الفهرس 
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Abstract
Patients with end stage kidney disease (ESKD) treated with hemodialysis (HD) are at substantially increased risk of life-threatening infections. The majority of bloodstream infections (BSI′s) are related to vascular access, of which 70% are associated with the use of a central venous catheter (CVC).
The aim of the present work is to evaluate the infection control measures to prevent Catheter related BSI in HD unit at the military hospital of Alexandrai.
The study was carried out in one of the military hospitals. The study population included 45 HCW′s and 50 HD patients at different phases. This study was divided into 3 phases, the first phase was observational for 3 months, the second phase was interventional for 3 months and the third phase; re-evaluation was conducted after 6 month from the start of the study.
The results of the present study revealed:-
1. In the present study there have been a statistically significant difference (p≤0.001); between the exam results before and after the training.
2. There have been statistically significant differences (p≤0.05) in the observational points (audit tools) of the guidelines of CVC insertion steps;comparing between emergent &non-emergent group compliance in aseptic technique in insertion before and after training.
3. There have been a statistically significant difference in the checklist points (audit tools) of HD connection steps; comparing between compliance to the guidelines of aseptic technique in all steps of HD connection, HD disconnection, exit site care steps before and after training (p≤0.05).
4. There have been a statistically significant difference in the checklist points (audit tools) of medications administration guidelines adherence comparison before and after training; (p≤0.05) in (P1-P5&P7-P9), as (med prep done in designated area, med prep area is clean, all vials are inspected, hand hygiene, septum of all vial are inspected, med prep done aseptically, all single dose inspected, all multi dose stored properly).
5. There have been a statistically significant difference (p≤0.05) in observational points of steps of cleaning and disinfection (p1,p3&p5-p9) comparing adherence to the guidelines before and after training as;(all supplies removed from station and prime bucket emptied, station is empty before disinfection, disinfectant applied to all surfaces and prime bucket, all surfaces are wet with disinfectant, all surfaces allowed to dry, gloves removed, hand hygiene performed, no supplies or patient brought to station until disinfection is complete).
6. There have been statistically significant differences between the success of the non-emergent and emergent hand washing opportunities before and after training.
7. There have been statistically significant differences (p≤0.001) in the use of antibiotic lock (ALT) before and after training, as application ofALT was performed 4(8%) cases before training which increased to 23(46%) cases after training.
8. There have been statistically significant differences (p≤0.001) between the numbers of positive blood culture bottles before training compared to after training. 23(46%) and 6(12%), respectively.The BSI ratio in the HD before starting the training program was 18.5\1000 catheter days which decreased to 4.8\1000 catheter days after the training program.
9. There have been no statistically significant relations (p≥1.000) between the blood culture bottles results in relation to the application of ALT therapy.