Introduction
Bloodstream infections (BSIs) pose significant challenges for clinicians as they are costly to treat and have a negative impact on patients’ health and lifestyle. Healthcare facilities also face consequences such as lower scores and reduced Medicare payments when they experience high BSI rates. Therefore, it is crucial for facilities to review policies and ensure adherence to protocols and guidelines. In the dialysis setting, preventing BSIs is especially important, considering that hemodialysis (HD) patients are immunocompromised and have frequent access to their bloodstream during treatment (Al-Barshomy et al., 2021). Patients with indwelling catheters for dialysis are at a higher risk of BSIs, and it is vital for healthcare personnel accessing the catheters to have the necessary education, training, and skills to prevent such infections. In light of a recent increase in BSIs among hemodialysis patients with central venous catheter (CVC) access in my practice, I have analyzed the factors contributing to this rise. This analysis led to the development of the following question: Does the experience and skill level of a nurse, compared to a novice nurse with minimal training, contribute to reducing catheter-related bloodstream infections in dialysis patients? This paper aims to analyze, summarize, and evaluate changes in CVC handling for hemodialysis patients to reduce BSIs.
NURS 4105 Week 2 Reducing Bloodstream Infections in Hemodialysis Patients Recommended Practice Change
To address CVC infections, it is crucial to ensure that the nurses accessing the catheters have the necessary training and experience. Saggu et al. (2018) emphasize the essential role of hemodialysis nurses in catheter care. These nurses rely on their knowledge, skills, and experience to provide optimal care (Saggu et al., 2018). One practice change that can decrease infection incidence is assigning patients with indwelling catheters to more experienced nurses. This change can yield positive outcomes since experienced nurses possess the necessary years of experience to prevent infections and identify early signs and symptoms of BSIs. In a study conducted by Osman and colleagues in a hemodialysis unit, surveys were administered to 30 nurses, more than half of whom had 10-15 years of experience. These nurses demonstrated better knowledge of infection control practices compared to those with less than five years of experience (Osman et al., 2021).
NURS 4105 Week 2 Reducing Bloodstream Infections in Hemodialysis Patients
Another change in practice that can be implemented to reduce BSIs in hemodialysis patients is the provision of training and educational programs for new hemodialysis nurses. Staff shortages often prevent the assignment of CVC patients to experienced nurses, necessitating other staff members to provide care. In such cases, it is vital to ensure that the rest of the staff is capable of caring for these patients. Implementing a training program specifically focused on catheter care for new hemodialysis nurses can be instrumental. This training should encompass proper aseptic techniques and early detection of infections. Additionally, regular assessments and checklists should be implemented to evaluate clinicians’ skills (Soi et al., 2016). In a study conducted in a pediatric hemodialysis unit, 40 nurses participated in an educational intervention on infection control. The study concluded that participants’ knowledge and practice improved following the intervention (Mayoumi and Mahmoud, 2017), indicating that education and training significantly enhance clinical expertise.
NURS 4105 Week 2 Reducing Bloodstream Infections in Hemodialysis Patients Evaluation Strategies
Once the practice change is implemented, several evaluation strategies can be employed to assess the results. Both qualitative and quantitative data will be collected. Qualitative data will be obtained through a self-administered questionnaire consisting of approximately 25 questions. The questionnaire will assess nurses’ knowledge of infection prevention after the post-implementation period (Morkes et al., 2018). Additionally, an observational skill checklist will be used to evaluate participants’ adherence to best practices. Data will be collected over the next 12 months following the intervention to determine if the incidence of BSIs is reduced.
Conclusion
Bloodstream infections present significant challenges for healthcare providers working with hemodialysis patients. Ensuring adherence to guidelines and protocols is crucial for nurses providing care to patients with central venous catheters. While there is limited evidence directly correlating nurses’ expertise to infection reduction, studies indicate that training and education can greatly improve clinical practice and yield better outcomes.
References
Al-Barshomy, M., Al-Ali, A., Aljoudi, A., Al-Sayyari, A., Tarannum, H., Al-Swailmi, F. K., … & Saeed, M. A. (2021). Bloodstream infections in patients on hemodialysis: A single-center experience. Saudi Journal of Kidney Diseases and Transplantation, 32(2), 339-346. Mayoumi, N., & Mahmoud, N. F. (2017). Effect of education program on nurses’ knowledge and practice regarding care of central venous line in pediatric hemodialysis: Evidence-based practice guidelines. Egyptian Nursing Journal, 14(2), 87. Morkes, S. M., Abozead, S. E. S., & Azer, S. Z. (2018). Effect of educational program on nurses’ performance about infection control for patients undergoing hemodialysis. Assiut Scientific Nursing Journal, 6(15), 162-168. Osman, F. K., El Banna, H. M., Sharaf, A. Y., & Mohammed, Y. F. (2021). The effects of educational interventions on nurses’ knowledge and practices in a hemodialysis unit regarding infection control practices. The Egyptian Journal of Hospital Medicine, 84(1), 1739-1748. Saggu, Y., Asmat, K., Margrate, M., & Ahmad, N. (2018). Preventing central line infections among hemodialysis patients: Nurses’ knowledge and practices in accordance with Center for Disease Control and Prevention (CDC) guidelines. Isra Medical Journal, 10(2), 102-108. Soi, V., Moore, C. L., Kumbar, L., & Yee, J. (2016). Prevention of catheter-related bloodstream infections in patients on hemodialysis: Challenges and management strategies. International Journal of Nephrology and Renovascular Disease, 9, 95-103.
