Bloodstream infections (BSI) are one of the most cited complications among hemo-dialysis patients within dialysis units (Center for Disease Control and Prevention, 2017). These types of infectious complications, such as peritonitis, often associated with unhygienic technique and exit-siteinfection. Prevention of exit-site location is largely associated with skin-resident microbes. Approximately 42% of peritonitis episodes are known to be associated with touch contamination.
One of the most commonly cited tools to prevent infections is efficient hand washing (Center for Disease Control and Prevention, 2017). In 2005, the International Society for Peritoneal Dialysis (ISPD) recommended hand washing as a standard care recommendation and procedure to befollowed in dialysis treatment centers.
In a 2013 study, researchers compared the hand washing efficiency of two different techniques for patients undergoing dialysis care: (1) the use of simple hand hygiene followed by antiseptic hand hygiene, and (2) only antiseptic hand washing. Simple hand hygiene followed traditional hand washing techniques, while the antiseptic hand hygiene mechanism included the use of 3 mL of 70% ethyl alcohol as a mechanism. Interestingly, this study found that the number of bacteria found on hands was increased when the mechanism for hand washing included the use of simple hand hygiene in addition to the antiseptic hand washing method in comparison to only antiseptic hand washing.
The results of this study potentially indicate that one of biggest hindrances in achieving bacteria-free hands is the use of improper or ineffective techniques for washing hands. This study indicates that one of the largest obstacles to achieving sufficient hand hygiene likely relies on the ability of patients to accurately and efficiently clean their hands.
References:Center of Disease Control and Prevention. (2017). Infection Prevention Tools. U.S. Department of Heath & Human Services. Retrieved from:https://www.cdc.gov/dialysis/prevention-tools/index.html
Figueiredo, A. E., de Siqueira, S. L., Poli-de-Figueiredo, C. E., & d’Avila, D. O. (2013). Hand hygiene in peritoneal dialysis patients: a comparison of two techniques. Peritoneal Dialysis International, 33(6), 655-661.