Abstract
Purpose of Review
We summarize the barriers and controversies with current best practices for HD catheter BSI reduction and propose risk mitigation strategies.
Recent Findings
Most hemodialysis (HD) patients receive treatment through a central venous catheter. HD catheters result in a high risk of bloodstream infections (BSI) in comparison to other forms of HD access, notably when adherence to risk reduction interventions is lacking.
Summary
Provider-specific considerations include adherence to best-practice standards in the face of interconnected barriers such as work stresses, education gaps, and organizational/framework aspects. Thus, providers should advocate for standardization, leadership support, and appropriate staffing/resources for patient care. Healthcare facilities should focus on risk reduction and developing a culture of collaboration and safety in the face of organizational resistance and financial, legal/policy, and cultural barriers. Federal and state governments should aim to improve social determinants of health while instituting healthcare policy reform to support healthcare personnel, patients, families, and organizations in the face of political, cultural, and structural/systemic barriers. Patient barriers such as noncompliance, additional healthcare conditions, and non-modifiable factors are met with a focus on empowering and educating the patient and caregivers with the tools to become an effective ally in HD catheter BSI reduction.
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Wooten, R., Kothari, D., Pryor, R. et al. Preventing Hemodialysis Catheter-Related Bloodstream Infections: Barriers, Controversies, and Best Practices. Curr Infect Dis Rep 24, 21–27 (2022). https://doi.org/10.1007/s11908-022-00773-6
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DOI: https://doi.org/10.1007/s11908-022-00773-6