KHA-CARI guidelines: infection control for haemodialysis units — a summary review

Abstract

Context The latest KHA-CARI guidelines provide recommendations on screening for and management of blood-borne viruses (BBV) and multi-resistant organisms (MRO). The Guidelines comprise almost 80 pages, and include detailed practical advice related to clinical infection prevention, management considerations, and the working party’s evidence sourcing methodologies. Objectives To outline the format and content of the guidelines, summarising key points as relevant to nursing practice within haemodialysis units. To review the key points in the guidelines in regard to standard precautions, routine and enhanced surveillance screening, management of patients with positive results for BBV and MRO, environmental and equipment use and cleaning, use of personal protective equipment, and suggestions for clinical care. To highlight how the guidelines can support a dialysis unit in meeting relevant standards in the accreditation process. Key findings The KHA-CARI guidelines governing infection control in Australian and New Zealand haemodialysis units are detailed and evidence-based, and if adopted within an appropriate clinical governance framework, provide a comprehensive approach toward unit-based infection control that supports compliance with a number of the eight Australian National Safety and Quality Health Service (NSQHS) standards. Patient-centred care and implementation impact is a key focus of the guidelines, although they highlight limitations imposed by gaps in evidential knowledge. Conclusion The KHA-CARI infection control guidelines provide a high-quality, evidence-focused and detailed review of recommendations in regard to preventing and managing BBV and MRO infections in dialysis units. They align with NSQHS accreditation standards.