As a dialysis clinician, I am committed to improving patient safety and preventing bloodstream infections in patients on dialysis.

Do you mind changing your gloves, I get very nervous about infection?

Infections are serious and sometimes life-changing events, but you can do something about them. 

You know what, you're right. Thank you for pointing that out to me......NEW VERSION ADD TEXT

Patients and staff each play a role in preventing infections. 

There's some blood there Stephanie.  

The first step is recognizing that we are part of a big team and the patients are included. 

It starts with "hello, how are you doing."

I always start out being nice. 

It takes a lot of courage for a patient to speak up.

Patients are more inclined to speak up and engage if they see that the staff is doing the same.

You have to speak up, in a polite way, but still you need to let them know. 

I've had very good nurses and doctors along the way that have taught me you need to speak up if something doesn't feel right or you aren't comfortable.

There is a genuine interaction, that's where it starts. And as patients and their caregivers and the staff at dialysis centers are doing that, it becomes kind of an influence throughout the environment.

You need to voice your opinion, and your opinion is very important.

PART 2- Should I speak up? The Patient Perspective

Maybe ten years ago I was a little bit reluctant to speak up,

but through a lot of education, advocacy, experience, and seeing different circumstances; I now have no problem speaking up.

It starts with the staff, they should be encouraging all patients to speak up for themselves because you are your best advocate. And once you learn that, it is something you need to embrace.

In order to, you know, help prevent infection, we all need to speak up. And I think the key is just to be kind as you are speaking to the staff.

Mother always told me you get more with honey than vinegar. 

There is accountability through the entire patient group.

It's a very stressful job and there's a high turnover in patients so sometimes they can fall behind, and some have a tendency to want to cut corners.

Well, you don't want to be the one they cut corners on.  

Infections are a leading cause of hospitalization and death. 

Check your vascular access daily for possible sings of infection: Redness, pus or unusual drainage, swelling. Tell your healthcare team if you see any of these.

PART THREE- Preventing Infections, A Team Approach

Changing the culture to involve patients and reduce infections seems like a hard thing to do, but I suggest you start with small things.

Encourage conversation, involve the patients and teach them why it's important to prevent infections. 

When I come in, I'll wash my access, get everything set down, I'll even do another round of sanitizer and say to the tech, "okay are we ready to get started?"

And if they continue on and I see that maybe they haven't washed their hands or something, I'll say

"Do you mind changing your gloves, I see you touched some equipment and I get nervous about infection."

And then once people see that they start to respect where you are coming from with regard to being compliant and using the proper techniques when putting me on the machine. 

It's about taking care of yourself first, making sure you take care of your arm, your area, and making sure your area is clean. 

Even though you are on dialysis, it doesn't have to be your life. It saves your life, but it doesn't have to become your whole life.

And living your best life on dialysis means a couple of things.

That you know, being compliant, not missing any treatments, but also being very aware of your surroundings. 

And it's not just what you do, it's what other people do. 

It is just being mindful of the little things. 

My advice would be to learn as much as you can about whichever modality you choose. Whether it be PD or in-center or home hemo. 

Learn as much as you can, be your own advocate, don't be afraid to challenge your nurses, your doctors, whoever, because it is in your best interest. 

Speak up if you see blood on your equipment or chair, you do not see someone clean their hands right before touching your fistula, graft, or catheter.

If you have questions- SPEAK UP!

If you are a patient or caregiver, although it may be uncomfortable at first, try to speak up and ask staff some general questions about your care and what steps they are taking to keep you safe from an infection.

You can find resources and learn more about CDC's work to reduce infections.

Visit CDC.gov/dialysis

The clinic should be a safe place.