ANAHEIM–The results of a study on reducing catheter-related blood stream infections in an outpatient dialysis setting showed that special care by nurses can make a difference.

The study, presented at the 45th annual meeting of the American Nephrology Nurses Association here and lead by Nancy Culkin, RN, BSN, CNN of DaVita HealthCare Partners, Denver, Colo., concludes that technical and adaptive approaches from the Johns Hopkins University Armstrong Institute have reduced catheter related bloodstream infection (CRBSI) in hospitals.

A survey was sent out by 431 DaVita employees. “We found areas for systematic improvement in pre, intra, and post dialysis central venous catheter (CVC) care from the medical literature.”

Early in the process
Early in the stages of opening the new clinics, the DaVita team created a procedural kit with checklist, antimicrobial swabs for skin prep, triple antibiotic ointment for on site application, alcohol swabs to facilitate hub scrub, and exit site dressing. Another kit/procedural checklist was created for central venous catheters, dialysis initiation and termination. Teammates charted each new CRBSI episode utilizing a calendar to monitor progress. “During the evaluation period, we saw a greater decline in CRBSI rates in projects around the city,” said DaVita staffers.

Conclusion
Safety assessment tools and interventional approaches that reduce CRBSI in hospitals can be successfully applied to reduce CRBSI in chronic dialysis facilities, the authors noted.