cdc press release 5 13-13 following cdc protocols cuts dialysis bloodstream infections in half
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CDC issued a press release May 13, 2013 titled “Following CDC Protocols Cuts Dialysis Bloodstream Infections in Half.” (Click here to view CDC Press Release on Dialysis Protocols 5-13-2013 hear at Dialysis Lawsuit or click here to view the press release on the CDC website.) The press release summarized the findings of a study of 17 outpatient dialysis facilities and compared infection rates before and after a set of CDC interventions were consistently used. The study was published in the American Journal of Kidney Diseases. Among other things of interest to people who are undergoing dialysis (and their family members), consider: The shocking title of the press release that says half of all bloodstream infections would be eliminated if only the dialysis centers would follow CDC protocols; The statement by CDC Director Tom Frieden, M.D., M.P.H., who said, “These infections are preventable. CDC has simple tools that dialysis facilities can use to help ensure patients have access to the safe healthcare they deserve.” The fact that the CDC protocols do not impose costly improvements to dialysis clinics, but on things such as: “hand hygiene…” This seems to be saying, “dialysis center employees, wash your hands, wash them well, and wash them between every patient.” applying an antiseptic to the skin for catheter exit-site care. The CDC press release also stated: ”About 8 in 10 of these patients start treatment with a central line, which is a tube that a doctor usually places in a large vein in a patient’s neck or chest to give important medical treatment. When not put in correctly or not kept clean, central lines can provide a portal for germs to enter the body and cause bloodstream infections. As a result of the study, dialysis centers received a simple CDC checklist for dialysis centers. The checklist is a PDF file that will be uploaded on Michael J. Evans' SlideShare network The checklist contains things such as: Check that there is no visible soil or blood on surfaces; Ensure that the patient has left the dialysis station; Discard all single-use supplies; Remove gloves and perform hand hygiene; Wear clean gloves. There are more items on the checklist, but most are common sense items such as the ones listed above. Did half the dialysis patients who got blood infections before the CDC press release get the infections simply because the dialysis center employees didn’t follow proper hygiene? How many hospitalizations for bloodstream infections and how many dialysis deaths could have been prevented? It would seem to be reasonable to conclude from the CDC documents that half of all bloodstream infections are due to poor medical hygiene. Read the documents for yourself. And if you or your family member is a patient at an outpatient dialysis center, it might not be a bad idea to print out a copy of the CDC Checklist and take it with you the next time you go to the dialysis center.TRANSCRIPT
Press ReleaseFor Immediate Release: Monday, May 13, 2013Contact: CDC Division of PublicAffairs (http://www.cdc.gov/media/index.html)(404) 639-3286
Following CDC Protocols Cuts Dialysis Bloodstream Infectionsin HalfCDC provides tools to help all U.S. dialysis facilities reduce potentially deadly infections
Today, the Centers for Disease Control and Prevention (CDC) released results of its DialysisBloodstream Infection Prevention Collaborative (http://www.cdc.gov/dialysis/collaborative/)showing a 32 percent decrease in overall bloodstream infections and a 54 percent decrease invascular access-related bloodstream infections after CDC prevention guidelines were used. Vascular access-related bloodstream infections are those related to devices used to access thebloodstream for hemodialysis. With approximately 37,000 bloodstream infections occurringeach year among dialysis patients with central lines, at an estimated cost of $23,000 perhospitalization, wider implementation of the practices in this study (http://www.cdc.gov/dialysis/prevention-tools/core-interventions.html) could help save lives and reduce excess health carespending.
Published in the American Journal of Kidney Diseases (http://www.ajkd.org/) (http://www.cdc.gov/Other/disclaimer.html) , the study looked at data reported to the NationalHealthcare Safety Network (http://www.cdc.gov/nhsn/dialysis/index.html) (NHSN) by 17outpatient dialysis facilities and compared infection rates before and after a set of CDCinterventions were consistently used. Interventions included chlorhexidine (an antiseptic forthe skin) for catheter exit-site care, staff training and competency assessments focused oncatheter care and aseptic technique, hand hygiene and vascular access care audits, andfeedback of infection and adherence rates to staff. Facility staff were also encouraged to useantimicrobial ointment on central line exit sites.
"Dialysis patients often have multiple health concerns, and the last thing they need is abloodstream infection from dialysis,” said CDC Director Tom Frieden, M.D., M.P.H. “Theseinfections are preventable. CDC has simple tools that dialysis facilities can use to help ensurepatients have access to the safe healthcare they deserve.”
In 2010, more than 380,000 patients in the United States relied on hemodialysis for treatmentof their end-stage kidney disease. About 8 in 10 of these patients start treatment with a centralline, which is a tube that a doctor usually places in a large vein in a patient’s neck or chest togive important medical treatment. When not put in correctly or not kept clean, central linescan provide a portal for germs to enter the body and cause bloodstream infections. Other forms
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of vascular access used for hemodialysis, such as arteriovenous fistulas and grafts, can also putpatients at risk for bloodstream infections, but to a lesser extent than central lines.
Although the overall rate of hospitalization among hemodialysis patients has remainedrelatively stable since 1993, the rate of hospitalization for bloodstream infections has increased51 percent. A dialysis patient is more than 100 times more likely to get a bloodstream infectionfrom a common resistant bacteria, methicillin-resistant Staphylococcus aureus, than otherpeople. Infections with Staphylococcus aureus can be potentially devastating and can result inhospitalization, death, and serious complications such as endocarditis (heart infection) andosteomyelitis (bone infection).
To address this critical public health issue, CDC launched a collaborative project in April 2009to prevent bloodstream infections among dialysis patients and invited outpatient dialysiscenters to participate. CDC and the participating dialysis centers worked together to developand implement the package of interventions to prevent bloodstream infections. The dialysisfacilities tracked bloodstream infections in their patients using CDC’s National HealthcareSafety Network (http://www.cdc.gov/nhsn/dialysis/index.html) (NHSN), which is now being usedby over 5,000 dialysis facilities nationwide for tracking and prevention of healthcare-associated infections.
“Dialysis patients are particularly vulnerable to infections,” said Dr. Priti Patel, head of CDC’sdialysis safety efforts. “We now know it is possible to significantly reduce the infections amongdialysis patients by following CDC’s checklists and tools. If all dialysis facilities nationwidewere using the CDC interventions, we could see dramatic reductions in infections and adverseoutcomes in this population.”
Dialysis facilities can implement many of CDC’s recommendations by using a series ofchecklist (http://www.cdc.gov/dialysis/PDFs/collaborative/checklist-Portfolio.pdf) s andperforming observations using audit tools (http://www.cdc.gov/dialysis/PDFs/collaborative/audit-tools-Portfolio2.pdf) that are currently available on CDC’s website. Additionally, CDC hasreleased a free infection prevention course (http://www.cdc.gov/dialysis/clinician/CE/infection-prevent-outpatient-hemo.html) for dialysis nurses and technicians that reviews CDCrecommended practices in a convenient, 1-hour self-guided internet training course that alsooffers continuing education credits.
Preventing bloodstream infections among dialysis patients has been identified as a nationalpriority (http://www.hhs.gov/ash/initiatives/hai/esrd.html) (http://www.cdc.gov/Other/disclaimer.html) by the U.S. Department of Health and Human Services (http://www.hhs.gov/)
(http://www.cdc.gov/Other/disclaimer.html) . Several initiatives have demonstrated the abilityto reduce bloodstream infections in hospital intensive care units, but prior to the CDC DialysisBloodstream Infection Prevention Collaborative, there have been few similar initiativesattempted in outpatient settings.
For more information on what CDC is doing to make dialysis safer for patients, please see:www.cdc.gov/dialysis (http://www.cdc.gov/dialysis) .
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Page last reviewed: May 15, 2013Page last updated: May 15, 2013Content source: Centers for Disease Control and Prevention
Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA30333, USA800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
For more information about the study, visit: http://www.sciencedirect.com/science/article/pii/S0272638613006677 (http://www.sciencedirect.com/science/article/pii/S0272638613006677)
(http://www.cdc.gov/Other/disclaimer.html) .
To access CDC’s dialysis infection prevention tools, see: http://www.cdc.gov/dialysis/prevention-tools/index.html (http://www.cdc.gov/dialysis/prevention-tools/index.html) .
###U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (http://www.hhs.gov/)
(http://www.cdc.gov/Other/disclaimer.html)
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