CHAPTER ONE

1.0       INTRODUCTION

1.1       BACKGROUND TO THE STUDY

Hemodialysis is a medical procedure to remove excess fluid and waste products from the blood and to correct electrolyte imbalances. This is accomplished using a machine and a dialyzer also referred to as an artificial kidney. (Medical Dictionary, 2016).

Hemodialysis is used to treat both acute (temporary and chronic permanent) kidney failure (Medical Dictionary, 2016).

Patient on Hemodialysis are at a high risk for infection because the process of haemodialysis requires frequent use of catheters or insertions of needles to access the bloodstream. Patient on hemodialysis have weakened immune system which increase their risk of infection and they require frequent hospitalizations and surgery where they might acquire an infection (CDC, 2016).

Patient on haemodialysis treatment present a high risk of mortality by the primary disease itself, they are further submitted to other invasive procedure demanding considerable efforts to establish adequate infection prevention and control measures (Dianep, Natalia and Strabilli 2009).

Patients on hemodialysis have an increased risk of infection due to the fact that hemodialysis requires vascular access for a prolonged period of time. During the dialysis process, multiple patients received dialysis at the same time which gives repeated opportunities for transmission of infectious organism (Hammer, 2015).

According to CDC (2017), infections are the second leading cause of death among patients on haemodialysis. These patients are more at risk of infections such as staphylococcus aureus and other blood stream infections and viral hepatitis.

Saha (2001) also stated that patients on heamodialysis are at risk for hepatitis, viral infections due to high number of blood transfusion, prolonged vascular access and the potential for exposure to infected patients and contaminated equipment.

Schwab (2009), said that a patient on haemodialysis is more than 100 times more likely to get a blood stream infection and this can result in hospitalization and even death.

According to CDC report in (2010), more than 380,000 patients in the United States relied on haemodialysis for treatment of their End State Kidney disease. About 8 in 10 of these patients start treatment with a central line, when not put correctly or not kept clean, it can provide a portal for germs to enter the body and cause blood stream infections.

Preventing blood stream infection among patients on haemodialysis has been identified as a national priority by the United States Department of Health and Human services.

Patricia, Natalia, Strabilli, (2009), opined that in general, data disclosed that the highest rate of infection in haemodialysis patients are related to temporary catheters when compared to tunneled catheters fistulas or grafts.

1.2       STATEMENT OF THE PROBLEM

Various studies have reported that patients who undergo haemodialysis treatment have an increased risk of infection because the process of haemodialysis requires frequent use of vascular access to access the bloodstream.

Furthermore, due to the weakened immune system of patients on haemodialysis, it increases their risk for infection and frequent hospitalization.

Dialysis access related infections and associated hospitalization affect general wellbeing of patient and also one of the major causes of morbidity and mortality second only to cardiovascular disease (Wood, 2007).

Better understanding of the risk factors for vascular access-related infections may inform efficacious prevention strategies that lead to early detection of infections, prevention of infection and improved patients care.

The researcher also observed during the course of practice in renal unit of Federal Medical Centre, Owo that about 3 out of 10 patients on vascular access (catheter) have shown signs of infection at one time or the other, hence the need to further investigate why this is so and this research study.

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