125. Infection prevention practices for non-tunnelled haemodialysis catheters in the intensive care unit: preliminary results from an Australia-wide cross-sectional survey

Abstract

Introduction: Haemodialysis catheters (HCs) are large-bore catheters inserted in central veins of the groin or neck to facilitate renal replacement therapy (RRT) in critically ill patients with acute renal failure. HCs have the highest failure rate of all central venous catheters at 7% and their unique management needs to maintain blood-flow may contribute to failure and infective complications. We aim to describe HC infection prevention and post-insertion care practices. Methods: Cross-sectional internet-based survey of Australian critical care nurses across seven care domains. Results are reported descriptively. Results: From 138 respondents, 68 (49%) were registered nurses, 25 (18%) clinical nurses and 28 (20%) clinical nurse specialists/consultants, from adult ICUs (75%), with an average 14 years ICU experience. One-in-four respondents reported their ICU RRT policy did not include specific infection prevention recommendations to guide practice. Infection prevention components used for HC dressing change were a dressing pack (in 91% of respondents), ANTT® and handwashing with water and soap (both 80%, respectively), sterile gloves (76%), and non-sterile gown (67%). Only 22% of respondents reported using sterile gowns and 5% reported using sterile drapes. Disinfection of needleless connectors prior to HC accessing was reported by 90% of respondents, with a drying time of >15 seconds reported by 59%. Two-thirds of respondents reported that specimens were always collected from HCs suspected of infection. Conclusion: This survey describes current HC post-insertion care practices in ICU and preliminary findings suggest significant opportunities exist for improvement in infection prevention practices to decrease patient harm.