Change Strategies to Prevent Infections in Dialysis Patients  NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Change Strategies to Prevent Infections in Dialysis Patients 

The focus of this assessment is to improve the lives of long-term hemodialysis-dependent patients by minimizing the risks of infections and improving existing infection states among the selected population. The evidence-based strategies which are important to bring change within the healthcare system are applying standards CDC for preventing bloodstream infections, increasing the use of catheters that have a low risk of infections, patients’ self-care education, and adequate care of dialysis catheters/access. 

Following the Standard Guidelines of the CDC 

According to the CDC guidelines, it is essential to initially encourage the practices which will help in the prevention of the progression of the disease. Moreover, it is advised to use the types of vascular accesses which claim to have reduced risks of infections like fistulas and grafts. Lastly, it is recommended to apply proven healthcare practices to prevent infections in hemodialysis units (Office of the Associate Director for Communication – CDC, 2023). 

Using Catheters with Low Risk of Infections 

Catheters with a low risk of infections should be utilized for hemodialysis patients. However, certain interventions have proven to decrease the risk of catheter-associated infections in dialysis patients. The strategy of early referral to nephrologists, vascular access coordinators, and healthcare teams is significantly important. These stakeholders will provide adequate education to the patients regarding the implantation of permanent access to decrease the use of catheters ultimately, reducing the risks of infections (Fisher et al., 2019). 

Patients’ Self-care Education 

Patient education is important in the prevention of catheter-associated infections by self-care. This enables patients to play an active role in their self-management of the disease process. Patients must be educated about the care of catheters while they are at their homes. Moreover, instructions must be provided about the management of catheters during showers, which improves the quality of life. According to the recommendations provided by CDC, showers are permitted however, patients must be careful about the ports and hubs of the access site. These ports and hubs should be covered with an impermeable sheet to control the introduction of microorganisms on the access site (Fisher et al., 2019). 

Providing Care of Dialysis Access 

Many of the infections observed in dialysis patients are related to poor practices of healthcare professionals especially in terms of managing catheters. Some of the preventive measures advised are the use of antimicrobial ointments during the insertion of the catheter and after every dialysis session. Moreover, it is essential to use antimicrobial dressings to cover the catheter site. Along with the use of antimicrobial products, it is also essential that healthcare professionals improve their practices of hand hygiene and aseptic techniques to ensure patients remain free of infectious agents interacting with their bodies (Fisher et al., 2019). 

Various challenges might take place while these strategies are implemented. These challenges include socio-economic factors, whereby various social and cultural differences would arise in choosing the types of therapies and treatments. Economic factors would be essential in defining the insurance status while patients are referred to developing invasive vascular access. Other challenges can be limited resources (human and financial) and a need for standardized guidelines within the organization. To combat these challenges, a multidisciplinary team should be established to identify the barriers to standard practices and change strategies and analyze the solutions for these challenges. Moreover, it is essential to collaborate with governmental organizations which provide financial aid in terms of healthcare, for example, the Center for Medicaid and Medicare Services. 

Justification of the Proposed Change Strategies

All of the change strategies presented above are important for improving quality of life by reducing the risks of infections in hemodialysis patients. A study showed that nurses’ knowledge of CDC guidelines to prevent central line infections in dialysis patients is crucial to reduce the risk of infections (Saggu et al., 2018). Thus, adequate training of nurses and other healthcare professionals is recommended. Another study that justifies the early referral to nephrologists concludes that it reduces the complications of kidney disease and can lead to the early formation of AV fistula for hemodialysis.

This will eventually improve patient