Bloodstream Infection Executive Summary

Executive Summary According to Centers for Disease Control and Prevention (CDC) (2016) since 1993, hospitalization rates among hemodialysis (HD) patients related to bloodstream infection (BSI) have increased by 47% and by 87% for vascular access infection. Hand hygiene is the cornerstone of infection prevention. Staff and patient education and compliance with infection prevention practice must be mandatorily enforced at all HD outpatient facilities. Dialysis staff must ensure patients are actively involved and understand their role in infection prevention and control such as proper hand washing technique, hand hygiene, vascular access care and wound cleaning, identify signs and symptoms of infection, and be knowledgeable on standard
infection control policies and procedures. This proposal details a 4-week plan to present an in-service educational presentation on infection control and prevention for the staff of Maryvale DaVita during the mandatory monthly staff meeting.
This project will be presented in the implementation week. Evaluation of the presentation and extent of information learned will be assessed by a post-test cum survey by all staff present. Project success and continuity will be assessed based on the positive response on the survey along with staff and patient participation and compliance with hand washing before and after dialysis and cleaning of vascular access prior to dialysis. Any occurrence of vascular access related infection will be recorded as a negative outcome. The benefits derived from the educational presentation exceeds the estimated hospitalization cost for the treatment of BSI. Knowledge is power and this knowledge will be utilized to educate ESRD patients with compromised immunity to protect themselves from infections, cross-contamination, and disease transmission by complying with fundamental evidence-based self-management
skills.

In-Service Education on Infection Control for Hemodialysis Staff Infection is the second leading cause of death among hemodialysis patients.
In 2008, there were an estimated 37,000 central line-associated BSI among HD patients (Lindberg, Downham, Buscell, Jones, Peterson, & Krebs, 2013). These numbers are projected to increase because of the 15% predicted growth of end-stage renal disease (ESRD) patients by 2020 (Lindberg et al., 2013). The estimated cost per episode is $3,700 to $28,000 and the attributable mortality is 12-25% (Patel, 2013). ESRD patients are highly susceptible to infections because of their compromised immunity, frequent invasive use of vascular accesses, exposure to blood-borne pathogens (e.g., Hepatitis B or C), and colonization with multidrug-resistant microorganisms (e.g., methicillin-resistant Staphylococcus aureus (MRSA)). Hand hygiene is the most important evidence-based intervention to prevent transmission of nosocomial infection in a health care setting. Therefore, it is imperative for all HD patients to be educated on the importance of regular hand washing before and after treatment and perform vascular access care (CVC, AVF, or AVG) daily. This patient-centered in-service educational presentation will emphasize on the following safety concerns: importance of regular hand washing before and after dialysis; cleaning of fistulas or grafts before dialysis; recognize signs and symptoms of infection; and compliance with standard infection control policies
and procedures.