Compliance with good practice guidelines for the prevention of vascular access infections: The multicentre PHYDEL survey in French haemodialysis units.

BACKGROUND: French guidelines for the prevention of vascular access infections in a haemodialysis setting were released in 2005. Compliance with these guidelines is currently unknown. Our aim was to assess compliance with guidelines for vascular access infection prevention in French haemodialysis units, and to describe the difficulties reported.

METHODS: A cross-sectional survey was conducted between March and December 2019 in 200 haemodialysis units randomly selected in France. Data were collected via questionnaire, completed by telephone interview with an infection control practitioner. A practice was deemed compliant when > 85% of units declared always complying with guidelines.

RESULTS: A total of 103 units (51.5%) agreed to participate. Most practices complied with guidelines, however some of them (working in pairs when connecting central venous catheter (CVC) lines, performing hand hygiene before disconnecting lines, rinsing antiseptic soap before painting CVC exit site or arteriovenous fistula (AVF) puncture site, allowing antiseptic paint to dry, handling CVC branches with antiseptic impregnated gauze, performing hand hygiene after AVF compression with gloves, wearing protective eyewear when connecting/disconnecting CVC or when puncturing AVF, wearing a gown when puncturing AVF) did not reach the 85% compliance threshold. Most frequently reported difficulties were understaffing, difficulties with skin preparation because of exit site skin damage, and lack of buttonhole technical expertise.

CONCLUSIONS: Despite good overall compliance, this survey highlights some shortcomings in complying with infection prevention guidelines, which could be associated with either higher vascular access infection risk or with increased blood-borne virus transmission.