scholarly journals Surveillance of Hemodialysis Related Infections: A Prospective Multicenter Study

2022 ◽  
Author(s):  
İmran Hasanoglu ◽  
Rahmet Guner ◽  
Suzan Sahin ◽  
Fatma Yilmaz Karadag ◽  
Ergun Parmaksiz ◽  
...  
Keyword(s):  
Infection Rate ◽  
Vascular Access ◽  
Surveillance System ◽  
Surveillance Study ◽  
Surveillance Program ◽  
Dialysis Unit ◽  
Causative Microorganism ◽  
High Workload ◽  
Baseline Status ◽  
Reported Data

Abstract There is neither a surveillance system nor a study to reveal the HD related infection rates in Turkey. We aimed to investigate the infection rate among HD outpatients and implement CDC’s surveillance system. A multicenter prospective surveillance study is performed to investigate the infection rate among HD patients. CDC National Healthcare Safety Network dialysis event (DE) protocol is adopted for definitions and reporting. During April 2016–April 2018, 9 centers reported data. A total of 199 DEs reported in 10035 patient-months, and the overall DE rate was 1.98 per 100 patient-months. Risk of blood culture positivity is found to be 17.6 times higher when hemodialysis was through a tunneled catheter than through an arteriovenous fistula. DE rate was significantly lower in patients educated about the care of their vascular access site. Staphylococcus aureus was the most causative microorganism among mortal patients. Outcomes of DEs were hospitalization (73%), loss of vascular access (18.2%), and death (7.7%). This first surveillance study revealed the baseline status of HD related infections in Turkey and showed that NHSN DE surveillance system can be easily implemented even in a high workload dialysis unit and be adopted as a nationwide DE surveillance program.

Relationship between hemodialysis patients’ educational level and arteriovenous fistula patency

Vascular ◽  
2020 ◽  
Vol 28 (5) ◽  
pp. 604-608
Author(s):  
Atıf Yolgösteren
Keyword(s):  
High School ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Educational Level ◽  
Hemodialysis Patients ◽  
Binary Logistic Regression Analysis ◽  
School Graduate ◽  
Dialysis Unit ◽  
Educational Levels ◽  
Significant Difference

Objectives Vascular access is a lifeline for the patients who are in need of long-term hemodialysis. Native arteriovenous fistula is the most intensively preferred vascular access method owing to its longevity and convenience of use. Therefore, in this study, we aimed to determine whether there might be a relationship between hemodialysis patients’ educational levels and arteriovenous fistula patency. Methods A total of 349 patients who were attending in a chronic hemodialysis program between June 2018 and September 2018 at Bursa Uludağ University, Faculty of Medicine Dialysis Unit and in a private dialysis center in İstanbul were included in this study. The patients were grouped into two: those who have had arteriovenous fistula primary failure at least once and those who have never had arteriovenous fistula primary failure. Educational levels of the patients were classified according to Turkish National Education system (illiterate, primary school graduate, secondary school graduate, high school graduate, and university graduate). Mann–Whitney U and Chi-square tests were performed for statistical analyses. Risk factors were determined by applying backward binary logistic regression analysis. Results A total of 349 patients, 161 (46.1%) females and 188 (53.9%) males, were examined retrospectively. The median age of the patients was 64 years (range: 18–90 years). Educational level comparison revealed statistically significant difference in terms of fistula patency ( p = 0.016). In particular, fistula patency was significantly lower in illiterate, primary, secondary, and high school graduates in comparison with university graduates ( p = 0.001, p = 0.015, p = 0.003, and p = 0.018, respectively). When each group of educational level was analyzed separately in terms of fistula patency, it was observed that the higher the educational level was, the lower arteriovenous fistula primary failure rates were. Conclusions In this study, we observed a lower rate of fistula patency in patients with a low level of education. Hence, we are of the opinion that the trainings delivered on arteriovenous fistula care in dialysis centers are required to be shaped in accordance with educational levels of patients.

The five classes

2020 ◽  
pp. 29-38
Author(s):  
Shannon N. Davis ◽  
Theodore N. Greenstein
Keyword(s):  
Division Of Labor ◽  
Latent Profile Analysis ◽  
Profile Analysis ◽  
Complete Data ◽  
National Study ◽  
Level Data ◽  
High Workload ◽  
Reported Data ◽  
Latent Profile

Chapter 4 presents findings from couple-level data from the National Study of Families and Households (Wave 1). We employ latent profile analysis to describe categories, or classes, of couples. We found that couples fell into five categories: Ultra-traditional, Traditional, Transitional Husbands, Egalitarian, and Egalitarian High Workload. This chapter presents the profiles of each of these classes of couples based upon their joint division of labor. The analysis is unique in that we use self-reported data from each spouse in order to document patterns across the 3,906 couples for whom we have complete data.

P1366THE ROLE OF A NEPHROLOGIST IN THE CREATION OF VASCULAR ACCESS FOR HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Gennadii Fomenko
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Access ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Venous Catheter ◽  
Vascular Surgeon ◽  
Dialysis Unit ◽  
The Creation ◽  
Set Up

Abstract Background and Aims The creation of vascular access: has it anything to do with a nephrologist ? At first glance, the concept of vascular access is the responsibility of surgical specialists. However, a nephrologist has started executing some of the common intensive treatment methods, using the equipment and techniques, specific to the field of dialysis. In this case, a nephrology specialist sets up different kinds of vascular access, namely the AV (arteriovenous) fistula, the AV graft, and the venous catheter; he/she is, therefore, responsible for its assessment and congruent correction. Method the usage of statistical data, gathered by the medical specialists of the dialysis unit of the Regional Chernihiv Hospital; the analysis of the possible nephrologist’s contribution to the creation of vascular access in patients with kidney diseases. Results During 2017-2019, 332 catheterizations were performed, during each of them vascular access was established: Conclusion 1. A nephrologist, in collaboration with a vascular surgeon, is particularly interested in the creation of vascular access in a patient with chronic kidney disease at the pre-dialysis stage; 2. In most cases, a nephrologist can set up temporary or permanent vascular access in patients with chronic kidney disease or acute kidney injury, which improves the quality of hemodialysis by making him an active participant of the treatment process.

scholarly journals Severe alcohol intoxication among Canadian Youth: A 2-year surveillance study

2019 ◽  
Author(s):  
Amy Acker ◽  
Mark L Norris ◽  
Helen Coo ◽  
Alexandre Santos ◽  
Dominic Allain ◽  
...  
Keyword(s):  
Substance Use ◽  
Emergency Departments ◽  
Alcohol Intoxication ◽  
Final Analysis ◽  
Surveillance Study ◽  
Surveillance Program ◽  
Young Adolescents ◽  
Healthcare Facilities ◽  
Paediatric Emergency ◽  
Canadian Youth

Abstract Purpose To obtain data on Canadian youth, aged 11 to 15 years, presenting to paediatric emergency departments, with severe alcohol intoxication and to describe demographics, presentations to hospital, concurrent substance use, comorbidities, and short-term outcomes of admission to emergency departments. Methods Between March 2013 and February 2015, through the established methodology of the Canadian Paediatric Surveillance Program, Canadian paediatricians and paediatric subspecialists were surveyed monthly to identify cases of young adolescents presenting to paediatric emergency departments across Canada with severe alcohol intoxication. Those that identified cases were subsequently sent a detailed questionnaire. The detailed questionnaires were then screened to ensure the reported cases met the study’s inclusion criteria. Results A total of 39 cases (18 females and 21 males) were included in the final analysis. Overall, results indicate over 90% of presenting youth had consumed spirits, 39% had concurrent substance use and 46% experienced serious medical morbidity. Almost two-thirds of youth were admitted to hospital for a period ranging from 10 hours to 5 days; 12 youth required intubation. Follow-up referrals were provided to two-thirds of youth, with variable supports given. No statistically significant differences between sexes were noted for blood alcohol level or concurrent substance use. Conclusion Although rates of alcohol use in adolescents have been steadily decreasing, results from this surveillance study suggest that severe intoxication arising from the use of alcohol alone, and with concurrent substance use, results in significant immediate health consequences in young adolescents. Results from this study also highlight characteristics of patients, initial treatments and initial referrals across Canadian paediatric healthcare facilities, the results of which highlight variability and may aid in the guidance of a future longitudinal study, prevention strategies, and public health messaging.

Survey of Infection Control Practices in Hemodialysis Units: Preventing Vascular Access–Associated Bloodstream Infections

2014 ◽  
Vol 35 (7) ◽  
pp. 833-838 ◽  
Author(s):  
Pascale Trépanier ◽  
Caroline Quach ◽  
Milagros Gonzales ◽  
Élise Fortin ◽  
Mohammed Kaouache ◽  
...  
Keyword(s):  
Infection Control ◽  
Vascular Access ◽  
Practice Guidelines ◽  
Online Survey ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Control Measures ◽  
Face Validity ◽  
Surveillance Program ◽  
Skin Disinfection

ObjectiveDespite surveillance, the Quebec Healthcare-Associated Infections Surveillance Program saw no improvement in vascular access–associated bloodstream infections in hemodialysis (HD). We aimed to determine the infection control measures recommended and implemented in Quebec’s HD units, compliance of local protocols to infection control practice guidelines, and reasons behind the low prevalence of arteriovenous fistulas.MethodsAn online survey was elaborated on the basis of the Centers for Disease Control and Prevention (CDC) and National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines. The questionnaire was validated (construct, content, face validity, and reliability) and sent to all HD units in Quebec (n = 40). Results were analyzed using descriptive statistics, linear regression, and Poisson regression.ResultsThirty-seven (93%) of 40 HD units participated. Thirty (94%) of the 32 centers where central catheters are inserted have written insertion protocols. Compliance with practice guidelines is good, except for full-body draping during catheter insertion (79%) and ointment use at insertion site (3%). Prevention measures for catheter maintenance are in accordance with guidelines, except for skin disinfection with at least 0.5% chlorhexidine and 70% alcohol (67% compliance) and regular antiseptic ointment use at the insertion site (3%). Before fistula cannulation, skin preparation is suboptimal; forearm hygiene is performed in only 61% of cases. Several factors explain the low rate of fistulas, including patient preference (69%) and lack of surgical resources (39%; P = .01).ConclusionsImprovement in standardization of care according to practice guidelines is necessary. Fistula rate could be increased by improving access to surgical resources and patient education. Strategies are now being elaborated to address these findings.

Study of Cerebrospinal Fluid Shunt–Associated Infections in the First Year Following Placement, by the Canadian Nosocomial Infection Surveillance Program

2009 ◽  
Vol 30 (3) ◽  
pp. 285-288 ◽  
Author(s):  
Joanne M. Langley ◽  
Denise Gravel ◽  
Dorothy Moore ◽  
Anne Matlow ◽  
Joanne Embree ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Surveillance System ◽  
Antimicrobial Prophylaxis ◽  
Surveillance Program ◽  
First Year ◽  
Cerebrospinal Fluid Shunt ◽  
System Study ◽  
Medical Centers ◽  
Infection Surveillance ◽  
National Surveillance System

In a national surveillance system study, the infection rate following cerebrospinal fluid shunt surgery was 4.1% (95% confidence interval, 3.36%-4.92%). Cases of infection were more common in children than in adults (4.85% vs 3.24%; P = .04) and occurred sooner after surgery in children than in adults. A wide variation in compliance with antimicrobial prophylaxis was observed between 21 participating medical centers.

scholarly journals Vascular access parameters among prevalent dialysis patients: a single center survey

2020 ◽  
Vol 10 (2) ◽  
pp. 120-124
Author(s):  
Tanveer Bin Latif ◽  
Tanvir Rahman
Keyword(s):  
Vascular Access ◽  
Venous Catheter ◽  
Maintenance Hemodialysis ◽  
Similar Data ◽  
Age Group ◽  
Dialysis Unit ◽  
Medical Graduates ◽  
Number Of Patients ◽  
Venous Fistula ◽  
Access Surgery

Background: Vascular access is one of the most important outcome determinant of patients on hemodialysis. In Bangladesh increasingly more patients are started on hemodialysis as a lifesaving procedure. But we lack organized data on different aspects of dialysis practice. Data related to vascular access is even more scanty. Method: A survey was undertaken in one of the busy dialysis centers in Dhaka with a large number of patients on maintenance hemodialysis .Data were collected by doctors in dialysis units from patients along with records kept in the dialysis unit during November and December 2017. Results: Total 143 patients were included. 53% of these patients belonged to age group 61 to 80 years, 39% to age group 41 to 60 years; 56.6 % female and 43.4% male. 73.4% of the study patients received dialysis via central venous catheter at the initiation. But among the prevalent patients during study period, 84% patient were receiving dialysis via arterio-venous fistula and 5% via arterio-venous graft as permanent vascular access. Among these permanent vascular access left forearm was used in 47% and left upper arm in 33% of cases. Vascular ultrasound mapping before permanent access creation was done in only about 40% of cases. Almost 56 % of the vascular access surgery was done by experienced medical graduates in vascular access creation without any post graduate surgical qualifications. Conclusion: Vascular access data should be collected in a structured manner so that dialysis practice pattern of different centers and regions of the country can be compared. Similar data from several centers around the country will increase scope of improvement . Birdem Med J 2020; 10(2): 120-124

scholarly journals How to Deal with Antibiotic Resistance?

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Bilal H ◽  
◽  
Wang L ◽  
Khan MN ◽  
Yang X ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Current Situation ◽  
Surveillance Study ◽  
Surveillance Program ◽  
Prevalence Rates ◽  
Global Problem ◽  
High Prevalence ◽  
Study Programs ◽  
Comprehensive Surveillance

Antibiotic resistance is the most serious global problem to be addressed. This requires comprehensive surveillance study programs at the level of countries, especially those with high prevalence rates. Therefore, we have tried to point out the missing gaps of Pakistan’s antibiotic resistance surveillance study programs in the light of our previously published article. We hope this will help to improve the current situation of antibiotic resistance and the existing surveillance program.

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