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healthcare-associated infections (HAI) program

California Campaign to Prevent Bloodstream Infections in Hemodialysis Patients

The California Campaign to Prevent Bloodstream Infections (BSI) in Hemodialysis Patients is a collaborative between the California Department of Public Health (CDPH) Healthcare-Associated Infections (HAI) Program, Center for Disease Control and Prevention (CDC), End-stage Renal Disease (ESRD) Networks of California (Network 17 and Network 18) and participating California outpatient dialysis facilities. BSI are a dangerous complication and a leading cause of death in hemodialysis patients. The goal of the campaign is to provide resources and guidance to California healthcare personnel and the dialysis community.

This webpage provides links to infection prevention guidelines and recommendations, clinician and patient education, including use of the National Healthcare Safety Network (NHSN) infection surveillance system,  hemodialysis clinic infection prevention tools, and laws and regulations for dialysis clinics in California.

To attend the "Practical Guidance for Using NHSN Dialysis Infection Data for Prevention" webinar, see webinar login information on this

Webinar Course Flyer. (PDF)

To register for a "Basics of Infection Prevention in Outpatient Hemodialysis Centers" course,  click on the registration SurveyMonkey link on this

Course Flyer. (PDF)

resources for dialysis health care personnel

Dialysis Infection Prevention Guidelines and Recommendations

CDC Approach to BSI Prevention in Dialysis Facilities (PDF)
Nine core interventions to prevent dialysis-related BSI
CDC Infection Control Requirements for Dialysis Facilities and Clarification Regarding Guidance on Parenteral Medication Vials 
Infection Control requirements for dialysis facilities and recommendations for use of multi-dose vials
CDC Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care (PDF)
Summary guide to infection prevention for outpatient settings
CDC Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care (PDF)
Checklist used to assist implementation of infection prevention policies, procedures and practices in outpatient settings
CDC 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections
Evidenced-based recommendations for preventing intravascular catheter-related infections

Dialysis Infection Prevention Education

"Basics of Infection Prevention in Outpatient Hemodialysis Center" Course (PDF)

One-day (6 hour) in-person course for dialysis clinic staff offered in multiple locations throughout California. To register, see Course Flyer (PDF)

CDC Provider Training Video: Preventing Bloodstream Infections in Outpatient Hemodialysis Patients: Best Practices for Dialysis Staff (PDF)
Best practices for dialysis staff for prevention of bloodstream infections in patients receiving hemodialysis

CDC Continuing Education Course: Infection Prevention in Dialysis Settings
Continuing education for infection prevention in dialysis settings for healthcare workers

AHRQ Safety Program for End-Stage Renal Disease Facilities – Toolkit
Four instructional modules that a facilitator can use to teach dialysis center team members specific ways to create a culture of safety and prevent healthcare-associated infections in dialysis patients. Created by Agency for Healthcare Research and Quality (AHRQ) for End-Stage Renal Disease (ESRD) clinics

Dialysis Infection Surveillance Education

NHSN Tracking Infections in Outpatient Dialysis Facilities
NHSN training and support material for reporting dialysis events, process measures and data analysis

Infection Prevention Tools for Use in Dialysis Clinics

CDC Provider Poster: Put Together the Pieces to Prevent Infections in Dialysis Patients (PDF)
Illustration of the components of infection prevention for dialysis patients

WHO 5 Moments for hand Hygiene in Hemodialysis Poster (PDF)
Poster that illustrates how to perform hand hygiene when working with dialysis patients
CDC Compatibility Information for Skin Antiseptics and Antimicrobial Ointments with Chronic Hemodialysis Catheters
Information on skin antiseptics and antimicrobial ointment compatibility, contains links to catheter manufacturers' recommendations

CDC Protocol: Scrub-the-Hub for Hemodialysis Catheters (PDF)
Suggested approach to disinfecting catheter hubs prior to access for hemodialysis

CDC Hand Hygiene Observations Tool (PDF)
Data collection tool for hand hygiene compliance observations in the dialysis setting

CDC Checklist: Dialysis Station Routine Disinfection (PDF)
Checklist for routine disinfection of dialysis station when there is no visible blood or soil

CDC Checklist: Hemodialysis catheter connection (PDF)
Checklist of steps to connect a hemodialysis catheter aseptically to blood lines

CDC Checklist: Hemodialysis catheter disconnection (PDF)
Checklist of steps to disconnect a hemodialysis catheter aseptically from blood lines

CDC Checklist: Hemodialysis catheter exit site care (PDF)
Checklist for aseptic catheter exit site care for patients with a central venous catheter for dialysis access

CDC Checklist: Arteriovenous fistula/graft cannulation (PDF)
Checklist of steps on how to aseptically perform fistula/graft cannulation and connect to blood lines

CDC Checklist: Arteriovenous fistula/graft decannulation (PDF)
Checklist of steps on how to aseptically perform fistula/graft de-cannulation and disconnection from blood lines

CDC Checklist: Hemodialysis injectable medication preparation (PDF)
Checklist of steps for aseptic injectable medication preparation and administration

CDC Injection Safety Checklist (PDF)
Checklist to remind healthcare workers of safe injection practice

Making Dialysis Safer for Patients Coalition
A collaboration of dialysis organizations promoting the use of CDC’s core interventions and resources to prevent bloodstream infections among hemodialysis patients

Select links to Dialysis Clinic Laws and Regulations

California Outpatient Healthcare Facilities Health and Safety Code (1200-1209), including Outpatient Dialysis Clinics
Health and Safety Code 1205-1205.5

California Hemodialysis Technician Training Act
Health and Safety Code 1247-1247.9

CMS ESRD Conditions of Participation (CoP) (PDF)
Conditions for coverage for ESRD facilities to be certified under the Medicare Program

Frequently asked questions on the conditions for coverage for ERSD facilities

CMS Dialysis webpage
Basic information from Centers for Medicare and Medicaid Services (CMS), related to survey and certification of dialysis facilities

CMS Core Survey Training Manual Version 1.7 (PDF)
Contains components of the End-Stage Renal Disease (ESRD) Survey processes and resources to identify deficient practices in dialysis facilities

Resources for Dialysis Patients

CDC Patient Pocket Guide: 6 Tips to Prevent Dialysis Infections (PDF)
Pocket sized guide for hemodialysis patients with tips on how to prevent infections

CDC: Preventing Bloodstream Infections in Hemodialysis Patients: the Patient Perspective (PDF)
Focus group for patients taking a role in infection prevention

ESRD Network: Dialysis Patients Speak: a Conversation about the Importance of AV Fistulas
Educational video on hemodialysis patients speaking about the importance of AV fistulas for vascular access

ESRD Network: Dialysis Patients Speak Preventing Infections 2012
Educational video on the importance of hand hygiene, proper equipment and technique to prevent bloodstream infections

Kidney Foundation: Dialysis Patient Information
Webpage designed to provide dialysis patients with multiple resources for their active participation in dialysis care

APIC: Hemodialysis Infection Prevention
Patient information on the importance of infection prevention for hemodialysis patients

For more information, contact or HAI Dialysis Liaison Infection Preventionist: Sheila Segura, RN at​​

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