Infection prevention measures for patients undergoing hemodialysis during the COVID-19 pandemic in Japan: a nationwide questionnaire survey

Renal Replacement Therapy

Norio Hanafusa¹  Hidetomo Nakamoto²  Masao Iwagami³  Naoki Kashihara⁴  Ryoichi Ando⁵  Ken Sakai⁶  Munekazu Ryuzaki⁷  Yoko Yoshida⁸  Yuka Sugawara⁸  Masaomi Nangaku⁸  Kan Kikuchi⁹  Toshio Shinoda^1,10 

[1] Department of Blood Purification, Tokyo Women’s Medical University, Tokyo, Japan;Department of General Internal Medicine, Saitama Medical University, Saitama, Japan;Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan;Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK;Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan;Department of Nephrology, Seishokai Memorial Hospital, Tokyo, Japan;Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan;Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo, Japan;Division of Nephrology and Endocrinology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan;Division of Nephrology, Shimoochiai Clinic, Tokyo, Japan;Faculty of Medical and Health Sciences, Tsukuba International University, Tsuchiura, Japan;

关键词: COVID-19;    SARS-CoV-2;    Pandemic;    Hemodialysis;    Infection prevention measures;    PPEs;    Disinfectants;    Isolation;    Nosocomial transmission;    Japan;   

DOI  :  10.1186/s41100-021-00350-y

来源: Springer

【 摘 要 】

BackgroundCoronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic affecting a variety of medical treatments, including hemodialysis. This study aims to investigate the implementation of infection control measures, to examine the shortage of personal protective equipment (PPE) and disinfectants, and to quantify the number of nosocomial COVID-19 transmissions in hemodialysis facilities in Japan during the pandemic.MethodsWe conducted a nationwide questionnaire survey between 20 October and 16 November 2020 (i.e., between the “second wave” and “third wave” in Japan) in the 4198 dialysis facilities of the Japanese Association of Dialysis Physicians and the Japanese Society for Dialysis Therapy. A total of 2227 facilities (53.0%) responded. The questionnaire consisted of (i) characteristics of facilities, (ii) infection prevention measures in routine dialysis practices, (iii) shortage of PPE, (iv) feasibility of various isolation measures, and (v) nosocomial transmission.ResultsHalf of the responding facilities were hospitals with multiple departments, and the other half were clinics specialized in dialysis. Several infection prevention measures such as health checks of staff and patients, donning of masks before and after hemodialysis, and disinfection of frequently contacted areas were implemented during the COVID-19 pandemic. There was a significant improvement in the implementation rate of these measures during the pandemic, compared to before it, which reached over 90%. More than half of the facilities reported a shortage of disposable masks (67.2%) and hand sanitizer alcohol (56.7%). Isolation of COVID-19 patients in private rooms was possible only in 52.7% of the facilities. The majority of facilities (73.3%) could not accept COVID-19 dialysis patients due to lack of space and manpower. Nosocomial transmission of COVID-19 occurred in 4.0% of the facilities. Of those infected, 51.9% were staff.ConclusionsThis survey revealed that most hemodialysis facilities in Japan had improved implementation of infection control measures and had shortage of PPEs and disinfectants, though some facilities did not implement infection prevention measures adequately, mainly due to the limited space of the facility. It may be recommended that each facility immediately establishes isolation measures to prepare for the pandemic of COVID-19.

【 授权许可】

CC BY