Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units

Meg Jardine, Robert J. Commons, Janak R. de Zoysa, Muh G. Wong, Nicole Gilroy, Julianne Green, Belinda Henderson, Rhonda L. Stuart, David J. Tunnicliffe, Carolyn van Eps, Eugene Athan

    Research output: Contribution to journalArticle

    Abstract

    Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence.

    Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available.

    Results:
    The main guideline recommendations are:

    Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions.
    Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus.
    Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients.

    The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci. Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices.

    Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.
    Original languageEnglish
    Pages (from-to)951-957
    Number of pages7
    JournalNephrology
    Volume24
    Issue number9
    Early online date16 Oct 2018
    DOIs
    Publication statusPublished - Sep 2019

    Fingerprint

    Infection Control
    Renal Dialysis
    Dialysis
    Guidelines
    Kidney
    Health
    Methicillin-Resistant Staphylococcus aureus
    Viruses
    Hepatitis B
    New Zealand
    Caregivers
    Health Services
    Consensus
    Hospitalization
    Databases
    Education
    Mortality
    Infection
    Research
    Therapeutics

    Cite this

    Jardine, Meg ; Commons, Robert J. ; de Zoysa, Janak R. ; Wong, Muh G. ; Gilroy, Nicole ; Green, Julianne ; Henderson, Belinda ; Stuart, Rhonda L. ; Tunnicliffe, David J. ; van Eps, Carolyn ; Athan, Eugene. / Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units. In: Nephrology. 2019 ; Vol. 24, No. 9. pp. 951-957.
    @article{79f657dc9fd64ba0a43a8e8f3c271d83,
    title = "Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units",
    abstract = "Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence. Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available. Results: The main guideline recommendations are: Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions. Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus. Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients. The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci. Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices. Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.",
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    author = "Meg Jardine and Commons, {Robert J.} and {de Zoysa}, {Janak R.} and Wong, {Muh G.} and Nicole Gilroy and Julianne Green and Belinda Henderson and Stuart, {Rhonda L.} and Tunnicliffe, {David J.} and {van Eps}, Carolyn and Eugene Athan",
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    Jardine, M, Commons, RJ, de Zoysa, JR, Wong, MG, Gilroy, N, Green, J, Henderson, B, Stuart, RL, Tunnicliffe, DJ, van Eps, C & Athan, E 2019, 'Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units', Nephrology, vol. 24, no. 9, pp. 951-957. https://doi.org/10.1111/nep.13511

    Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units. / Jardine, Meg; Commons, Robert J.; de Zoysa, Janak R.; Wong, Muh G.; Gilroy, Nicole; Green, Julianne; Henderson, Belinda; Stuart, Rhonda L.; Tunnicliffe, David J.; van Eps, Carolyn; Athan, Eugene.

    In: Nephrology, Vol. 24, No. 9, 09.2019, p. 951-957.

    Research output: Contribution to journalArticle

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    T1 - Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units

    AU - Jardine, Meg

    AU - Commons, Robert J.

    AU - de Zoysa, Janak R.

    AU - Wong, Muh G.

    AU - Gilroy, Nicole

    AU - Green, Julianne

    AU - Henderson, Belinda

    AU - Stuart, Rhonda L.

    AU - Tunnicliffe, David J.

    AU - van Eps, Carolyn

    AU - Athan, Eugene

    PY - 2019/9

    Y1 - 2019/9

    N2 - Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence. Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available. Results: The main guideline recommendations are: Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions. Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus. Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients. The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci. Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices. Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.

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    KW - haemodialysis

    KW - infectious disease

    KW - multidrug resistant organism

    KW - practice guideline

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