Healthcare-associated infections are a major risk to patient safety.
Infection is the first cause of hospitalisation and the second most common
cause of mortality among haemodialysis (HD) patients. HD patients, as well as
the dialysis staff, are vulnerable to contracting healthcare-associated
infections due to frequent and prolonged exposures to many possible
contaminants in the dialysis environment. The extracorporeal nature of the
therapy, the associated common environmental conditions, and the immune
compromised status of HD patients are major predisposing factors. HD patients
are exposed to different types of infections which include bloodstream infections
and localized infections of the vascular access, blood-borne infections with
hepatitis B virus, hepatitis C virus, and/or human immunodeficiency virus, and
airborne infections. Sources of infections include contaminated water,
equipment, environmental surfaces, and infected patients. The evident increased
potential for transmission of infections in the HD settings led to the creation
and implementation of specific and stricter infection prevention and control
measures in addition to the usual standard precautions. Contaminated hands of
healthcare workers are among the most common modes of transmission of
healthcare-associated infections. Hand hygiene is singled out as the most
important infection prevention intervention. Hand hygiene compliance can be
improved by continuous education and monitoring, providing a sufficient number
of sinks with soap dispensers, paper towels, hand lotions and alcohol-based
hand rub placed at each patient station, and regular feedback of surveillance
results. Education and training and full awareness of infection control
policies and procedures should be provided to all Healthcare workers and to be
repeated regularly. The patient and/or caregiver should also be educated on
hand hygiene and the care of new vascular access.
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