Aplicación de los protocolos por parte de enfermería: la mejor barrera contra las infecciones de los catéteres de hemodiálisis

Abstract

Introduction: Using tunneled venous catheters for hemodialysis has increased in recent years, although its use is not free of complications, especially infectious, and increases mortality.
Objectives: To know the rate of bacteremia of our unit and the related complications.
Material and Method: The rate of catheter related-bacteremia was determined (number of infections / total number of catheter-days x 1000 catheter-days) in 30 patients with tunneled catheters after a revision of the catheter care protocol. In the second half of the study, new plugs (bioconnectors) were introduced during the study, although the comparison between two periods was not an objective of this study. The complications resulting from the bacteremia and the economic cost of the treatment of such bacteremia were also recorded.
Results: The rate of bacteremia was 0.30 / 1,000 catheter-days. There were no complications resulting from bacteremia. The economic cost was 126 euros / infection, without catheter replacement. Conclusion: In view of these results we can conclude that the rate of dialysis catheter-related bacteremia in our unit is low and that several factors converge: the strict use of a protocol for handling tunneled catheters, the knowledge and generalized use of all nursing personnel, in which we would highlight any manipulation by two professionals; and above all, the awareness of the whole group, that the first prevention of hemodialysis catheter-related infections, are the barrier measures.