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Abstract: FR-PO758

Decreasing the Incidence of Catheter-Related Blood Stream Infections in Hemodialysis Patients: A Quality Improvement Program

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Al-Badr, Wisam H.A., DaVita-Saudi Arabia, Riyadh, Saudi Arabia
  • Shaheen, Mahmoud Maamoun, DaVita-Saudi Arabia, Riyadh, Saudi Arabia
  • Salama, Hany AlAnany, DaVita-Saudi Arabia, Riyadh, Saudi Arabia
  • Ahmed, Mahmoud Ahmed mohamed, DaVita-Saudi Arabia, Riyadh, Saudi Arabia
  • Elshiekh, Hany, DaVita-Saudi Arabia, Riyadh, Saudi Arabia
  • Jubran, Ibrahim Abduh, DaVita-Saudi Arabia, Riyadh, Saudi Arabia
  • Alobaili, Saad S., DaVita-Saudi Arabia, Riyadh, Saudi Arabia
  • Alsuwaida, Abdulkareem, DaVita-Saudi Arabia, Riyadh, Saudi Arabia
Background

Hemodialysis patients dialyzing with a central venous catheter are at risk for developing catheter-related bloodstream infections (CRBSI), which are associated with substantial morbidity. In 2009, the US Centers for Disease Control and Prevention (CDC) sponsored a collaborative project to reduce CRBSIs in outpatient hemodialysis facilities. The aim of our study was to evaluate the impact of applying the CDC program on the occurrence of CRBSI in an outpatient hemodialysis population.

Methods

All cases of CRBSI that occurred among patients treated at 20 outpatient dialysis centers operated by DaVita-Saudi Arabia (Oct. 2015 to Dec. 2017) were recorded. The quality improvement project, which involved adopting the CDC Dialysis BSI Prevention Collaborative Interventions was initiated in April 2016. Interventions used included the CathAway protocol, ideal catheter lock, standardization of antibiotic therapy, training protocols, closed audits for catheter care, and maximal barrier precautions at the time of catheter insertion. The rate of CRBSI was calculated monthly as the incidence of CRBSI per 1000 catheter-days.

Results

During the studied period, the monthly CRBSI incidence decreased from 5.6 per 1000 catheter-days in the first quarter 2016 to a nadir of 1.8 during the last quarter 2017. There was also a substantial decrease in the mean monthly incidence of CRBSI from 5.1 ± 3.8 among 1477 patients in 2016 to 2.7 ± 0.86 among 2255 patients in 2017.

Conclusion

The most effective strategy for prevention of CRBSIs is reducing the use of catheters. However, given the reality that catheter use cannot be eliminated, adoption of CDC-recommended programs may reduce the rate of CRBSI.

Funding

  • Commercial Support