 QIA Guidelines

The Network will:

•  Assist facilities to implement and monitor all of the CDC recommended interventions for dialysis BSI prevention
•  Educate target facilities on the CDC Core Interventions, and assist the facilities in implementing the CDC Core Interventions,
• Assist Facilities in monitoring their own progress toward implementing the CDC Core Interventions and reduction of BSIs, and
•  Monitor the progress of QIA facilities and assist the facilities that are unable to progress to goal.
• Involve Patient SMEs and/or family members or care partners at the facility level in discussion about infection control practices and ways to feel more comfortable bring issues to the attention of staff members.

Goals:

LTC Goal: Decrease rate by at least 2 percentage points by evaluation based on June 2017 baseline data.

BSI Goal:  Demonstrate a 20% or greater relative reduction in the semi-annual pooled mean in the cohort with the highest 50% of BSIs in the Network service area at re-measurement compared to 2017.

Graduation Requirements: A facility may be removed and replaced for 2019 in the QIA if it is no longer in the cohort of facilities with the highest 50% of BSIs in the Network service area or maintains a BSI rate of zero for at least six (6) months of the QIA.

CMS Recommended Learning Activity:
Prevention of intravascular infections, blood-borne pathogen transmission (e.g., hepatitis B), and influenza and pneumococcal disease are priorities identified in the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination

Tools and Resources

Quality Improvement Webinars:

• BSI QIA Kick-Off & Continuation Webinar (12//17/18) Slides; Recording; Survey
• HAI BSI - LTC QIA Kick-Off Webinar (2/7/2018) Slides
• Vascular Access Planning Strategies to Reduce LTC Rates (5/3/2018) Slides 
• BSI Midpoint Webinar (7/20/2018) Slides 
• BSI - LTC Touch Point Webinar (10/23/2018) Slides 

Facility Resources: CDC Core Interventions 

• Surveillance and Feedback using NHSN (Data Report)
• Hand Hygiene Observations 
• Catheter/Vascular Access Care Observations 
• Staff Education and Competency
• Patient Education/ Engagement 
• Catheter Reduction
• Catheter Hub Disinfection 
• Chlorhexidine for Skin Antisepsis 
• Antimicrobial Ointment

National Healthcare Safety Network (NHSN)

• Infection Prevention in Dialysis Settings
• CMS Resources for NHSN Users
• Patient Safety Component Training 
• Biovigilance Component Training
• Resources for Users New to NHSN
• Healthcare Personnel Safety Component
• NHSN Educational Roadmap 
• Dialysis Component Training 
• NHSN Analysis
• Continuing Education 
• Request CDC Led Training

Tools for Facility: CDC Resource Center

• Preventing Bloodstream Infections in Outpatient Hemodialysis Patients: Best Practices for Dialysis Staff 
• Hemodialysis Central Venous Catheter Scrub the Hub Protocol 
• Environmental Surface Disinfection in Dialysis Facilities: Notes for Clinical Managers
• Days Since Infection Poster English 
• Days Since Infection Poster Spanish
• Hand Hygiene Audit Tool 
• AV Fistula & Graft Cannulation and Decannulation Audit Tool 
• Asteriovenous Fistula & Graft Cannulation Checklist
• Asteriovenous Fistula & Graft Decannulation Checklist 
• Catheter Connection and Disconnection Audit Tool
• Hemodialysis Catheter Connection Checklist 
• Hemodialysis Catheter disconnection Checklist 
• Dialysis Station Routine Disinfection Checklist 
• Catheter Exit Site Audit Tool 
• Hemodialysis Catheter Exit Site Care Checklist 
• Injection Safety: Medication Preparation & Administration Audit Tool 
• Hemodialysis Injection Safety: Medication Preparation Checklist
• Hemodialysis Injection Safety: Medication Administration Checklist