Analysis of Infectious Risk in the Hemodialysis Unit at the University Hospital Center

Abstract

Hemodialysis, as an extra-renal purification technique, carries an inherent infectious risk. This study aimed to assess the infection risk associated with hygiene practices around hemodialysis patients in a hospital setting. This study employed Failure Modes and Effects Analysis (FMEA) to evaluate risks. A comprehensive visit was conducted at the hemodialysis unit of the nephrology department at Sahloul University Hospital of Sousse on a single day. The visit comprised a documentary inventory, premises observation, professional and patient interviews, and observation of professional practices to comprehensively understand infectious risk during patient care. The study identified seventeen failure modes during a hemodialysis session, categorized into six of level 1 criticality, four of level 2, and seven of level 3. The most critical failure modes included the improper handling and distribution of multi-dose heparin into single-dose injections in an unspecific area, as well as the absence of a 4-stage skin preparation for the puncture site. Proposed corrective measures to mitigate infectious risk were outlined. The FMEA approach effectively identified potential risks, necessitated a review of certain procedures, and proposed matrices to manage the most critical risks. This analysis, when conducted periodically, facilitates a genuine quality-focused approach, enhancing patient satisfaction and bolstering all stakeholders' confidence within the hemodialysis center.