Nurses' Knowledge and Practice in Hemodialysis Units: Comparison between Nurses in Units with High and Low Prevalence of Hepatitis C Virus Infection

Hepatitis C Virus (HCV) infection constitutes a major health issue in many hemodialysis (HD) units all over the world, including Saudi Arabia. Despite the isolation policy practiced in many dialysis units, the prevalence is still high. Current literature does not support isolation policy and actually points to the role of health care providers in transmitting the disease. This study has been conducted in a questionnaire format to investigate the nurses' knowledge about HCV and their practice inside the HD units. Structured questionnaires were distributed among 36 nurses in units with high prevalence for HCV (Group I) and 34 nurses in units with low prevalence (Group II). Comparison was made between the two groups. In both groups, 54% of nurses received their HCV education by nurse educator, 13% by physicians, 10% by both and 23% had no targeted education. There is no statistical difference in the providers of education between the two groups. Most nurses in both groups isolate patients on the line of HCV serostatus. The difference was observed in the method of isolation and the use of dedicated machines. Twenty-five nurses (69%) of group I practice ward isolation while 16 nurses (47%) of group II use this practice (P = .04). Twenty-five nurses (69%) of group I reported using HCV-dedicated machines in comparison to only seven nurses (20.5%) of group II (P = .001). All nurses in group II cleaned the machine surfaces and HD tables after each patient, while only 58% of nurses in group I did so after each patient, 39% at the end of the day and three percent never cleaned the surfaces (P .003). In conclusion, HCV infection in high prevalence units is probably related to poor application of standard health precautions and that isolation does not prevent spread of the disease inside HD units. Improving the nurse: patient ratio and encouraging the liberal use of gloves, together with well implemented policies and practices, will result in a better control of HCV transmission in dialysis units.