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* 2. Complete the below information.

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* 3. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Surveillance and feedback using NHSN

Conduct monthly surveillance for BSIs and other dialysis events using CDC’s National Healthcare Safety Network (NHSN). Calculate facility rates and compare to rates in other NHSN facilities. Actively share results with front-line clinical staff.

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* 4. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Hand hygiene observations

Perform observations of hand hygiene opportunities monthly and share results with clinical staff.

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* 5. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Catheter/vascular access care observations

Perform observations of vascular access care and catheter accessing quarterly. Assess staff adherence to aseptic technique when connecting and disconnecting catheters and during dressing changes. Share results with clinical staff.

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* 6. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Staff education and competency

Train staff on infection control topics, including access care and aseptic technique. Perform competency evaluation for skills such as catheter care and accessing every 6-12 months and upon hire.

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* 7. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Patient education/engagement

Provide standardized education to all patients on infection prevention topics including vascular access care, hand hygiene, risks related to catheter use, recognizing signs of infection, and instructions for access management when away from the dialysis unit.

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* 8. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Catheter reduction

Incorporate efforts (e.g., through patient education, vascular access coordinator) to reduce catheters by identifying and addressing barriers to permanent vascular access placement and catheter removal.

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* 9. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Chlorhexidine for skin antisepsis

Use an alcohol-based chlorhexidine (>0.5%) solution as the first line skin antiseptic agent for central line insertion and during dressing changes.* 
* Povidone-iodine (preferably with alcohol) or 70% alcohol are alternatives for patients with chlorhexidine intolerance.

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* 10. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Catheter hub disinfection

Scrub catheter hubs with an appropriate antiseptic after cap is removed and before accessing. Perform every time catheter is accessed or disconnected.**
** If closed needleless connector device is used, disinfect device per manufacturer’s instructions.

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* 11. Rank your facility's current level of implementation of the below CDC Core Intervention for dialysis bloodstream infection (BSI) prevention.
 
Antimicrobial ointment

Apply antibiotic ointment or povidone-iodine ointment to catheter exit sites during dressing change.***
*** See information on selecting an antimicrobial ointment for hemodialysis catheter exit sites on CDC’s Dialysis Safety website (http://www.cdc.gov/dialysis/prevention-tools/core-interventions.html#sites). Use of chlorhexidine-impregnated sponge dressing might be an alternative.

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