Infection Control in Dialysis Units Flashcards

Which organization publishes the primary infection prevention recommendations specifically for hemodialysis settings in the United States?

Answer: The CDC (Centers for Disease Control and Prevention) through its Hemodialysis Infection Prevention Collaborative

The CDC's Hemodialysis Infection Prevention Collaborative and its Core Interventions for Hemodialysis Bloodstream Infection Prevention provide the primary infection control guidance for dialysis units in the US. CMS enforces compliance through ESRD conditions.

What is the correct technique for removing (doffing) PPE to avoid self-contamination?

Answer: Remove gloves first (turning inside out), then gown (rolling outward), then eye protection, then mask/respirator last

The correct doffing sequence removes the most contaminated items first: gloves (inside-out) → gown (rolling contaminated surface inward) → eye protection → mask/respirator. Hand hygiene is performed after each step and especially after final removal.

A dialysis unit is experiencing a cluster of bloodstream infections. What is the first step in the outbreak investigation?

Answer: Review infection surveillance data to identify the common pathogen, affected patients, and time-place patterns

Outbreak investigation begins with reviewing surveillance data to identify the organism, affected patients, timeline, and common exposures. This epidemiological analysis guides targeted interventions rather than unfocused actions like mass antibiotic use.

An occupational exposure report for a dialysis technician involved in a needlestick from a patient with unknown HIV status should include:

Answer: The time/date of exposure, type of needle, source patient information, employee's vaccination status, and post-exposure prophylaxis offered

Occupational exposure reports must be complete and timely. Source patient information (with consent for testing) is critical for determining post-exposure prophylaxis (PEP) for HIV and baseline testing for HBV/HCV. HIPAA permits disclosure for treatment-related purposes.

Which vaccine is specifically recommended for all susceptible hemodialysis staff and patients due to the high risk of HBV transmission in dialysis units?

Answer: Hepatitis B vaccine series with post-vaccination serologic testing to confirm immunity (anti-HBs ≥10 mIU/mL)

HBV vaccination is mandatory for dialysis staff and strongly recommended for patients. Post-vaccination testing confirms protective antibody levels (anti-HBs ≥10 mIU/mL). Dialysis patients may have a blunted immune response and require higher-dose or additional booster doses.

What is the correct disposal method for a used dialysis needle after treatment?

Answer: Drop the uncapped needle directly into a puncture-resistant sharps container without recapping

OSHA's Bloodborne Pathogen Standard requires immediate one-handed disposal of used needles directly into a puncture-resistant sharps container. Two-handed recapping is prohibited as it is the leading cause of needlestick injuries.