CMS's Role in Infection Control and Dialysis

In late November 2009, the Association for Professionals in Infection Control and Epidemiology (APIC) held a conference at the National Press Club in Washington D.C. to discuss the changing legal and regulatory landscape of healthcare-associated infections, better known as HAIs.

One of the speakers was Angela Brice-Smith, who is the deputy director for the Centers for Medicare & Medicaid’s survey & certification group. At the APIC conference, she cited the moribund fact that infection is the second highest cause of death in end-stage renal disease patient. Infection is also the most frequent citation for dialysis facilities: 218 times in surveys of new facilities and 1,188 times in dialysis recertification surveys.

She pointed to four main reasons behind the heightened risk: ESRD patients are immunosuppressed, they are exposed to a significant amount of blood, unlicensed staff are caring for multiple patients and there is a rapid “turnover” time between shifts.

Two of the most observed poor practices were unlicensed patient care technicians not following appropriate infection control practices, such as hand hygeine and disinfection of transducer protectors on machine. In addition, surveyors often found licensed medical staff was not using gloves when working with vascular accesses.