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hello my name is Dr John Jernigan and
I'm a medical officer at the Centers for
Disease Control and prevention or
CDC infections are the second leading
cause of death among hemodialysis
patients and many of these infections
are preventable the following video
segments will review recommended
practices based on publish evidence and
best practices that you can use to help
prevent infections and keep your
patients safe
hand hygiene is one of the most
important ways to prevent the spread of
infections hand hygiene means either
washing your hands with soap and water
or using an alcohol-based hand rub when
your hands are contaminated with blood
other body fluids or are visibly dirty
wash them with soap and water if your
hands aren't visibly dirty you can use
an alcohol-based hand rub instead
there are many times when it's necessary
for you to perform hand hygiene
including before and after you provide
care for a
patient before you draw inject or Infuse
a medication or
solution before you cannulate a fistula
or graft or access a
catheter after you touch blood body
fluids mucous membranes or use materials
such as dressings or spent
dialysate after you touch medical
equipment or other items at the dialysis
station
and after you remove your
gloves changing your gloves is important
to protect your patients from infections
examples of when you should remove your
gloves and put on new gloves include
after contacting a potentially
contaminated site before moving to a
clean site after contact with blood or
body fluids and after completing task at
one patient station and moving to
another
station remember two easy ways to reduce
the chances of spreading an infection
are to perform hand hygiene and change
your
gloves safely handling and caring for a
patient's vascular access is vital for
preventing infections particularly in
patients who use a catheter because the
risk of infection is highest in these
patients this segment will teach you
ways to follow aseptic technique which
means taking great care not to
contaminate the catheter during con
connection or disconnection
procedures it's also important to follow
aseptic technique while caring for the
catheter exit site which includes the
following steps while wearing other
appropriate personal protective
equipment or PPE perform hand hygiene
and put on a new clean pair of
gloves remove the catheter
dressing evaluate the catheter exit site
for signs of infection like redness or
swelling remove your gloves perform hand
hygiene and put on a new clean pair of
gloves apply chlorhexadine to the exit
site using mild friction let the exit
site air dry naturally and do not touch
it apply an antimicrobial ointment that
is compatible with the catheter
material apply clean dressing to the
exit site being careful not to touch the
exit s and remove your gloves and
perform hand
hygiene to properly perform a catheter
scrub the Hub procedure during
connection use the following steps put
on a gown and a face shield use a mask
if required by facility
policy perform hand hygiene and put on a
new clean pair of gloves some centers
may choose to use sterile
gloves make sure to clamp both limbs of
the catheter to prevent an air
embolis remove the
Caps while keeping the catheter clamped
apply antiseptic to each end of the
catheter which are the hubs using new
sterile antiseptic pad for each
Hub scrub the end and sides of each Hub
with friction ensuring that all debris
is
removed to maintain aseptic technique
let the catheter Limbs and hubs air dry
naturally do not touch the cleaned hubs
and do not set the hubs
down connect the catheter to the blood
lines using aseptic technique unclamp
the catheter only after it's
connected and remove your gloves and
perform hand
hygiene if any of your patients use a
needleless connector device on their
catheter you should follow the
manufacturer recommendations for that
type of device when the patient has
completed treatment the same care should
be taken using the scrub The Hub
procedure for catheter
disconnection while wearing other
appropriate PPE perform hand hygiene and
put on a new clean pair of
gloves make sure to clamp the catheter
and then disconnect the catheter from
the blood lines using aseptic
technique once again apply antiseptic to
the ends or hubs of each
catheter use a new sterile antiseptic
pad for each
Hub scrub the end and sides of each Hub
with friction ensuring that all debris
is
removed let the catheter Limbs and hubs
air dry
naturally do not touch the cleaned hubs
and do not set the hubs
down attach new sterile caps using a
peptic technique and remove your gloves
and perform hand
hygiene you should scrub The Hub anytime
there is a line disconnection or
reversal following the scrub The Hub
protocol and paying close attention to
aseptic technique will help prevent
bloodstream
infections safely handling or caring for
a patient's vascular access is important
to prevent infections
this segment will teach you ways to
follow aseptic technique which means
taking great care to not contaminate the
fistula or graphite during canulation
and de
canulation this video segment does not
apply to patients who use button hole
access here's how to perform the
canulation procedure for patients with
fistulas or graphs patients are
encouraged to wash their own excess site
if possible clean the site with soap and
water if the patient hasn't already done
so put on on a gown and a face shield
perform hand hygiene and put on a new
clean pair of
gloves assess the vascular access site
for signs of infection such as redness
or
swelling if there are signs of infection
do not culate without further
investigation if the site is clear apply
skin antiseptic to the site and allow it
to
dry to maintain aseptic technique let
the antiseptic air dry naturally and do
not touch the clean sight
perform canulation and be careful not to
contaminate the area that has been
cleansed secure the needles and connect
to the Bloodlines using aseptic
technique and remove gloves and perform
hand
hygiene when the patient has completed
treatment here are the steps for fistula
or graft DEC
canulation put on a gown in a face
shield assist the patient with gloving
if they will be compressing their access
site perform hand hygiene and put on a
new clean pair of
gloves disconnect from the blood lines
using aseptic
technique activate the needle retraction
device and remove needles using aseptic
technique dispose of the needles in a
proper Sharps
container apply clean Galls or a bandage
to the access site and compress it with
Clean gloved Hands both the staff and
patient should remove gloves and perform
hand
hygiene following these steps will
reduce the risk of an access related
infection dialysis staff must perform
routine disinfection of the dialysis
station to prevent the spread of
infections the following steps are
intended to be used when there is no
visible blood on surfaces at the
dialysis station when blood or other
soil is visible surfaces must be cleaned
prior to
disinfection here are the actions you
should take before begin beginning
routine disinfection of the dialysis
station while wearing a gown and gloves
disconnect and take down the used blood
tubing and dialyzer from the dialysis
machine discard tubing and dialysers in
a leak proof container or remove dialer
from the station in a leak proof Manner
and check for Visible soil or blood on
surfaces all visible blood should be
cleaned
immediately the following actions may be
performed in any order
ensure that the priming bucket has been
emptied discard all single use
supplies move any reusable supplies to
an area where they will be disinfected
before being stored or returned to a
dialysis station ensure that the patient
has left the dialysis
station finally remove your gloves and
perform hand
hygiene now here are the steps for
routine disinfection of the empty
dialysis station when there is no
visible soil or blood on Surface
while wearing a gown put on clean
gloves apply disinfectant to all
surfaces in the dialysis station using a
firm wiping motion make sure that
surfaces of the station are visibly wet
with
disinfectant also disinfect all surfaces
of the emptied priming bucket let all
surfaces air dry
naturally avoid Rec contaminating
surfaces by keeping any used or
potentially contaminated items away from
the disinfected
surfaces finally remove your gloves and
perform hand
hygiene do not bring the next patient or
any supplies for the next treatment to
the dialysis station until all of these
steps have been
completed following these steps for
routine disinfection will help prevent
the spread of
infections e