Premium
Dialysis catheter management practices in Australia and New Zealand
Author(s) -
Smyth Brendan,
Kotwal Sradha,
Gallagher Martin,
Gray Nicholas A,
Polkinghorne Kevan
Publication year - 2019
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13507
Subject(s) - medicine , catheter , dialysis , population , intensive care medicine , infection control , emergency medicine , surgery , environmental health
Aim Dialysis catheter‐associated infections (CAI) are a serious and costly burden on patients and the health‐care system. Many approaches to minimizing catheter use and infection prophylaxis are available and the practice patterns in Australia and New Zealand are not known. We aimed to describe dialysis catheter management practices in dialysis units in Australia and New Zealand. Methods Online survey comprising 52 questions, completed by representatives from dialysis units from both countries. Results Of 64 contacted units, 48 (75%) responded (Australia 43, New Zealand 5), representing 79% of the dialysis population in both countries. Nephrologists (including trainees) inserted non‐tunnelled catheters at 60% and tunnelled catheters at 31% of units. Prophylactic antibiotics were given with catheter insertion at 21% of units. Heparin was the most common locking solution for both non‐tunnelled (77%) and tunnelled catheters (69%), with antimicrobial locks being predominant only in New Zealand (80%). Eight different combinations of exit site dressing were in use, with an antibiotic patch being most common (35%). All units in New Zealand and 84% of those in Australia undertook CAI surveillance. However, only 51% of those units were able to provide a figure for their most recent rate of catheter‐associated bacteraemia per 1000 catheter days. Conclusion There is wide variation in current dialysis catheter management practice and CAI surveillance is suboptimal. Increased attention to the scope and quality of CAI surveillance is warranted and further evidence to guide infection prevention is required.