Hemodialysis infection

When a person suffers from renal failure, medical intervention is required. Severe renal failure requires hemodialysis, which is a very complex technology and also causes severe pain to patients undergoing hemodialysis. There are also many precautions during the implementation of hemodialysis. So what should we do if an infection occurs after hemodialysis?

Infection Prevention and Control Program

1. Each dialysis room should develop and implement an infection control plan to prevent and reduce the risk of infection

2. Dialysis rooms or centers should establish rapid response procedures to deal with emergencies, such as epidemics and national disasters

3. Implement the following measures based on the specific circumstances of each institution:

➤ Develop, implement and monitor infection control systems to protect the health of dialysis staff

➤ Provide infection control education and training to dialysis staff

➤Disinfection of dialysis equipment and supplies

➤Environmental cleaning and disinfection

➤Control blood-borne infections, vascular access infections, water treatment infections and vaccination

➤ Basic protective measures such as hand hygiene, isolation and aseptic technique

02

Hand Hygiene

The following are the times to perform hand hygiene:

➤ Before contact with the patient (e.g., measuring vital signs, assessing vascular access)

➤ Before cleaning or aseptic operation

➤ Before administration

➤Before contact with wounds (such as catheter dressings)

➤ Before invasive procedures (eg, vascular access or venipuncture)

➤ After contact with body fluids (e.g., to stop bleeding after dialysis treatment)

➤After contact with the patient

➤ When hemodialysis patients, their families and visitors enter the dialysis room

03

Isolation protection

➤ Take isolation measures when necessary to prevent patients with suspected or confirmed infection from spreading the infection

➤ Patients with acute respiratory infections should wear surgical masks when entering the dialysis room

➤ Contact with patients with suspected or confirmed infection should use standard precautions and take appropriate precautions based on the mode of transmission (contact, body fluids, and/or airborne).

➤ Patients with infections transmitted through contact or body fluids should receive dialysis in a single isolation room or after others have completed dialysis treatment.

➤ Patients with airborne infections should be dialyzed in a negative pressure isolation room or a single isolation room

04

Preventing infection during dialysis

➤ Arteriovenous fistulas or arteriovenous grafts should be inspected for infection at the exit or cannulation site during each hemodialysis visit.

➤ Strictly follow hand hygiene and aseptic techniques during dialysis

➤ It is forbidden to use the same supplies for different patients

➤ Injections should be prepared in a non-dialysis treatment area

05

Control of blood-borne infection sources

➤ All patients receiving hemodialysis should be tested for hepatitis B and C

➤ Patients at risk of hepatitis B infection should be vaccinated against hepatitis B

➤ Patients who are positive for HBsAg should be equipped with specialized dialysis equipment and supplies

06

Controlling Vascular Access Infection

➤ Avoid long-term use of temporary catheters and remove them as soon as possible

➤ When using a dialysis catheter for dialysis, the catheter outlet site and catheter interface should be checked for infection during each hemodialysis session.

➤ When inserting the catheter, the operator should wear a mask and sterile gloves

➤When using arteriovenous access for dialysis, the catheter site should be cleaned and disinfected

➤When inserting the catheter, the operator should strictly follow the aseptic technique operation procedures

07

Water treatment

➤Use ultrapure dialysate for dialysis, especially high-flux dialysis or hemodiafiltration

➤ Dialysis water should be regularly monitored for bacterial and chemical contaminants

➤ Bacterial monitoring should be done once a month

08

Waste Disposal

➤ Materials used in the hemodialysis process, such as dialysis membranes, tubing or needles should be disposed of as biomedical waste in special containers

➤ Dialysate should not come into direct contact with blood and need not be treated as biomedical waste

09

Cleaning, disinfection and sterilization

➤Items and equipment used in the dialysis process should be cleaned, disinfected, and sterilized according to their characteristics.

➤ Regularly disinfect the water treatment system

10

Environmental Control

➤ Strictly comply with the environmental infection control system of each medical institution to ensure the cleanliness and safety of patients, medical staff and visitor areas

➤The hemodialysis machine should be flushed after each dialysis session and disinfected at the end of the day

➤ Waste disposal areas should be separated from patient treatment areas, storage rooms, and cleaning areas

11

Vaccination

➤ Hepatitis B, pneumococcal and influenza vaccines are recommended for dialysis patients

➤ Herpes zoster vaccination is recommended for dialysis patients over 60 years old

➤ Hepatitis A vaccination is recommended for dialysis patients born after 1961