Step 1. Vaccinate Staff and Patients
Get influenza vaccine
Give influenza and pneumococcal vaccine to patients in addition to routine vaccines (e.g. hepatitis B)

Step 2. Get the Catheters out
Hemodialysis
Use catheters only when essential
Maximize use of fistulas/grafts
Remove catheters when they are no longer essential
Peritoneal Dialysis
Remove/replace infected catheters

Step 3. Optimize Access Care
Follow established KDOQI and CDC Guidelines for access care
Use proper insertion and catheter-care protocols
Remove access device when infected
Use the correct catheter

Step 4. Target the Pathogen
Obtain appropriate cultures
Target empiric therapy to likely pathogens
Target definitive therapy to known pathogens
Optimize timing, regimen, dose, route, and duration

Step 5. Access the Experts
Consult the appropriate expert for complicated infections

Step 6. Use local data
Know your local antibiogram
Get previous microbiology results when patients transfer to your facility

Step 7. Know when to say "no" to vanco
Follow CDC guidelines for vancomycin use
Consider 1st generation cephalosporins instead of vancomycin

Step 8. Treat infection, not contamination or colonization
Use proper antisepsis for drawing blood cultures
Get one peripheral vein blood culture, if possible
Avoid culturing vascular catheter tips
Treat bacteremia, not the catheter tip

Step 9. Stop Antimicrobial Treatment
When infection is treated
When infection is not diagnosed

Step 10: Follow Infection Control Precautions
Use standard infection control precautions for dialysis centers
Consult local infection control experts

Step 11: Practice Hand Hygiene
Wash your hands or use an alcohol-based handrub
Set an example

Step 12: Partner With Your Patients
Educate on access care and infection control measures
Re-educate regularly

Download/Printable Format PDF (55KB/2 pages)