AlHulays Reem Hamed, Ghazy Amany A, Taha Ahmed E
Prince Mansour Military Hospital, Taif 26315, Saudi Arabia.
Medical Microbiology and Immunology Unit, Department of Pathology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia.
Diseases. 2024 Nov 24;12(12):301. doi: 10.3390/diseases12120301.
Dialysis-associated events such as bloodstream infections represent serious complications for hemodialysis patients, with the potential to increase morbidity and mortality. 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. The study enrolled 111 hemodialysis participants. A comprehensive dialysis event prevention bundle consisting of 6 key components was implemented. Implementation of the dialysis event prevention bundle showed a significant decrease in IV antimicrobial start ( = 0.003), positive blood culture ( = 0.039), and inflammation at the vascular access site eliminated ( = 0.004). There was a positive correlation between IV antimicrobial start and both patients' age ( = 0.005) and the permanent catheter site ( = 0.002). Positive blood culture was significantly correlated with comorbidities ( = 0.000) and patients' age ( = 0.320). A positive correlation between pus, redness, or increased swelling at the vascular access site with comorbidities ( = 0.034), patients' age ( = 0.021), and the permanent catheter site ( = 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. Implementation of a comprehensive dialysis event prevention bundle can effectively reduce dialysis event rates and enhance patient safety.
诸如血流感染等与透析相关的事件是血液透析患者的严重并发症，有可能增加发病率和死亡率。为评估实施一套全面的循证实践措施对降低曼苏尔王子军事医院透析中心导管透析患者透析事件发生率的影响。该研究纳入了111名血液透析参与者。实施了一个由6个关键组成部分构成的全面透析事件预防方案。透析事件预防方案的实施显示静脉使用抗菌药物的起始率显著下降（=0.003）、血培养阳性率显著下降（=0.039）以及血管通路部位的炎症消除（=0.004）。静脉使用抗菌药物起始率与患者年龄（=0.005）和永久性导管部位（=0.002）均呈正相关。血培养阳性与合并症（=0.000）和患者年龄（=0.320）显著相关。观察到血管通路部位出现脓液、发红或肿胀加剧与合并症（=0.034）、患者年龄（=0.021）和永久性导管部位（=0.002）呈正相关。在血液透析导管断开连接、导管出口部位护理和常规消毒方面，工作人员对透析事件预防方案组成部分的依从性有所提高。实施全面的透析事件预防方案可有效降低透析事件发生率并提高患者安全性。
