By Peter Laird, MD
Inadequate infection control practices remains the single largest preventable source of dialysis related complications by many reports. Sadly, the culture of overlooking basic hand washing, changing gloves and proper cleaning of the dialysis machine is prevalent in every dialysis unit I have dialyzed (9 in 7 different states). The lessons learned in the ICU preventing blood borne infections with central line catheters by a simple check list where health care associated infections (HAI) have been essentially eliminated should become the model of care in dialysis units.
The World Health Organization (WHO) is now sponsoring the Clean Care is Safer Care initiative which promotes the annual wash your hands day events now ongoing in Canada, but apparently it has yet to catch on here in the United States.
The Canadian Patient Safety Institute (CPSI) launched a national hand hygiene campaign in 2007 under the theme “STOP! Clean your hands”. CPSI is working on this initiative with the Community and Hospital Infection Control Association–Canada, the Canadian Council on Health Services Accreditation and the Public Health Agency of Canada.
A simply mental checklist is also available to remind health care workers when they must wash their hands to prevent HAI's from the WHO. Simply applying these simple concepts could help prevent thousands of dialysis center acquired infections every year. It is time to put this life saving knowledge to work and change our cultures of death in our American dialysis centers.
The My 5 Moments for Hand Hygiene approach defines the key moments when health-care workers should perform hand hygiene.
This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings.
This approach recommends health-care workers to clean their hands
- before touching a patient,
- before clean/aseptic procedures,
- after body fluid exposure/risk,
- after touching a patient, and
- after touching patient surroundings.