Using collaboration and a standardised approach to achieve a sustained reduction in haemodialysis related blood stream infections (BSI)

Megan Brown 1, Amanda Sharpe 1, Danielle Field 1

Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia


Haemodialysis patients are recognised as being at risk of developing bloodstream infections (BSI). In May 2015 routine surveillance identified that the number of BSI affecting our haemodialysis patients had risen to nine from a baseline of four in 12 months. There had been a shift in the type of causative pathogens from mostly gram negative up until June 2014 to mostly gram positive.

An infection prevention and control review identified poor compliance with policies for the storage and management of reusable patient equipment, sterile stock, cleaning and aseptic technique. hand hygiene compliance was 87.8%. A multidisciplinary collaborative approach was used to develop and implement improvement strategies which included staff education, a standardised approach for cleaning and storage of patient equipment, aseptic technique and monthly environmental audits.

From June 2015 to May 2016 there have been no haemodialysis related BSI affecting patients undergoing haemodialysis within this unit. Strategies have been implemented within all LHD renal units in a coordinated approach that has been led by renal unit nurse managers and physicians. Rates across the district have also reduced. The possible role of patient-designated equipment containers on the risk of BSI in this patient group was identified.

Success of this project largely lies in the collaboration and team work across disciplines and the ownership of the project by the renal department. The findings from this project could be transferable to other renal units or similar high risk settings.

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