A Design Thesis: Hemodialysis Infection Prevention using Polysporin Ointment with Shower Technique in Satellite Hemodialysis Centres

Abstract

Background: As part of this thesis work, we developed a Shower Technique protocol (‘STP’) for hemodialysis patients with healed central venous catheter (catheter) exit sites, designed to permit showering but not increase infection risk. Research question: Is it feasible to conduct a randomized control trial called the Hemodialysis Infection Prevention using Polysporin Ointment with Shower Technique in Satellite Centres (HIPPO SAT) study comparing the rate of CRB in adult satellite hemodialysis patients using STP versus standard catheter care alone with 6 month follow up? Study Design: The HIPPO SAT pilot study is a multi-centre randomized control trial. Eligible participants will be randomized to STP versus standard care after meeting predefined criteria to confirm healed tunneled catheter exit site. Primary Outcome: Feasibility will be determined based on 5 outcome measures: accuracy of the CRB rate documentation in the satellite setting, and percentage of patients screened, recruited, educated successfully in the STP (intervention arm), and using aspects of STP (% of contaminated patients in the control arm). Study Setting: In satellite units affiliated with 2 academic and 3 community centres in south central Ontario, Canada. Patient Population: Adult satellite Hemodialysis patients dialyzing via catheter with healed catheter exit sites. Intervention: STP and standard catheter care; or Control: standard catheter care; Analysis: Each measure of feasibility has its statistical threshold for success. If the threshold is reached in 4 of the 5 measures, the full HIPPO SAT study will be deemed feasible. Discussion: A pilot feasibility study of the larger study is critical due to the potential challenges associated with recruitment, compliance and contamination.