Prevention of infection in patients with chronic kidney disease part III: surveillance and auditing in a renal care environment.

This third paper, in a three-part CE series on the preventions of infection in patients with chronic kidney disease, focuses on surveillance and auditing of healthcare-associated infections within the renal care environment. The last decade has seen an increased awareness of the threat to patient safety from healthcare-associated infection (HCAI) and the emergence of multi-drug resistance organisms. Effective HCAI prevention strategies include adequate governance structures, access to expert advice, adherence to standard and transmission-based precautions, minimising the use of invasive medical devices, and surveillance. Surveillance data can be collected using outcome (e.g. infection) and/or process (e.g. hand hygiene compliance audit) measures. Establishing a surveillance programme requires: commitment from senior management and the multidisciplinary team, prompt feedback of the data to clinical managers resulting in action been taken if necessary, to address specific areas of concern. While many renal units have access to infection prevention and control expertise to assist in the development of such a programme, units without such expertise should also have a surveillance programme in place.