Abstract
Little is known about the challenges of infection prevention and control (IPC) program implementation in hemodialysis settings. A survey was conducted to study these challenges and the resources needed to overcome them.
Outpatient hemodialysis centers (OHC) and hospitals with hemodialysis units were invited to send healthcare professionals (HCPs) accountable for IPC to attend an IPC training program. All attendees were asked to complete an anonymous 11-question IPC program needs-assessment survey during the training. Qualitative and descriptive analyses were used to study the results.
Out of 32 HCPs who responded to the survey, a majority (n=24, 75%) reported working in OHC. Half of the respondents (50%) identified their primary job roles as RN/LPN involved in patient care, 10 (31.3%) as nurse managers/other leadership positions and only 7 (21.9%) as infection preventionists. Many (68.8%) reported >10-year experience. They identified issues related to hand hygiene (66.7%), bloodstream infection (BSI) prevention (38.9%), and cleaning and disinfection (38.9%) as top 3 IPC concerns at their facilities. The top 3 barriers to implementing IPC practices were: high volume of patients/ time constraints (72.4%), lack of staff understanding/motivation/compliance (69%); and lack of patient engagement (34.5%). Educational webinars (68.8%), conferences (68.8%), and having IPC experts available via phone or video-conferencing (53.1%) were reported as potentially helpful in developing and improving IPC programs. Top educational needs identified were hand hygiene (40.6%), preventing BSI (25%), and cleaning and disinfection (21.9%). The preferred methods for receiving educational updates on IPC-related topics were e-mails (87.5%), conferences (78.1%), and webinars (43.8%).
HCPs accountable for IPC in hemodialysis settings usually have other primary job roles. Several barriers were reported in program implementation, which will require significant time commitment to mitigate. Professional organizations and other stakeholders should advocate for protected IPC time for these HCPs, and support IPC program improvement efforts.