Assessing Hemodialysis Catheter Insertion Practices Against CDC Guidelines: A Closed-Loop Audit at a Tertiary Hospital in Egypt.

Abstract

Background Following evidence-based guidelines during hemodialysis catheter insertion procedures is key to lowering catheter-related bloodstream infections (CRBSI) and other complications. Our aim was to examine all aspects relevant to the insertion of hemodialysis catheters in the dialysis unit at Alexandria Main University Hospital,Alexandria, Egypt, in order to identify practices that could be contributing to high complication rates. Methods We used the CDC's Guidelines for the Prevention of Intravascular Catheter-Related Infections to define the criteria relevant to hemodialysis catheter insertion procedures. These criteria were made into a form to be used as the primary auditing tool. The form was then used to record catheterization procedures in the dialysis unit from March 2024 to July 2024. Eighty patients scheduled for hemodialysis catheter insertion were randomlyselected, 40 in the initial cycle of the audit, and 40 in the re-audit cycle. Percentage adherence to each criterion was then calculated for each audit cycle and compared. Results Overall, adherence to the criteria assessed showed significant improvements, with mean compliance increasing from 69% in the initial cycle to 90% in the second cycle. In addition, the rate of mechanical complications recorded decreased. Conclusion Our study emphasized the effectiveness of using closed-loop clinical audits to ensure continuous improvement of care delivered during hemodialysis catheter insertion procedures.