Vascular Access Infection Prevention Measures

References

Catheter insertion: (Not addressed in KDOQI 2000/2006 guidelines)

・ Avoid the use of femoral veins in adult patients

・ Catheters should be inserted under strict aseptic technique

・ Maximal barrier precautions (use of mask, cap, sterile gown and sterile gloves by the inserter, and large sterile drape to cover the patient)

[17] [32] [41]

[17] [32] [41] - [43]

[17] [32] [43]

Catheter care:

・ Only trained dialysis staff should perform catheter dressing changes and catheter manipulations

・ The catheter exit-site should be examined for proper position and absence of infection by experienced personnel before accessing the bloodstream at each HD session

・ Aseptic technique should be used to prevent contamination of the catheter system

・ Use of a surgical mask for staff and patient for all catheter system connect, disconnect, and dressing procedures

・ Catheter manipulation should be kept at a minimum

[17] [32] [43] - [45]

[17] [32] [41] [44] [45]

[17] [32] [41] [43] [44]

[32] [43] [44]

[32] [43] [44]

Skin preparation technique for permanent AV access:

・ The patient’s access arm should be washed with antimicrobial soap and water prior to skin preparation with antiseptic solution

・ To locate and palpate the needle cannulation sites prior to skin preparation

・ To cleanse the skin by applying antiseptic solution before cannulation (alcohol-based chlorhexidine, or 10% povidone iodine solution and/or 70% alcohol)

[32] [43] - [45]

[32] [43] - [45]

[32] [43] - [45]