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Abstract Dialysis is defined as the diffusion of molecules in solution across a semipermeable membrane along an electrochemical concentrationgradient.Theprimarygoalofhemodialysisisto restore the intracellular and extracellular fluid environment that is characteristic of normal kidney function. End-stage renal disease (ESRD) is defined as irreversible decline in a person’s own kidney function, which is severe enough to be fatal in the absence of dialysis or transplantation. ESRD is included under stage 5 of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative classification of chronic kidney disease (CKD), where it refers to individuals with an estimated glomerular filtration rate less than 15 mL per minute per m2 body surface area, or those requiring dialysis irrespective of glomerular filtration rate. Infection is the most common cause of hospitalization and the second most common cause of mortality among hemodialysis (HD) patients, after cardiovascular disease. HD patients are exposed to different types of infection, which include bloodstream infections and localized infections of the vascular access, blood-borne infections with hepatitis B virus (HBV), hepatitis C virus (HCV) and/or human immunodeficiency virus (HIV) and airborne infections like tuberculosis. Studies showed that the main route of transmission of HAIs is via the transiently contaminated hands of the HCW. Therefore, hand hygiene is singled out as the most important infection prevention intervention. However, the compliance rates of HCWs in hand hygiene is very poor, with an overall average of only 40%. Based on hand hygiene indications as per recommendations from the APIC, CDC and World Health Organization Summary and Conclusion 76 (WHO) we estimated the number of times a single dialysis staff is required to perform hand hygiene per HD session per patient . The large number of times an HD staff is required to perform hand hygiene could be a reason for lack of compliance. However, compliance can be improved by continuous education and supervision, and by providing, in convenient locations, a sufficient number of sinks with soap dispensers, paper towels, hand lotions (e.g., one for every two to four dialysis stations) and alcohol-based hand rubs (ABHRs) placed at each patient station. Personal protective equipment (PPE) refers to a variety of barriers and respirators used alone or in combination to protect mucous membranes, airways, skin and clothing from contact with infectious agents. Sterile gloves must be used during procedures requiring a sterile aseptic technique, such as during catheter insertion or at any time a dialysis catheter is handled/manipulated. Audit originates from the Latin term “Audire” which means “to hear” just as in ancient times auditors used to listen to officers and people of authority to confirm the validity of their words. Audit is a systematic, independent and documented process for obtaining objective evidence and evaluating it objectively to determine the extent to which the audit criteria are fulfilled or put simply; an audit is a means to establish the extent to which performance meets the objectives for that performance. The aim of the work is to assess the implementation of CDCrecommended practices for infection prevention in hemodialysis facilities. This will be achieved by performing auditing to health care providers’ infection control related practices in HD units in the South Sinai Governorate, Egypt. Summary and Conclusion 77 All hemodialysis units (HDU) of South Sinai were included in the study and all nurses were invited to participate in the study and to fill in a selfadministered questionnaire. Patients and worker staff in hemodialysis units in south Sinai Hospital’s according to inclusion criteria We summarized our results as the following: Regarding age group, 0 were age <20, 22(46.8) were 20 years old, 21(44.6) were 30 years old, 9(19.1) were above 40 years. Regarding Level of education,19(40.4) graduated from School of nursing, 23(48.9) graduated from Nursing institutes, 5(10.6) graduated from Nursing college. Regarding Years of experience, 19(40.4) had Less than 5 years of experience, 28(59.6) had more than 5 years. All nurses had Course training in infections control in hemodialysis units. Distributions of health workers in hemodialysis units in south Sinai Governorate, El Tor Facility A consisted of 2(28.6) Doctors, 16(34.0) Nursing, 33(37.1) Patients. 7(63.6) of patients had Temporary central venous catheter and 26(33.7) had A-V shunt. Ras Sidr Facility B consisted of 2(28.6) Doctors, 11(23.4) Nursing, 19(21.3) Patients. 1(14.3) of patients had Temporary central venous catheter and 18(23.3) had A-V shunt. Regarding medical disorders of patients,29 had HTN in El Tor Facility A, 11 in Ras Sidr Facility B,6 in Sharm El Sheikh. Facility C ,5 in Dahab Facility D, 4 in Catherine Facility E, 8 in Abu Radis Facility F. 6 had DM in El Tor Facility A ,4 in Ras Sidr Facility B,4 in Sharm El Sheikh. Facility C ,3 in Dahab Facility D, 3 in Catherine Facility E, 3 in Abu Radis Facility F. 3 had cardiac disease in El Tor Facility A ,2 in Ras Sidr Facility B,1 in Sharm El Sheikh. Facility C ,1 in Dahab Facility D, 1 in Summary and Conclusion 78 Catherine Facility E, 1 in Abu Radis Facility F. 3 had renal atrophy in El Tor Facility A ,4 in Ras Sidr Facility B,1 in Sharm El Sheikh. Facility C ,1 in Dahab Facility D, 1 in Catherine Facility E, 4 in Abu Radis Facility F. Clinical characteristics of patients in hemodialysis units in southSinai Governorate,1(14.28) of patients had HBV + in Facility A, HCV +, presented in 7 patients, 5(15.15) and 1(9.1) in Facility F, HBV & HCV co-infection,HIV +, MRSA +, wasn’t observed in any case. CPE + presented in 27 patients ,3(9.1) in Facility A, 3(15.78) in Facility B, 5(41.67) in Facility C, 6(85.71) in Facility D, 4(57.14) in Facility E, 6(54.54) in Facility F. AMR GNB + presented in 17 patients, 7(21.2) in Facility A, 7(36.8) in Facility B, 2(16.67) in Facility C, 0in Facility D, 0 in Facility E, 1(9.1) in Facility F. Other infections presented in 34, 10(30.3) in Facility A, 0 in Facility B, 5(41.67) in Facility C, 4(57.14) in Facility D, 5(71.42) in Facility E, 10(90.9) in Facility F. ICU was 3(9.1) in El Tor Facility A, 4(21.05) % in Ras Sidr Facility B, 0% in Sharm El Sheikh. Facility C, 1(14.28) in Dahab Facility D,0% in Catherine Facility E, 0%Abu Radis Facility F. Death patient was 3(9.1) in El Tor Facility A, 2(21.05) in Ras Sidr Facility B, 0% in Sharm El Sheikh. Facility C,0% in Dahab Facility D, 1(14.28) in Catherine Facility E, 1(9.1)Abu Radis Facility F. Mortality rate was 9.1%in El Tor Facility A, 10.52% in Ras Sidr Facility B, 0% in Sharm El Sheikh. Facility C,0% in Dahab Facility D,14.28% in Catherine Facility E, 9.10%Abu Radis Facility F Free machines were USED IN 13 in Facility A, 12 in Facility B, 5 in Facility C, 3 in Facility D, 5 in Facility E and 5 in Facility F. HCV machines were USED IN 5 in Facility A, 1 in Facility B,0 in Facility C, 0 in Facility D, 0 in Facility E and 1 in Facility F. Summary and Conclusion 79 HBV machines, was USED were not used in Facility A,Facility B, and in Facility C, 1 in Facility D, 0 in Facility E and 0 in Facility F. Total machine number used for each dialysis treatment, USED IN 18in Facility A, 13 in Facility B,5 in Facility C, 4 in Facility D,5 in Facility E and 6 in Facility F. No. of staff members who connect and disconnect the patient to and from a machine, USED IN 18 in Facility A, 13 in Facility B,8 in Facility C, 4 in Facility D,4 in Facility E and 6 in Facility F. Side effect during and after dialysis in hemodialysis units,17(19.1) of patients had difficulty breathing, 6(18.2) in Facility A, 4(21.0) in Facility B, 1(8.3) in Facility C, 2(28.5) in Facility D, 2(28.5) in Facility E, 2(18.2)in Facility F. 18(20.2) of patients had Confusion, 6(18.2) in Facility A, 5(26.3) in Facility B, 2(16.7) in Facility C, 1(14.3) in Facility D, 2(28.5) in Facility E, 2(18.2) in Facility F. 29(32.6) of patients had Inflammation in limbs, 15(45.5) in Facility A, 7(36.8) in Facility B, 3(25.0) in Facility C, 1(14.3) in Facility D, 1(14.3) in Facility E, 2(18.2) in Facility F. 32(35.9) of patients had Fever, 10(30.3) in Facility A, 3(15.8) in Facility B, 5(41.7) in Facility C, 4(57.1) in Facility D, 5(71.4) in Facility E, 5(45.4)in Facility F. 20(22.4)of patients had Hypotension, 7(21.1)in Facility A, 3(15.8) in Facility B, 2(16.7)in Facility C, 2(28.5)) in Facility D, 2(28.5)) in Facility E, 4(36.3)in Facility F. 19(21.3)of patients had Muscle cramps, 8(24.2)in Facility A, 3(15.8) in Facility B, 1(8.3)in Facility C, 2(28.5)) in Facility D, 3(42.8)in Facility E, 2(18.2))in Facility F. 25(28.0) of patients had Itchy skin, 10(30.3) in Facility A, 4(21.0) in Facility B, 3(25.0)in Facility C, 1(14.3)in Facility D, 3(42.8)in Facility E, 4(36.3)in Facility F. 17(19.1) of patients had Blood clots, 6(18.2)) in Facility A, 2(10.5)in Facility B, 2(16.7))in Facility C, 2(28.5)in Facility D, 3(42.8)in Facility E, 2(18.2)in Facility F. 32(35.9) of Summary and Conclusion 80 patients had an Infection, 10(30.3) in Facility A, 3(15.8) in Facility B, 5(41.7)in Facility C, 4(57.1)in Facility D, 5(71.4)in Facility E, 5(45.4)in Facility F. 14(15.7)of patients had Anemia, 6(18.2)in Facility A, 2(10.5)in Facility B, 1(8.3)in Facility C, 1(14.3)in Facility D, 1(14.3)in Facility E, 3(27.3)in Facility F. 17(19.1) of patients had Fluid overload, 4(12.1) in Facility A, 2(10.5)in Facility B, 2(16.7)in Facility C, 2(28.5)in Facility D, 3(42.8))in Facility E, 4(36.3)in Facility F. 16(17.9) of patients had hypertension), 6(18.2) in Facility A, 3(15.8)in Facility B, 2(16.7)in Facility C, 2(28.5)in Facility D, 2(28.5)in Facility E, 1(9.1)in Facility F. Infection control related practices in hemodialysis units in south Sinai Governorate, CDC recommended practices was 70% in El Tor Facility A, 80% in Ras Sidr Facility B, 90% in Sharm El Sheikh. Facility C, 65% in Dahab Facility D, 60% in Catherine Facility E, 70% in Abu Radis Facility F. CDC recommended practices was > 70 in 2 units and ≤70 in 4 units. There was no significant difference between Sharm El Sheikh and Catherine hemodialysis units regarding socio‑ demographic and clinical characteristics of the nursing staff in south Sinai Governorate There was no significant difference between Sharm El Sheikh and Catherine hemodialysis units regarding patients’ characteristics(There was no significant difference between Sharm El Sheikh and Catherine hemodialysis units regarding patients’ characteristics. Temporary central venous catheter, Patients with A-V shunt, no, HBV +, no HCV +, no, HBV & HCV co-infection, no, HIV +, no, MRSA +, no, CPE +, no, AMR GNB +, no, Other infections , no, ICU administration, no , Death patient , no, Mortality rate, |