The Impact of the Dialysis Event Prevention Bundle on the Reduction in Dialysis Event Rate in Patients with Catheters: A Retrospective and Prospective Cohort Study

透析事件预防措施对导管患者透析事件发生率降低的影响:一项回顾性和前瞻性队列研究

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Abstract

Background: Dialysis-associated events such as bloodstream infections represent serious complications for hemodialysis patients, with the potential to increase morbidity and mortality. Aims: To assess the impact of implementing a comprehensive bundle of evidence-based practice on reducing dialysis event rates among catheter dialysis patients at Prince Mansour Military Hospital Dialysis Center. Participants and Methods: The study enrolled 111 hemodialysis participants. A comprehensive dialysis event prevention bundle consisting of 6 key components was implemented. Results: Implementation of the dialysis event prevention bundle showed a significant decrease in IV antimicrobial start (p = 0.003), positive blood culture (p = 0.039), and inflammation at the vascular access site eliminated (p = 0.004). There was a positive correlation between IV antimicrobial start and both patients' age (p = 0.005) and the permanent catheter site (p = 0.002). Positive blood culture was significantly correlated with comorbidities (p = 0.000) and patients' age (p = 0.320). A positive correlation between pus, redness, or increased swelling at the vascular access site with comorbidities (p = 0.034), patients' age (p = 0.021), and the permanent catheter site (p = 0.002) was observed. Staff compliance with the dialysis event prevention bundle components has improved regarding hemodialysis catheter disconnection, catheter exit site care, and routine disinfection. Conclusions: Implementation of a comprehensive dialysis event prevention bundle can effectively reduce dialysis event rates and enhance patient safety.

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