Impact of implementation of standard infection control measures on the reduction of vascular access infection among hemodialysis patients at Alexandria university student hospital

ABSTRACT

Many advances have been made in the care and treatment of those with renal insufficiency and End Stage Renal Diseases [ESRD]. However, infection is still the second highest cause of death, after cardiovascular causes, with 71.6% of this mortality associated with sepsis is 50 times greater in renal patient than that seen in the general population. It accounts for around 30% of all hospital admissions. Additionally, in the hemodialysis [HD] population between 25-50% of infection are associated with vascular access most notably central venous catheter [CVCs] causing major morbidity rates for these patients. The study was conducted on 52 patients on maintenance [HD] in Alexandria University student hospital for 9 months before and after implementation of standard infection control measures [S1CM]. The sample included 45 patients with native vein arteriovenous fistula [AVF], 2 with prosthetic graft [PG-A VF] and 5 with central venous catheters [CVCs]. From the start of infection control program, orientation and training of dialysis unit staff on [SICM] together with supervision from assigned personnel from the unit and infection control team in the hospital. Sign and symptoms of infection, lab investigations, hospital admission and antibiotic therapy were recorded. Data collected were compared to registered records 9 months before the start of infection control program. Remarkable reduction of infection rates were observed. Before the implementation of infection control program the rates were 20% in [AVE], 27% in PGA VF and 50% of [CVCs] and later were reduced to 4%, 10% 15% respectively after 9 months from the start of [S1CM] and the difference were found to be statistically significant [p<0.001]. It is concluded that compliance to SICM; have resulted in a remarkable reduction of infection rates of vascular access among HD patients. These results will be used to improve the quality of health care and will help to evaluate the efficiency of SICM