Thank you to the facilities in the Long Term Catheter (LTC) Reduction QIA who completed a root cause analysis for identified barriers associated removal of LTC in patients. There will always be patients that require a catheter for treatment due to:
- Multiple failed fistula/grafts
- Patients being to ill to undergo fistula surgery
- Patient refusal
Identified barriers that the Network would like facilities to focus on to reduce the rate of LTC use are:
- Patient missing appointment
- Patient education on preservation of fistula/graft
- Communication between the vascular surgeon office and the dialysis center
Every facility should appoints a Vascular Access Coordinator who can build a working relationship with the local vascular surgeon groups. This individual will also be responsible to tracking each patient with a LTC to determine where they are in the process of having a fistula placed.
Dialysis patients are immunocompromised and have a greater risk of developing an infection. Dialysis patient have their bloodstream accessed at least three times a week, either during needle cannulation or central venous catheter connection. Patients who dialyze using a central venues catheter are at an even greater risk for developing an infection. The Center for Disease Control and Prevention estimates that there were about 37,000 central venues catheter infections in 2008. For this reason, the Network is asking all facilities to audit any staff member who initiate or terminate dialysis treatment.
Each facility is being tasked with completing:
*10 Catheter Connection Audits
*10 Catheter Disconnection Audits
*10 AVF/AVG Cannulationon Audits
*10 AVF/AVG Decannulation Audits
All audits should be entered into NHSN by Friday,
May 11, 2018.
Each facility should have at least one staff member enroll and complete annual training in the National Healthcare Safety Network (NHSN). This will ensure that all bloodstream infections and any Dialysis Events are accurately documented in NHSN. Facilities should enter data in NHSN on a monthly basis.