2015.55
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>OBJECTIVE</title> <p>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.</p> </sec> <sec id="abs2" sec-type="general"> <title>SETTING AND PARTICIPANTS</title> <p>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.</p> </sec> <sec id="abs3" sec-type="general"> <title>MEASUREMENTS</title> <p>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.</p> </sec> <sec id="abs4" sec-type="results"> <title>RESULTS</title> <p>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% overall but varied from 0% to 35% by facility type. The 8 checklists varied in the frequency of perfect performance from 0% for meeting every item on the checklist for disinfection practices to 22% on the arteriovenous access practices at initiation.</p> </sec> <sec id="abs5" sec-type="conclusions"> <title>CONCLUSIONS</title> <p>Our findings suggest that there are many areas for improvement in hand hygiene and other infection prevention practices in end-stage renal disease. These NOTICE project findings will help inform the development of a larger quality improvement initiative at dialysis facilities.</p> <p> <italic>Infect Control Hosp Epidemiol</italic> 2015;36(7):802–806</p> </sec> </abstract>