Online Publication Date:
13 Oct 2016
Improving Dialysis Care: ASN Partners with CDC to Prevent Infections

“Among patients undergoing hemodialysis, hospitalizations for infection have increased 43% since 1993, although the overall hospitalization rate and total hospital days have declined,” they noted. “Mortality due to infection peaks in the second month after starting dialysis, at 43 deaths/1,000 patient-years, and falls to 19.4 deaths/1,000 patient-years after one year...Nonetheless, only half of all patients who start hemodialysis are still living three years later, and infections cause or contribute to many of these deaths.” (1)  
By:
Raymond C Harris MD FASN
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“Among patients undergoing hemodialysis, hospitalizations for infection have increased 43% since 1993, although the overall hospitalization rate and total hospital days have declined,” they noted. “Mortality due to infection peaks in the second month after starting dialysis, at 43 deaths/1,000 patient-years, and falls to 19.4 deaths/1,000 patient-years after one year...Nonetheless, only half of all patients who start hemodialysis are still living three years later, and infections cause or contribute to many of these deaths.” (1)  

I encourage you to participate in two NTDS activities at ASN Kidney Week 2016. First, the NTDS Project Committee will hold a Town Hall on Thursday, November 17, from 10:30 a.m. to 12:30 p.m. in McCormick Place, Room W183C.  Second, the project committee is holding a series of focus groups during Kidney Week. If you are interested in participating in a focus group, please contact Susie Stark, NTDS Project Director at sstark@asn-online.org . 

Raymond C. Harris, MD, FASN

In 2013, 469,648 of the 661,648 Americans with kidney failure were treated in approximately 6,000 dialysis facilities across the United States. The federal government spent $30.9 billion in 2013 treating these beneficiaries, which is 7.1% of the program’s budget. By comparison, the entire budget for the National Institutes of Health (NIH) was also $30.9 billion in 2013.

To help prevent infection in dialysis facilities, the US Centers for Disease Control and Prevention (CDC) awarded ASN a three-year contract. Recognizing ASN’s commitment to educating health professionals and advocating for the highest quality of care for patients, CDC’s contract targets nephrologists who care for patients in dialysis facilities, such as facility medical directors.

Entitled “Nephrologists Transforming Dialysis Safety” or NTDS, this initiative will challenge nephrologists to:

Accelerate current strategies for achieving reductions in the overall burden of bloodstream infections and other healthcare-associated infections (HAI) in dialysis patients.

Strengthen infection control practices in dialysis settings.

Improve screening and detection of infections through the implementation of clinical protocols.

Improve collaboration with state and federal HAI programs.

For several years, CDC has recommended practices to dialysis providers to prevent bloodstream infections (BSI) and hepatitis C virus (HCV) infections. As part of this effort, CDC developed publicly availabletools to help reduce dialysis bloodstream infections. CDC also supports transitioning the reporting of BSIs and related infections from approximately 6,000 US dialysis facilities to a national surveillance system, “giving dialysis providers real-time data to help them track progress toward reducing infections..” (2)

ASN is also part of CDC’s Making Dialysis Safer for Patients Coalition promoting  the use of CDC’s core interventions and resources proven to prevent bloodstream infections among hemodialysis patients.

Led by Alan S. Kliger, MD and   Susan A. Stark , ASN’s NTDS initiative will:

Include educational sessions at ASN Kidney Week (see table).

Develop a webinar series.

Create an educational module on infection prevention for fellowship programs.

Engage ASN’s members via social media, surveys, and focus groups.

Initiate a contest to develop tools to detect, diagnose, and treat infections in dialysis units.

Reach out to state public health and nephrologists to increase collaboration and promote awareness of reportable infectious diseases and participation on state HAI advisory committees.

Join us at Kidney Week (see Table) to learn more about this exciting initiative.

 

1. Infection Prevention and the Medical Director. Clin J Amer Nephrol doi:10.2215/​CJN.06050614

2. Centers for Disease Control: Dialysis Safety. http://www.cdc.gov/dialysis/index.html Accessed 10.13.16    

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