Chlorhexidine-impregnated transparent dressings decrease catheter-related infections in hemodialysis patients: a quality improvement project

Apata, Ibironke W.; Hanfelt, John; Bailey, James L.; Niyyar, Vandana Dua

doi:10.5301/jva.5000658

Cited by 25 publications

(19 citation statements)

References 16 publications

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“…16,17 There are two published studies in which chlorhexidine-based exit site applications were performed in patients using TCs for hemodialysis, however their the outcomes are conflicting. 18,19 The first study compared a chlorhexidine-impregnated sponge dressing vs. a transparent dressing (dressings were changed weekly in both groups), and found no difference in CRBSI in a small cross-over study. 18 In contrast, a significant reduction in CRBSI was reported in a recent quality improvement project using chlorhexidine transparent dressings (changed weekly) vs. dry gauze dressings and antibiotic ointment (changed thrice weekly).…”

Section: Catheter Exit Site Applicationmentioning

confidence: 99%

“…18 In contrast, a significant reduction in CRBSI was reported in a recent quality improvement project using chlorhexidine transparent dressings (changed weekly) vs. dry gauze dressings and antibiotic ointment (changed thrice weekly). 19 A well-powered, and well-designed study is needed to evaluate chlorhexidinebased exit site applications for use in hemodialysis TCs.…”

Section: Catheter Exit Site Applicationmentioning

confidence: 99%

“…These data are derived from studies performed in hospitalized adult patients with short term, nontunneled catheters in an ICU setting in which there was a marked reduction in the CRBSI rate using chlorhexidine‐impregnated dressings, (HR: 0.30, 95% CI: 0.10‐0.92, P = 0.04) . There are two published studies in which chlorhexidine‐based exit site applications were performed in patients using TCs for hemodialysis, however their the outcomes are conflicting . The first study compared a chlorhexidine‐impregnated sponge dressing vs. a transparent dressing (dressings were changed weekly in both groups), and found no difference in CRBSI in a small cross‐over study .…”

Section: Prevention Of Catheter‐related Infectionsmentioning

confidence: 99%

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Prevention of hemodialysis catheter infections: Ointments, dressings, locks, and catheter hub devices

Golestaneh

Mokrzycki

2018

Hemodialysis International

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Tunneled central venous catheters used for the provision of hemodialysis are associated with excess morbidity and mortality. Catheter related exit site and blood stream infections are major risks of their use. Although catheter‐avoidance is the best strategy to reduce infections and mortality in the hemodialysis population, the use of catheters remains unacceptably high. In this review, the existing clinical practice guidelines for the prevention of hemodialysis catheter associated infections are outlined, and a comprehensive evidenced‐based summary of interventions is provided. This includes details about the use of topical antimicrobial ointments and dressings, intranasal ointment application, prophylactic use of antibiotic and non‐antibiotic catheter lock solutions, and catheter hub devices for the prevention of catheter blood stream infections.

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Section: Catheter Exit Site Applicationmentioning

confidence: 99%

Section: Catheter Exit Site Applicationmentioning

confidence: 99%

Section: Prevention Of Catheter‐related Infectionsmentioning

confidence: 99%

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Prevention of hemodialysis catheter infections: Ointments, dressings, locks, and catheter hub devices

Golestaneh

Mokrzycki

2018

Hemodialysis International

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“…Es gibt Produkte, bei denen der Exit mit einem Gelkissen abgedeckt wird, das Chlorhexidin freisetzt. Für diese Produkte ist sowohl in der Intensivmedizin als auch in der Dialyse nachgewiesen worden, dass sie die Rate an BSI reduzieren können[7]. Auch diese Produkte kommen daher als valide Maßnahme infrage, wenn die BSI-Rate in einem Zentrum auffällig hoch liegt.…”

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Hygiene und Infektionsprävention in Hämodialyseeinrichtungen

Girndt¹

2020

Krankenh.hyg. up2date

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“…The use of a combination of CAI prophylaxis measures in a standardized protocol has been shown to reduce rates of CAB . However, while multiple trials and meta‐analyses have demonstrated benefit for individual products or procedures the optimal combination of prophylactic measures remains unknown. In this context, significant clinical variability in catheter management practices across Australia and New Zealand dialysis units might be expected.…”

mentioning

confidence: 99%

Dialysis catheter management practices in Australia and New Zealand

et al. 2019

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Aim: Dialysis catheter-associated infections (CAI) are a serious and costly burden on patients and the health-care system. Many approaches to minimizing catheter use and infection prophylaxis are available and the practice patterns in Australia and New Zealand are not known. We aimed to describe dialysis catheter management practices in dialysis units in Australia and New Zealand.Methods: Online survey comprising 52 questions, completed by representatives from dialysis units from both countries.Results: Of 64 contacted units, 48 (75%) responded (Australia 43, New Zealand 5), representing 79% of the dialysis population in both countries. Nephrologists (including trainees) inserted non-tunnelled catheters at 60% and tunnelled catheters at 31% of units. Prophylactic antibiotics were given with catheter insertion at 21% of units. Heparin was the most common locking solution for both non-tunnelled (77%) and tunnelled catheters (69%), with antimicrobial locks being predominant only in New Zealand (80%). Eight different combinations of exit site dressing were in use, with an antibiotic patch being most common (35%). All units in New Zealand and 84% of those in Australia undertook CAI surveillance. However, only 51% of those units were able to provide a figure for their most recent rate of catheter-associated bacteraemia per 1000 catheter days.Conclusion: There is wide variation in current dialysis catheter management practice and CAI surveillance is suboptimal. Increased attention to the scope and quality of CAI surveillance is warranted and further evidence to guide infection prevention is required.

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Chlorhexidine-impregnated transparent dressings decrease catheter-related infections in hemodialysis patients: a quality improvement project

Abstract: Replacing adhesive dry gauze dressing with CHG-transparent dressing for hemodialysis patients with tunneled CVC was associated with decreased CRI rates.

Cited by 25 publications

References 16 publications

Prevention of hemodialysis catheter infections: Ointments, dressings, locks, and catheter hub devices

Prevention of hemodialysis catheter infections: Ointments, dressings, locks, and catheter hub devices

Hygiene und Infektionsprävention in Hämodialyseeinrichtungen

Dialysis catheter management practices in Australia and New Zealand

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