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Overview

Reducing healthcare-associated infections (HAIs) is a national priority. Healthcare providers (HCPs) have made incredible efforts to prevent these infections in intensive care units and other inpatient settings. That same commitment to prevention must be applied in outpatient settings such as dialysis clinics.

In 2008, hemodialysis patients experienced approximately 37,000 central-line associated bloodstream infections (CLABSIs). Within the past 10 years, there have been more than 30 outbreaks of hepatitis B and hepatitis C in non-hospital healthcare settings such as outpatient clinics, dialysis centers, and long-term care facilities. The reduction and ultimate elimination of HAIs in dialysis settings (CLABSIs) requires a partnership between many stakeholders; however, clinicians are ultimately responsible for ensuring every patient receives safe care.

CDC provides a recommended set of interventions to prevent bloodstream infections (BSI) in hemodialysis patients [PDF - 529KB]. These recommendations are already being implemented by a group of dialysis providers in collaboration with CDC. This partnership, known as CDC’s Dialysis BSI Prevention Collaborative, was established to allow facilities to share best- and evidence-based practices to prevent BSIs.  Results are measured using CDC’s HAI surveillance system, the National Healthcare Safety Network (NHSN). The Collaboration includes freestanding and hospital-based facilities. Please contact cdcinfo@cdc.gov  for more information.

Basic steps clinicians can take to prevent infections in hemodialysis patients include:

  • Promote fistula use
  • Get catheters out
  • Improve catheter care
  • Clean hands before and after every patient contact
  • Talk to patients about good vascular access care

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Continuing Education

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Guidelines and Recommendations

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Clinical Practice Consensus Guidelines

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Immunizations

  • CDC. Guidelines for Vaccinating Kidney Dialysis Patients and Patients with Chronic Kidney Disease.  [PDF - 298 KB] ACIP 2006.
  • STIC: The Safe and Timely Immunization Coalition
    This national coalition consisting of healthcare professionals and patients with end stage renal disease (ESRD) was formed in 2005 to increase the rate of hepatitis B, influenza, and pneumococcal immunizations in patients and staff in dialysis settings.
    • ESRD Network 6. Safe and Timely Immunization Coalition (STIC): A Comprehensive Resource Guide of Educational Materials on Hepatitis B, Influenza, and Pneumococcal Immunizations.
    • ESRD Network 11. Safe and Timely Immunization Coalition (STIC). Resource Guide & Guidelines for Vaccinating Kidney Dialysis Patients and Patients with Chronic Kidney Disease.
    • ESRD Network 15. Safe and Timely Immunization Coalition (STIC): Sample QI Project: Improving Immunization Rates.

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Centers for Medicare and Medicaid Services (CMS) Conditions and Interpretive Guidance

Centers for Medicare & Medicaid Services. ESRD Program Interpretive Guidance Version 1.1 and Measures Assessment Tool. [PDF - 1.53 MB]

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Resources

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CDC's Dialysis BSI Prevention Collaborative

CDC's Dialysis BSI Prevention Collaborative

Established in 2009.

Learn more about CDC's Dialysis BSI Prevention Collaborative

USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
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