Upland Hills Health Dialysis Center, Leading Infection Prevention

Wednesday, January 22, 2014

[Dodgeville] In the effort to reduce bloodstream infections in U.S. hemodialysis patients, Christy Pier, BSN, RN, Team Facilitator and her team at Upland Hills Health Dialysis Center in Dodgeville are leading the way.

Pier’s infection control model includes diligent data collection, idea sharing, process monitoring, continuous training and a persistent effort to replace catheter “access connections” in hemodialysis patients with an Arteriovenous Fistula (AVF).

The move toward the use of AVFs was prompted by an effort to reduce infections called the Fistula First Initiative driven by End-Stage Renal Disease (ESRD) National Vascular Access Improvement Initiative (NVAII).

Since the Fistula First Initiative was launched, the use of AVF as a primary access has jumped from 32% in 2003, to 61% in 2012 in all networks in the US. As of March 2012, fistula use in Wisconsin is at 61%. The Upland Hills Health Dialysis Center in Dodgeville is currently at 67% fistula use and as a result the Dodgeville Center has experienced only 4 infections in the past five and a half years. The fact that the Center has given over 14,050 treatments in that time underscores the success of this low infection rate.

The Fistula First Initiative is only part of a comprehensive infection control model in place at Upland Hills Health Dialysis Center. Pier believes that their success with keeping infections at bay is a result of a team effort that includes both staff and patients. The program consists of data collection and sharing, ongoing staff and patient education and diligent monitoring and modification of procedure.

Pier commented, “The patient’s dialysis access is the patient’s lifeline-whether it is a fistula or a catheter.@ For a patient’s improved dialysis treatment and health and well-being, a fistula is the access of choice to receive their treatment.@ We are striving to hit 80% fistula rate, if patients have not exhausted their fistula options.@ The dialysis team is passionate about keeping our patients in our dialysis center receiving treatment, not in a hospital fighting off infection.”

Pier belongs to the Wisconsin Healthcare-Associated Infections (HAI) Prevention Program Advisory Committee, and during their most recent quarterly teleconference Pier presented the process she is using to eliminate infections at Upland Hills Health Dialysis Center. Shortly thereafter, the HAI Prevention Program Coordinator for the Wisconsin Division of Public Health asked Pier to publish her model in the HAI Newsletter.