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      Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities

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          Abstract

          Patients receiving hemodialysis are vulnerable to infectious diseases due to their impaired immunity and high risk of exposure to pathogens. To protect patients, staff, and visitors from potential infections, each hemodialysis unit should establish and follow standard infection control and prevention measures. Therefore, clinical practice guidelines were developed by a working group of nephrologists and infection control specialists to provide evidence-based guidance for dialysis physicians and nurses, with the aim of preventing infection transmission and controlling infection sources in hemodialysis facilities. The areas of infection control covered by these guidelines include standard precautions, isolation strategies, vascular access, water treatment, cleaning/disinfecting/sterilizing, and vaccination. This special report summarizes the key recommendations from the Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities.

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          Clinical practice guidelines for vascular access.

          (2006)
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            Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

            Lynne Sehulster, Raymond Y W Chinn (2003)
            The health-care facility environment is rarely implicated in disease transmission, except among patients who are immunocompromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g., Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g., Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections. The incidence of health-care--associated infections and pseudo-outbreaks can be minimized by 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions. This report reviews previous guidelines and strategies for preventing environment-associated infections in health-care facilities and offers recommendations. These include 1) evidence-based recommendations supported by studies; 2) requirements of federal agencies (e.g., Food and Drug Administration, U.S. Environmental Protection Agency, U.S. Department of Labor, Occupational Safety and Health Administration, and U.S. Department of Justice); 3) guidelines and standards from building and equipment professional organizations (e.g., American Institute of Architects, Association for the Advancement of Medical Instrumentation, and American Society of Heating, Refrigeration, and Air-Conditioning Engineers); 4) recommendations derived from scientific theory or rationale; and 5) experienced opinions based upon infection-control and engineering practices. The report also suggests a series of performance measurements as a means to evaluate infection-control efforts.
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              Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus.

              Walter Zingg, Alison Holmes, Markus Dettenkofer … (2015)
              Despite control efforts, the burden of health-care-associated infections in Europe is high and leads to around 37,000 deaths each year. We did a systematic review to identify crucial elements for the organisation of effective infection-prevention programmes in hospitals and key components for implementation of monitoring. 92 studies published from 1996 to 2012 were assessed and ten key components identified: organisation of infection control at the hospital level; bed occupancy, staffing, workload, and employment of pool or agency nurses; availability of and ease of access to materials and equipment and optimum ergonomics; appropriate use of guidelines; education and training; auditing; surveillance and feedback; multimodal and multidisciplinary prevention programmes that include behavioural change; engagement of champions; and positive organisational culture. These components comprise manageable and widely applicable ways to reduce health-care-associated infections and improve patients' safety.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Kidney Res Clin Pract
                Journal ID (iso-abbrev): Kidney Res Clin Pract
                Title: Kidney Research and Clinical Practice
                Publisher: Korean Society of Nephrology
                ISSN (Print): 2211-9132
                ISSN (Electronic): 2211-9140
                Publication date (Print): March 2018
                Publication date (Electronic): 31 March 2018
                Volume: 37
                Issue: 1
                Pages: 8-19
                Affiliations
                [1 ]Division of Nephrology, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
                [2 ]Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Korea
                [3 ]Department of Internal Medicine, Dongguk University Medical Center, Dongguk University College of Medicine, Gyeongju, Korea
                [4 ]Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
                [5 ]Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
                [6 ]Department of Internal Medicine, Kyung Hee University Hospital at Kangdong, Seoul, Korea
                [7 ]Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
                Author notes
                Correspondence: Young-Ki Lee, Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine, 55 Beodeunaru-ro, Yeongdeungpogu, Seoul 07247, Korea. E-mail: km2071@ 123456naver.com . ORCID: http://orcid.org/0000-0003-3464-6144
                Article
                Publisher ID: krcp-37-008
                DOI: 10.23876/j.krcp.2018.37.1.8
                PMC ID: 5875572
                PubMed ID: 29629273
                SO-VID: 69b1344f-a3f9-436f-9423-e694aae52ea0
                Copyright © Copyright © 2018 by The Korean Society of Nephrology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 November 2017
                Date revision received : 27 December 2017
                Date accepted : 28 December 2017
                Categories
                Subject: Special Article

                Keywords: hemodialysis units,hospitals,infection control,practice guideline
                Data availability:
                Keywords: hemodialysis units, hospitals, infection control, practice guideline

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