It is now one year since Nephrologists Transforming Dialysis Safety (NTDS) began its work. The Centers for Disease Control and Prevention (CDC) awarded the American Society of Nephrology (ASN) 3 years of funding to sponsor NTDS, as part of its effort to improve infection-control practices in dialysis facilities across the United States.
The critical need to eliminate preventable infections in dialysis is shown in the dialysis databases. The PEER Report (2014) demonstrates only modest improvement in the rate of patient admission for infection between 2004 and 2014.
The USRDS 2016 Annual Data Report (vol 2, ESRD, Ch 5) shows hospitalization rates for dialysis patients, indicating that while all-cause and cardiovascular hospitalization rates have been declining from 2005 to 2014, hospitalization for infection has not improved substantially
The 2014 PEER Report, “Cause of death in prevalent dialysis patients” shows that infection causes 9.5% of all deaths (1).
For several years, the CDC worked with dialysis companies to promote evidence-based best practices and useful tools to prevent bloodstream infections (BSI) and hepatitis C virus (HCV) infections. The NTDS project aims to more directly involve nephrologists as team leaders and as professional role models to reduce the burden of BSI and other healthcare-related infections in dialysis patients.
Building upon the foundational principles of the CDC’s Making Dialysis Safer for Patients Coalition, the NTDS project is aimed at transforming dialysis care, to make infection prevention part of the fabric of everyday care for dialysis patients. The specific project aims include:
Adhere to CDC-recommended infection prevention practices
Screen and detect infections
Implement clinical protocols to ensure accurate detection and treatment of infections
Facilitate collaboration between nephrologists and state/federal healthcare-associated infection programs
Cause of death in prevalent dialysis patients: Peer Dialysis Initiative, Peer Report: Dialysis Care and Outcomes in the United States, 2014.