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Assessing Hemodialysis Catheter Insertion Practices Against CDC Guidelines: A Closed-Loop Audit at a Tertiary

Youssef A Ahmed1, Habiba E Hussen1, Ahmed M Elbarawy1

  • 1Internal Medicine Department, Nephrology Unit, Faculty of Medicine, Alexandria University, Alexandria, EGY.

Cureus
|November 12, 2024
PubMed

Insights

Implementing evidence-based guidelines for hemodialysis catheter insertion significantly improves adherence and reduces complications. Clinical audits are effective for enhancing patient care and safety in dialysis units.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Healthcare Quality Improvement

Background:

  • Catheter-related bloodstream infections (CRBSI) are a significant concern during hemodialysis.
  • Adherence to evidence-based guidelines is crucial for preventing complications.
  • High complication rates were observed at Alexandria Main University Hospital's dialysis unit.

Purpose of the Study:

  • To audit hemodialysis catheter insertion practices at Alexandria Main University Hospital.
  • To identify specific practices contributing to high complication rates.
  • To improve patient safety and care quality.

Main Methods:

  • Utilized CDC's Guidelines for the Prevention of Intravascular Catheter-Related Infections as an auditing tool.
  • Conducted a closed-loop clinical audit over two cycles (March-July 2024).
  • Assessed 80 randomly selected hemodialysis catheter insertion procedures, comparing adherence rates between cycles.

Main Results:

  • Overall adherence to guidelines increased significantly from 69% to 90% between audit cycles.
  • A decrease in the rate of recorded mechanical complications was observed.
  • The audit process demonstrated a positive impact on practice adherence.

Conclusions:

  • Closed-loop clinical audits are effective in improving care during hemodialysis catheter insertion.
  • Continuous quality improvement initiatives can enhance patient safety and reduce CRBSI.
  • Standardized auditing is essential for maintaining high standards in dialysis units.

Keywords:
catheter-related infectionscenters for disease control and preventionguideline adherencehemodialysis unitrenal dialysis

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