Hemodialysis Access Sites (HAS) and infection prevention
Adhikari, Krishna; Aryan, Attaulhaq (2019)
All rights reserved. This publication is copyrighted. You may download, display and print it for Your own personal use. Commercial use is prohibited.
Julkaisun pysyvä osoite on
Hemodialysis access sites are essential for the end stage renal disease patients for their treatment either long-term or short-term basis. These patients are in tremendous risk of infections due to invasive procedures on a regular basis and immunocompromised state of life. Infectious complications continue to be a major cause of morbidity and mortality among hemodialysis (HD) patients. The objective of this literature review is to explore about the risks of infection associated with the HD patients due to their vascular access sites and infection preventions from the nursing perspective. Research questions guiding this study is to understand the risk factors of infections through hemodialysis access sites, and the nursing interventions to improve infection preventions. The theoretical framework has been formed from the fusion of Joanne Duffy’s Quality Care Model, Germ theory of disease by Louis Pasteur and Evidence Based Practices. The data for this study are collected using the academic guidelines and are analyzed by using qualitative data analysis with inductive approach. The major findings in risk factors of infections include patient himself/herself, environment, health care providers and equipment’s in hemodialysis. Similarly, the nursing interventions for improving infection preventions are proper hand hygiene, use of personal protective equipment, cleaning and disinfection of environmental surfaces and equipment’s, safe injection practices, routines serologic testing and patient placement during dialysis, proper use of skin antiseptics, immunization of patients and health care workers, taking part in continuous quality improvement programs, proper use of antimicrobial solutions, using needleless catheter hub, managing the waste products and education of patient as well as staff. Finally, aseptic/sterile techniques for execution of all dialysis procedures are central aspects for infection preventions for nurses. In addition, continuous quality improvement through staff and patient education in a multidimensional health care environment is essential. This research has the limitations such as inclusion of only 20 articles which are freely available and written in English language but can be useful to the nurses and concerned people.