Healthcare workers compliance to infection control practices in the haemodialysis unit in Sungai Buloh Hospital Malaysia

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Background: The number of patients with end-stage renal failure treated with haemodialysis in Malaysia has been increasing in recent years. Haemodialysis patients are at a higher risk of developing infections either directly or indirectly via contaminated devices, equipment, environmental surfaces or hands of healthcare workers (HCWs). Thus compliance to infection control practices by HCWs is very crucial in the prevention of the transmission of infections among haemodialysis patients. The Haemodialysis Unit in our hospital has been in existence only for the past two years and we would like to determine the compliance of the HCWs to the infection control practices.

Methods: We carried out a survey on the compliance to infection control practices among HCWs in the haemodialysis unit of our hospital over a two-week period. Two infection control nurses were stationed at the unit and a standard checklist was prepared. The CDC recommendations for preventing transmission of infections among chronic haemodialysis patients were used as a guide (MMWR 2001;50(No. RR-5).

Results: The unit has 25 dialysis machines with an average number of 46 patients per month. Four medical assistants, 4 nurses and 4 healthcare attendants were observed during the study period. Hepatitis B seropositive patients were managed in a separate area with dedicated dialysis machine fom Hepatitis B seronegative patients. The HCWs were most compliance to wearing gloves, provided dedicated items, medications or supplies for single patient use (100% compliance). The HCWs were least compliance to hand washing and removal of gloves in between patients (9% compliance rate). The staff failed to clean or disinfect the prime buckets (0%).

Conclusion: The results of the study provided a baseline information on the compliance of the HCWs to infection control practices in the care of haemodialysis patients in our hospital. Continuous education and training of the HCWs in infection control practices which are unique to the haemodialysis centre are required in order to create the awareness of the importance of adherence to these practices and thus will help reduce infections in the patients.