Tennessee Partners with Dialysis Facilities to Strengthen Infection Prevention
Tennessee Partners with Dialysis Facilities to Strengthen Infection Prevention Tennessee and Dialysis Facilities Strengthen Infection Prevention Alex Kurutz, Joshua Key, Connie Harig Learn how Tennessee partners with dialysis facilities to address training needs and, in turn, strengthen infection prevention. More than 800,000 people in the United States are living with end-stage kidney disease, and over half receive life-sustaining treatment through dialysis. Unfortunately, healthcare-associated infections (HAIs) remain a leading cause of hospitalization and death for this population. Patients undergoing dialysis, especially hemodialysis, are at increased risk for infections due to frequent vascular access, compromised immune systems, and regular exposure to clinical settings. To support patient safety and reduce the risk of dialysis-related infections, it is critical to ensure that facility staff have access to training on evidence-based protocols such as proper hand hygiene and vascular access care. In Tennessee, the Department of Health works closely with dialysis facilities to identify and address the training needs of their staff and improve infection control practices that advance the safety of patients on dialysis. To gain further insights into this successful partnership, ASTHO spoke with two Tennessee Department of Health personnel — Dialysis Nurse Consultant Joshua Key and Epidemiologist Alex Kurutz — as well as Connie Harig, Nurse Educator from Dialysis Clinic, Inc. in Knoxville, who shared their experiences implementing and participating in this program, shedding light on the process, benefits, and lessons learned from this collaboration. Identifying Training Needs To effectively support training facility staff, the Tennessee Department of Health began by looking at what data could tell them about their state’s needs. In addition to reviewing reports from the National Healthcare Safety Network (NHSN), the Department of Health conducted a learning needs assessment in fall 2022 to identify educational and training needs expressed by dialysis providers. All dialysis facilities in Network 8, which encompasses Tennessee, Mississippi, and Alabama, received the assessment, and results revealed that dialysis technicians and nurses desired additional training related to infection prevention practices. In response, Tennessee initiated the Hemodialysis Infection Prevention Educational Program — a day-long, interactive simulation training, inspired by a similar effort in Massachusetts. Joshua Key 1 - Tennessee Partners with Dialysis Facilities to Strengthen Infection Prevention Developing and Implementing the Simulation Training The department hired four part-time educators — two dialysis nurses, one certified hemodialysis technician, and one biomedical technician — to develop the training materials based on CDC guidance. They also developed pre- and post-tests as well as a training evaluation to assess any increase in knowledge and intent to apply the content moving forward. Lastly, they worked with the Georgia Nurses Association to offer continuing education credits for participating providers. A typical simulation training has the capacity for about 40 participants and involves an eight-hour day, beginning with brief presentations on each topic and moving into applied practice in the second half of the day during which participants rotate through stations to apply the skills they learned. Participants also hear from a patient advocate to learn more about the real-life impact of dialysis-related infections, an experience many trainees have described as powerful and important. Despite facing initial challenges connecting with a patient advocate, Tennessee Department of Health emphasized its importance, ultimately leaning on partners such as the National Kidney Foundation and the National Forum of ESRD Networks to identify an available advocate. article yes