"Preventing Bloodstream Infections is not only Possible, It Should be Expected"

By Peter Laird, MD

The CDC recently announced the dramatic news that catheter based infections in the ICU’s across America since 2011 are greatly reduced by the use of “Bundled” protocols of catheter insertion and preventive care saving over 1.8 billion in the last decade alone. One of the central factors to the success of the bundle is peer pressure from public reporting of each physicians outcomes.


However, dialysis units have not shared this success despite the fact that bundled central lines in the ICU have been the standard of care for several years.

CDC: Too Many Infections in Dialysis Clincs

"Preventing bloodstream infections is not only possible, it should be expected,” said Thomas R. Frieden, MD, MPH, CDC director. “Meticulous insertion and care of the central line by all members of the clinical care team including doctors, nurses and others at the bedside is essential. The next step is to apply what we’ve learned from this to other healthcare settings and other healthcare-associated conditions, so that all patients are protected.”

The CDC is now targeting blood infections in the dialysis unit in the same manner as their program against cather associated infections in the ICU over the last several years. The steps to prevent infections are quite simple and proven over hundreds of years beginning with the simple procedure of washing your hands before doing any patient care. Unfortunately, the record on hand washing in American dialysis units is abysmal.

I am pleased to see this new focus on dialysis related infections which if implemented widely shall significantly reduce the pain and suffering of dialysis patients at the hands of those they trust with their lives simply because they don’t care enough to wash their hands or change gloves between patients. As in many issues, simply taking the time to treat your patients in the same manner as you would expect is the beginning of professional health care. It is time to remember these simple truths.


There is a new infection control initiative called NOTICE (National Opportunity to Improve Infection Control in ESRD) that is a collaboration of Centers for Medicare & Medicaid Services, the Centers for Disease Control & Prevention, and the Agency for Healthcare Research & Quality. NOTICE is funded by the Department of Health and Human Services under the American Reinvestment and Recovery Act (ARRA). The goal is produce checklist(s) like they did in Michigan hospitals under the Keystone Initiative which was a collaborative between the Michigan Hospital Association and Johns Hopkins in Baltimore. That project reduced hospital acquired catheter-related infections saving thousands of patients’ lives and $100 million dollars. Read about Dr. Peter Pronovost who spearheaded this here. I haven’t read his book (Safe Patients, Smart Hospitals), but know people who have and say it’s great.