Nephrology Nurses and Infection Preventionists: Working Together to Improve Quality Outcomes

Tunneled central venous hemodialysis catheters have higher infection rates compared to other access devices. Recommendations for dressing changes of these catheters are to apply povidone iodine (PI) or a triple antibiotic ointment during catheter dressing changes. Growing evidence supports using chlorhexidine gluconate (CHG) dressings to prevent catheter-related bloodstream infections in patients with short-term central venous catheters. This quality improvement project studied whether dressing changes with PI ointment in tunneled dialysis catheters was equivalent to CHG-impregnated dressings in preventing vascular access infections (VAIs). Standardized education was required for all nurses and dialysis technicians working at four dialysis centers. VAIs were measured before and after the change. Results showed that CHG is equivalent to PI ointment in preventing VAI in tunneled dialysis catheters.