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Table 1 Checklist for handling vascular haemodialysis access

From: Access-related infections in two haemodialysis units: results of a nine-year intervention and surveillance program

Dressing change
Perform hand hygiene* Yes/No
Wear a surgical mask (nurse and patient) Yes/No
Wear non-sterile disposable gloves Yes/No
Remove the dressing from the catheter without touching adjacent skin Yes/No
Remove gloves and perform hand hygiene Yes/No
Open the dressing change kit Yes/No
Pour 2% chlorhexidine solution into a bowl Yes/No
Perform hand hygiene and put on sterile gloves Yes/No
Place three swabs in the chlorhexidine bowl Yes/No
Disinfect the exit site thrice, once with each swab; wait for the area to dry Yes/No
Wrap the catheter hubs with a sterile gauze Yes/No
Cover the exit site with a sterile dressing Yes/No
Remove gloves and perform hand hygiene Yes/No
Connecting the patient to the haemodialysis machine (immediately after dressing change)
Open the kit for connecting the patient Yes/No
Pour 2% chlorhexidine solution into a bowl Yes/No
Wear sterile gloves Yes/No
Put gauze pads in the chlorhexidine bowl Yes/No
Place a sterile towel beneath the catheter Yes/No
Clean the catheter hubs with the gauzes Yes/No
Draw dead space from each lumen Yes/No
Connect the haemodialysis tubing Yes/No
Remove gloves and perform hand hygiene Yes/No
Disconnecting the patient from the haemodialysis machine
Perform hand hygiene and put on non-sterile gloves Yes/No
Wear a surgical mask (nurse and patient) Yes/No
Return blood from the machine Yes/No
Measure blood pressure Yes/No
Remove gloves and perform hand hygiene Yes/No
Open the kit for disconnecting the patient Yes/No
Pour 2% chlorhexidine solution into a bowl Yes/No
Perform hand hygiene and put on sterile gloves Yes/No
Put gauze pads in the chlorhexidine bowl Yes/No
Place a sterile towel beneath the catheter Yes/No
Clean the catheter hubs with the chlorhexidine gauzes Yes/No
Inject saline and heparin into the catheter Yes/No
Put sterile caps on the catheter hubs Yes/No
Put the designated dressing around the catheter hubs Yes/No
Remove gloves and perform hand hygiene Yes/No
  1. * Hand hygiene – Hand disinfection using alcohol-based hand rub