Original InvestigationDialysisBloodstream Infection Rates in Outpatient Hemodialysis Facilities Participating in a Collaborative Prevention Effort: A Quality Improvement Report
Section snippets
CDC Dialysis BSI Prevention Collaborative and Interventions
Participation in the CDC Dialysis BSI Prevention Collaborative project (the Collaborative) was voluntary and open to any US outpatient hemodialysis facility. Core activities of the Collaborative included participation in the CDC's NHSN surveillance system, implementation of the Collaborative interventions, and participation in monthly conference calls and yearly in-person meetings. The CDC provided participant training and assistance on NHSN enrollment and reporting procedures. Participants
Results
Of the 17 facilities included in the analysis, most facilities were not for profit (n = 15), hospital affiliated (n = 11), not part of a corporate chain (n = 16), and located in the Northeast (n = 11; Table 1). Facilities reported a median of 17 months of data to the NHSN during the evaluation period.
During the preintervention period, pooled mean BSI and access-related BSI rates were 1.09 and 0.73 events per 100 patient-months, respectively. During the postintervention period, these rates were
Discussion
The mostly hospital-based hemodialysis facilities participating in this collaborative project were able to demonstrate substantial intervention-associated decreases in their BSI and access-related BSI rates, adding evidence that multicenter initiatives can effectively prevent vascular access infections. BSI reductions of this magnitude have the potential to markedly advance patient safety and produce cost savings.18 Previous initiatives have reduced central catheter–associated BSIs in inpatient
Acknowledgements
The authors thank all members of the CDC Dialysis BSI Prevention Collaborative, Ms Barbara Bond for support, and Dr Katherine Ellingson for providing technical guidance.
These findings were presented in part at the National Kidney Foundation Spring Clinical Meetings in Washington DC, May 10, 2012.
Support: The collaborative project described in this article was funded by the US CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official
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Originally published online May 15, 2013.