["Getting to zero infections" in hemodialysis]. / "Getting to zero infections" in emodialisi: un obiettivo raggiungibile. Ruolo della formazione del personale sanitario e dell'impiego di nuovi presidi nella prevenzione delle infezioni cvc correlate.
G Ital Nefrol
; 32(5)2015.
Article
en It
| MEDLINE
| ID: mdl-26480255
ABSTRACT
INTRODUCTION:
We describe two measures adopted in hemodialysis outpatient population in order to reduce Central Venous Catheter (CVC) related infections. The first is a nurse staff training in the field project and the second deals with the employment of chlorhexidine-impregnated dressing devices. These actions were performed after high infection rates were observed through a dedicated register. MATERIALS ANDMETHODS:
In the limited assistance dialysis center, direct observation (12/2012-02/2013) quantified the gap between the observed and expected health care behaviour. Training needs were defined and a 40 hours nurse staff training in the field was performed on two occasions. In the hospital dialysis center, we introduced alcoholic 2% chlorhexidine solution and chlorhexidine-impregnated dressing devices to the exit site (CHG-Tegaderm and BioPatch). Infections (cumulatively bacteremia/sepsis/skin exit/subcutaneous tunnel) were monitored continuously.RESULTS:
Infection rates at the two locations were progressively reduced, reaching a value of zero at the limited assistance center. Nurse staff training in the field produced two patient reports and three CVC management protocols, Italian language translation of the "The 5 moments of dialysis" WHO poster, alcoholic 2% chlorhexidine adoption to exit-site medication and improvement of environment cleaning/sanitation actions.CONCLUSIONS:
Our experience shows that continuously monitoring infection rates represents the first step for timely corrective action. The continuous updating of health personnel, codified prevention measures and an ongoing commitment to raise awareness in a routine practice, allows us to obtain the goal of "getting to zero infections". The staff training produced equal or superior results compared to the isolated use of new chlorhexidine-impregnated dressing devices.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vendajes
/
Clorhexidina
/
Diálisis Renal
/
Educación en Enfermería
/
Infecciones Relacionadas con Catéteres
/
Antiinfecciosos Locales
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
It
Revista:
G Ital Nefrol
Asunto de la revista:
NEFROLOGIA
Año:
2015
Tipo del documento:
Article