Assessing Gaps in Dialysis Station Disinfection Practices


Mar 12, 2019 - Vital Signs: Central line - associated blood stream infections - United. States, 2001, 2008, and 2009. MMWR Morbidity and Mortality Weekly ...

Assessing Gaps in Dialysis Station Disinfection Practices APIC MEETING 3.12.19 LEAH BOMESBERGER, RN BSN (AND, HOPEFULLY BY MAY 2019: MPH)

Disclosures 

None

Background 



Infection: Second leading cause of hospitalization and death for dialysis population (USRDS, 2017).

Approximately 37,000 infections occurring in outpatient hemodialysis centers in 2008 (CDC, 2011). 

One in every four dialysis patients may die from complications of infection (CDC, 2015).

We need your help!

The Problem(s) 

What are the common trends or citations during Medicare surveys related to infection control?



What gaps or needs, exist surrounding these infection control issues for frontline staff?

The Assessment (methods)

Results



Adenosine triphosphate (ATP) Testing Sites

Forensic Luminol Results (Chemiluminescent Marker testing)

Easier/more interesting to say

If I can’t see it, it doesn’t exist. Right?

Forensic Luminol Results

All low light photographs courtesy of GHS Medical Media Department

Themes identified from staff interviews

Interviews Qualitative Data

Spills, Sprays & Other Unique Situations “You do the best you can”



Provide the tools and time



Clearly communicate and educate



Simulate real-life experiences to develop muscle memory

Checking the Box - Patient Perspective Teaching opportunity

“Some things I think they do, that are Medicare regulated, are overkill, and I think that they are unnecessary. Like the fact that they can’t clean the machine until I leave the station. I think that’s silly. I’m sitting here and blood isn’t going to squirt on the machine, or I’m not going to spit on the machine. I think it cuts down on their efficiency of time because they can’t clean it until I leave the station.”

Teaching opportunity

Thank you!

Shift Perspectives

Retrieved from Campbells soup website, 2019

Shift Perspectives

Retrieved from: The MoMA Learning website, 2019 Retrieved from: The Andy Warhol Museum website, 2019

Encourage Collaboration

References Cited Association for Professionals in Infection Control and Epidemiology. (2010). Guide to the Elimination of Infections in Hemodialysis. Centers for Disease Control and Prevention. (2018). Making Dialysis Safer for Patients Coalition. Retrieved from https://www.cdc.gov/dialysis/coalition/index.html Centers for Disease Control and Prevention. (2015). National Healthcare Safety Network (NHSN): Tracking Infections in Outpatient Dialysis Facilities. Retrieved from https://www.cdc.gov/nhsn/dialysis/index.html Centers for Disease Control and Prevention. (2011). Vital Signs: Central line - associated blood stream infections - United

States, 2001, 2008, and 2009. MMWR Morbidity and Mortality Weekly Report, 60(8), 243-247. United States Renal Data System. 2017. Incidence, prevalence, patient characteristics and treatment modalities. Retrieved from https://www.usrds.org/2017/download/v1_c01_GenPop_17.pdf

MANY THANKS! 

Gundersen Infection Control Department



GHS Renal: staff, patients, and leadership



Bridget Pfaff & Dr. Gary Gilmore



GHS Medical Media Department



Google Images→ and funny people who create Memes



My Couch (Grad School + Writing/ stats homework x µ sin 𝛼 ± sin 𝛽 = 1 1 2 sin 𝛼 ± 𝛽 cos 𝛼 ∓ 𝛽 = really nice naps) 2

2



Family & Friends



APIC Badger! (For being the test run for my oral defense - THANK YOU)

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