{"indexed":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T20:22:21Z","timestamp":1517257341976},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2015,7]]},"abstract":"\n OBJECTIVE<\/jats:title>\n To observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection.<\/jats:p>\n <\/jats:sec>\n \n SETTING AND PARTICIPANTS<\/jats:title>\n Thirty-four hemodialysis facilities were randomly selected from among 772 facilities in 4 end-stage renal disease participating networks. Facility selection was stratified on dialysis organization affiliation, size, socioeconomic status, and urban\/rural status.<\/jats:p>\n <\/jats:sec>\n \n MEASUREMENTS<\/jats:title>\n Trained infection control evaluators used an infection control worksheet to observe 73 distinct infection control practices at the hemodialysis facilities, from October 1, 2011, through January 31, 2012.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n There was considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68% (range, 45%\u201392%) across all facilities. Overall adherence to expected hand hygiene practice was 72% (range, 10%\u2013100%). Compliance to hand hygiene before and after procedures was high; however, during procedures hand hygiene compliance averaged 58%. Use of chlorhexidine as the specific agent for exit site care was 19% overall but varied from 0% to 35% by facility type. The 8 checklists varied in the frequency of perfect performance from 0% for meeting every item on the checklist for disinfection practices to 22% on the arteriovenous access practices at initiation.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Our findings suggest that there are many areas for improvement in hand hygiene and other infection prevention practices in end-stage renal disease. These NOTICE project findings will help inform the development of a larger quality improvement initiative at dialysis facilities.<\/jats:p>\n \n Infect Control Hosp Epidemiol<\/jats:italic> 2015;36(7):802\u2013806<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/ice.2015.55","type":"article-journal","created":{"date-parts":[[2015,3,16]],"date-time":"2015-03-16T07:34:35Z","timestamp":1426491275000},"page":"802-806","source":"Crossref","is-referenced-by-count":1,"title":"Variation in Infection Prevention Practices in Dialysis Facilities: Results From the National Opportunity to Improve Infection Control in ESRD (End-Stage Renal Disease) Project","prefix":"10.1017","volume":"36","author":[{"given":"Carol E.","family":"Chenoweth","affiliation":[]},{"given":"Stephen C.","family":"Hines","affiliation":[]},{"given":"Kendall K.","family":"Hall","affiliation":[]},{"given":"Rajiv","family":"Saran","affiliation":[]},{"given":"John D.","family":"Kalbfleisch","affiliation":[]},{"given":"Teri","family":"Spencer","affiliation":[]},{"given":"Kelly M.","family":"Frank","affiliation":[]},{"given":"Diane","family":"Carlson","affiliation":[]},{"given":"Jan","family":"Deane","affiliation":[]},{"given":"Erik","family":"Roys","affiliation":[]},{"given":"Natalie","family":"Scholz","affiliation":[]},{"given":"Casey","family":"Parrotte","affiliation":[]},{"given":"Joseph M.","family":"Messana","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2015,3,16]]},"reference":[{"key":"S0899823X15000550_ref9","DOI":"10.1053\/j.ajkd.2008.10.043","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref11","DOI":"10.1016\/j.ajic.2005.08.012","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref7","volume":"57","first-page":"875","year":"2008","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0899823X15000550_ref6","DOI":"10.1093\/cid\/cir257","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref5","volume":"50","first-page":"1","year":"2001","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0899823X15000550_ref17","DOI":"10.1053\/j.ajkd.2013.03.011","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref4","DOI":"10.1053\/j.ajkd.2006.07.015","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref16","volume":"61","first-page":"169","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0899823X15000550_ref3","year":"2009"},{"key":"S0899823X15000550_ref15","volume":"21","first-page":"24","year":"2008","journal-title":"Semin Dial"},{"key":"S0899823X15000550_ref2","DOI":"10.1053\/j.ajkd.2010.02.352","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref14","DOI":"10.1001\/archinternmed.2011.627","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref1","volume":"60","first-page":"243","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0899823X15000550_ref13","DOI":"10.1056\/NEJMoa061115","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref12","DOI":"10.1086\/659407","doi-asserted-by":"publisher"},{"key":"S0899823X15000550_ref8","volume":"73","first-page":"20293","year":"2008","journal-title":"Fed Regist"}],"container-title":"Infection Control & Hospital Epidemiology","original-title":[],"link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X15000550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,4,23]],"date-time":"2017-04-23T05:28:41Z","timestamp":1492925321000},"score":1.0,"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,16]]},"references-count":16,"alternative-id":["S0899823X15000550"],"URL":"http:\/\/dx.doi.org\/10.1017\/ice.2015.55","relation":{"cites":[]},"ISSN":["0899-823X","1559-6834"],"subject":["Microbiology (medical)","Epidemiology","Infectious Diseases"],"container-title-short":"Infect. Control Hosp. Epidemiol."}