Using Chlorhexidine-Coated Dialysis Catheter Caps to Reduce Central Venous Dialysis Catheter Infection Rates: A...

Area of Science:

• Nephrology
• Infectious Disease Prevention
• Healthcare Quality Improvement

Background:

• Central venous dialysis catheters are essential for end-stage kidney disease patients but increase bloodstream infection risk.
• Dialysis catheter-related bloodstream infections (CLABSIs) are severe complications for patients on dialysis.
• A southern California medical center faced CLABSI rates three times the national benchmark in 2023.

Purpose of the Study:

• To decrease the high rate of dialysis catheter-related bloodstream infections (CLABSIs) at an acute care medical center.
• To evaluate the effectiveness of adding chlorhexidine-coated dialysis catheter caps to standard care.
• To implement a quality improvement project using the Knowledge to Action model.

Main Methods:

• A quality improvement initiative replaced non-chlorhexidine caps with chlorhexidine-coated caps for central venous dialysis catheters.
• Data on CLABSIs, central venous dialysis catheter days, and infection rates were collected pre- and post-intervention.
• Staff training and compliance audits were conducted to ensure fidelity to the new practice.

Main Results:

• The preimplementation period (8 weeks) recorded 2 CLABSIs per 1000 catheter days.
• The postimplementation period (8 weeks) showed 0 CLABSIs.
• No CLABSIs occurred during a subsequent 24-week sustainability assessment.

Conclusions:

• Chlorhexidine-coated dialysis catheter caps significantly reduced CLABSIs in dialysis patients.
• The intervention demonstrated clinical effectiveness in an acute care setting.
• This practice change improved patient safety for those with central venous dialysis catheters.