The Impact of the Dialysis Event Prevention Bundle on the Reduction in Dialysis Event Rate in Patients with Catheters: A Retrospective and Prospective Cohort Study

Background: Dialysis-associated events such as bloodstream infections represent serious
complications for hemodialysis patients, with the potential to increase morbidity and mortality.
Aims: To assess the impact of implementing a comprehensive bundle of evidence-based practice on
reducing dialysis event rates among catheter dialysis patients at Prince Mansour Military Hospital
Dialysis Center. Participants and Methods: The study enrolled 111 hemodialysis participants. A
comprehensive dialysis event prevention bundle consisting of 6 key components was implemented.
Results: Implementation of the dialysis event prevention bundle showed a significant decrease in IV
antimicrobial start (p = 0.003), positive blood culture (p = 0.039), and inflammation at the vascular
access site eliminated (p = 0.004). There was a positive correlation between IV antimicrobial start
and both patients’ age (p = 0.005) and the permanent catheter site (p = 0.002). Positive blood culture
was significantly correlated with comorbidities (p = 0.000) and patients’ age (p = 0.320). A positive
correlation between pus, redness, or increased swelling at the vascular access site with comorbidities
(p = 0.034), patients’ age (p = 0.021), and the permanent catheter site (p = 0.002) was observed.
Staff compliance with the dialysis event prevention bundle components has improved regarding
hemodialysis catheter disconnection, catheter exit site care, and routine disinfection. Conclusions:
Implementation of a comprehensive dialysis event prevention bundle can effectively reduce dialysis
event rates and enhance patient safety.