Infection Control in Dialysis Units Flashcards

Why are dialysis patients at significantly higher risk for bloodstream infections compared to the general population?

Answer: Frequent vascular access cannulation, immunosuppression from uremia, and repeated exposure to healthcare environments

Dialysis patients have impaired immune function due to uremia, repeated needle punctures creating infection entry points, and multiple weekly healthcare contacts increasing exposure. These factors combine to make CRBSI and access infections major causes of morbidity and mortality.

What is the most effective single intervention for preventing healthcare-associated infections in a dialysis unit?

Answer: Hand hygiene with soap and water or alcohol-based hand rub before and after patient contact

Hand hygiene is the cornerstone of infection prevention. The WHO 5 Moments for Hand Hygiene apply: before patient contact, before aseptic tasks, after body fluid exposure, after patient contact, and after contact with patient surroundings.

What is the CDC's recommended approach for surface disinfection in dialysis units between patients?

Answer: Clean all external surfaces of the dialysis machine and chair with an EPA-registered disinfectant between each patient use

CDC and CMS require EPA-registered hospital disinfectant cleaning of all external machine surfaces, chair, and patient-contact areas between every patient. This includes the blood pump housing, touchscreen, armrests, and IV poles.

Hepatitis B virus (HBV) poses a special risk in dialysis units because:

Answer: HBV can survive on surfaces for up to 7 days and is highly infectious, making environmental contamination a significant transmission route

HBV is an extremely hardy virus that survives on contaminated surfaces for up to 7 days at room temperature. In dialysis units, blood contamination of surfaces, equipment, and supplies makes environmental cleaning critical. HBV-positive patients must be treated in separate rooms/machines.

What is the correct order of donning (putting on) personal protective equipment (PPE) when preparing to assist a dialysis patient with an active wound infection?

Answer: Gown first, then mask/eye protection, then gloves last

The correct donning sequence is: gown → mask/respirator → eye protection/face shield → gloves. This ensures that hand contamination from gloves does not contaminate face protection, and the gown is secured before gloves are placed.

A dialysis patient is diagnosed with active pulmonary tuberculosis (TB). What isolation precautions are required?

Answer: Airborne precautions: N95 respirator for staff, negative pressure room, and patient to wear surgical mask when outside their room

Pulmonary TB requires airborne precautions because M. tuberculosis is transmitted by airborne droplet nuclei. An N95 (or higher) respirator must be worn by staff, and a negative pressure isolation room is required. Dialysis units must have an emergency protocol for TB patients.