Improving Catheter-Related Blood Stream Infection in Haemodialysis Patients Using A Practice Development Framework

Catheter-related blood stream infection (CRBSI) contributes to hospitalisation and death in the haemodialysis population.Increasing numbers of catheter infections prompted a unit practice development program to reduce infection episodes.Objective/hypothesis Improvement in clinical practice in dialysis catheter care would decrease dialysis CRBSI in the haemodialysis population.Context Five dialysis units and one nephrology ward in regional Australia.Participants Nephrology nurses working with haemodialysis patients who have central venous dialysis catheters (CVDC) in situ.Method Use of a practice development framework to engage clinicians in reviewing their clinical practice and developing strategies to decrease dialysis CRBSI. Clinical practice was measured by undertaking clinical audits of CVDC care. The CRBSI rate was monitored and reported by the infection control department annually.Results Rates of dialysis CRBSI have decreased from 4.39 per 100 patient-months to 3.42 per 100 patient-months (p<0.001) 12 months after the implementation of the project.There was a statistically significant association between improved staff practice and infection outcome measures.Conclusion Dialysis CRBSI is a common, yet preventable complication in the dialysis unit. The results show that dialysis nurses play a significant role in preventing dialysis CRBSIs. Basic infection control standards are paramount and should be strictly followed for effective CVDC care.