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 use of National Health and Safety Network (NHSN), encouraging dialysis facility participation in the ESRD NCC HAI LAN, and assisting dialysis facilities in the implementation of the CDC Core interventions.

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


CDC Core Interventions

How to Make a Huddle Board

Click here for additional resources on Blood Stream Infection (BSI).

BSI Quality Improvement Activities

In order to focus efforts on BSI reduction there will only be one interventional cohort. For long term catheter there are 3 cohorts. The first is the benchmark cohort those operating above the Network performance rate. The next is the Interventional group, those performing just below the Network Performance rate with a census greater than 50 and LTC rate of greater than 15%. The observational cohort will be monitored and given performance expectations/ goals.

BSI Reduction Interventional Cohort

LTC Reduction Benchmark/ Best Practice Facilities 2020

LTC Reduction 2020 Interventional Facilities

LTC Reduction Observational Clinics 2020


BSI LTC Reduction QIA Kick Off 2020

See the ESRD NCC website to review the LAN presentation

COVID19 Supplemental CORE Knowledge

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

Patient Facility Representative

Research and best practices have demonstrated that units with active participation of patients as members of the health care team achieve better clinical outcomes more readily. This year, the Network is requesting that each facility in the BSI/LTC areas designate at least one patient, or preferably, one patient per shift to take the lead on special projects. We will provide training for these patients to supervise these programs in the clinic. Patients should be viewed as role models in the unit and have the ability to lead and become "an unofficial spokesman" on the care team.

In this role, the patient will:

  • Provide contact information to the Network.
  • Participate in educational information web conference presentations with the Network.
  • Assist with Audits and observations using tools provided by the Centers for Disease Control (CDC).
  • Review educational materials designed for patients in the target facilities and throughout the Network community.
  • Distribute and review resources with patients.

Patient Ambassador Resources and Materials

Patient Facility Representative Recruitment Materials

Sepsis Fact Sheet

Conversation Starter Sepsis

Patient Hand Hygiene Instruction

5 Hand Washing Points

Access Planning Guide

Look, Listen and Feel

Patient Access and Hand Hygiene-Audit Tool

Surface Disinfection-Audit Tool