Bloodstream Infection
Quality Improvement Activity (QIA)

Network Project Lead: Annabelle Perez
Quality Insights Renal Network 3 is conducting a Bloodstream Infections (BSIs) Quality Improvement Activity (QIA) to reduce bloodstream infection rates among dialysis patients. This year’s QIA includes two additional cohorts that will also aim to reduce long term catheters and improve communication with hospitals to join a HIE or obtain access to a hospital EMR system to receive information relevant to positive blood cultures during transition of care.
The following are the BSI QIA Aims:
  • All facilities in the BSI QIA shall work toward fully implementing all CDC Core Interventions. 
  • Achieve a 20% reduction in BSIs (in the BSI reduction group.)
  • Reduce LTC rates by 2 percentage points (in the LTC Reduction QIA group.)
  • Assist 20% of BSI QIA facilities to obtain access to an HIE or hospital EMR.

Network 3 facilities in the BSI QIA will implement at minimum, the following interventions:
  • Compare and align facility practices with the CDC recommended Core Interventions
  • Use the Plan-Do-Study-Act quality improvement process (PDSA cycle) for the implementation of the CDC recommended interventions 
  • Engage Subject Matter Experts (SMEs) in the audit process and PDSA cycle
  • Patient Education
  • Address gaps in patient knowledge of causes and prevention of BSIs based on a patient feedback from those who recently experienced a BSI
  • Provide resources to support facility catheter reduction activities.
Network 3 will also implement cohort specific interventions.

BSI Monthly PDSA Reporting Tool


Kick-Off Part One: “What Does It Really Mean to Follow the CDC Core Interventions?”
Kick-Off Part Two: “Responding to Prevent Infections” 
BSI Education/HIE-EMR Cohort Specific Call

BSI Reduction Resource Toolkit

CDC Staff Competencies 

Assess staff upon hire and at least yearly in the following competencies. (Note: Not all categories will be applicable to all staff.)
  • Gloving and Hand Hygiene (all staff) – includes recognition of appropriate situations for glove use/hand hygiene, proper use and removal of gloves, and proper hand hygiene technique.
  • Catheter Dressing Change Technique – includes correct performance of hand hygiene, and use of gloves, and correct use of antiseptics (proper application and allow drying, etc).
  • Vascular Access Technique – includes correct performance of hand hygiene and use of gloves, catheter site and port/vascular access antisepsis, and aseptic technique.
  • Safe Injection/Safe Medication Practices – includes proper technique for:
    • Parenteral medication preparation, handling, administration and storage (e.g., not in patient station, etc.)
    • Use of aseptic technique
    • Proper hand hygiene before preparing or administering medications or infusions
    • Proper cleansing of medication injection ports and medication vial diaphragms
    • Proper use and handling of single use vials and bags

TuneIn Logo Picture


Areas for Patient Education

Patients with Catheters
  • Hand hygiene
  • General access care at home (e.g., bathing with a catheter)
  • Signs and symptoms of infection
  • How to respond if problems with catheter develop outside of the dialysis center
  • Risks associated with catheters/importance of permanent access
  • Basic infection control practices during catheter accessing process (as a means to engage patients)
Patients with Other Access Types
  • Hand hygiene
  • Washing the access site prior to treatment
  • General access care at home (e.g., don’t scratch or pick at the site)
  • Signs and symptoms of infection
  • How to respond if problems with access develop outside of the dialysis center
  • Basic infection control practices during cannulation process (as a means to engage patients)
Making Dialysis Safer Logo Picture

Catheter Reduction Resource Toolkit

The FFCL Change Package includes 13 Change Concepts that provide a roadmap for implementation of the K/DOQI vascular access recommendations. Take a look at the overview.

Professional Resources

Patient Resources