Infections are the second leading cause of death in patients with end-stage renal disease (ESRD).  The majority of these infections are catheter-related bloodstream infection.  As a result, the following AIM with a 5-year target has been set to guide national health promotion and management to improve the health of all people in the United States living with ESRD: by 2023, reduce the national rate of blood stream infections in dialysis patients by 50% of the blood stream infections that occurred in 2016. The Networks shall reduce the rate of blood stream infections by supporting NHSN, participating in the ESRD NCC HAI LAN, and assisting dialysis facilities in the implementation of the CDC Core.

Overarching Goal: By 2023, reduce the rate of Blood Streams infections in Dialysis patients by 50% in the number that occurred in 2016.

CDC Core Interventions

NHSN Dialysis Surveillance Training

Cohort 1: 

Defined by CMS as the facilites that have the highest 50% of all the Network BSI rates and are the lowest performing half of the Network. This cohort is considered the educational cohort. Participants are responsible to attend all educational offerings and be present on the National HAI- BSI Learning and Action Network Calls (LAN). This cohort requires an attestation to verify the implementation of the CDC CORE interventions and the verification of completion of the annual NHSN Dialysis Surveillance training. 

Cohort 1 Facilities

Cohort 1 Monthly Checklist

Cohort 2:

Defined by CMS as a subset of facilities from cohort 1 who have the highest BSI rates in the Network. This is the interventional cohort. Members of Cohort 2 will be required in all educational offerings and the LAN as outlined in Cohort 1. Cohort 2 must submit project paperwork and reporting to the Network. 

Goal of Cohort 2: Demonstrate a 20% or greater relative reduction in the semi-annual pooled means rate in the cohort with the highest 20% of BSIs in the Network service area.

Cohort 2 Facilities

Cohort 2 Project Paperwork

Cohort 2 Monthly Checklist

Cohort 3:

Defined by CMS as a subset of facilities from cohort 1 who have and LTC rate greater than 15%.  This is an interventional cohort. Members of cohort 3 will be required to participate in all educational offerings and the LAN as outlined in cohort 1 plus they will be required to submit project paperwork and reporting to the Network.

Goal of Cohort 3: Demonstrate a 2% reduction in the Long Term Catheter Rates(LTC) in those clinics with greater than 15% LTC rate in the largest BSI cohort (50% of the network).

Cohort 3 Facilities

Cohort 3 Project Paperwork

Cohort 3 Monthly Checklist


HAI-BSI Kick Off Webinar 2018

Patient Ambassador Education Kick Off 2018

Core Interventions Introduction 2018

Core Interventions Part 2

Click here to view more resources for the Reduce Rates of Blood Stream Infection (BSI) Project.

Reduced Rates of Blood Stream Infections (BSI)

IPRO ESRD Network of the Ohio River Valley
Network 9 (IN,KY,OH)

Deb DeWalt, MSN, RN
Quality Improvement Director

Sue Swan-Blohm, BS, OCDT
Quality Improvement Coordinator

The Making Dialysis Safer for Patients Coalition is a group of both individuals and organizations that have come together to promote the use of the Center for Disease Control and Prevention's core interventions and resources to prevent dialysis bloodstream infections.

"Members include individuals, such as staff from individual clinics, nephrologists and nephrology nurses, dialysis technicians, leaders in infection prevention and/or patient safety, dialysis educators, patients, caregivers, and others. The role of Members is to help spread the word about the effectiveness of the CDC Core Interventions and motivate staff to implement them in their facilities".

Please click the link below to learn more about the Patients Coalition, as well as how to join: