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April 29, 2026

Infection Control Practices for Vascular Access Management in Hemodialysis: Results From a Nationwide Survey of Japanese National University Hospitals

Puntos clave

The aim was to examine infection control practices for vascular access management in hemodialysis across Japanese national university hospitals.
Two questionnaire surveys conducted between 2019 and 2022 at 42 hospitals
Assessment of glove, disinfectant, and PPE use according to vascular access type
Comparison of practices between the two survey years
All facilities used disposable gloves for cannulation and vascular access connection
Nonsterile gloves were frequently used for arteriovenous fistulas and grafts
Chlorhexidine gluconate was the most common disinfectant for vascular access
PPE use increased from the first to the second survey

Resumen

ABSTRACT Introduction Bloodstream infections due to repeated vascular access (VA) puncture and circuit connections remain major concerns in hemodialysis. Therefore, we examined current practices for glove, disinfectant, and personal protective equipment (PPE) use according to VA type in national university hospitals in Japan. Methods Two questionnaire surveys were conducted between 2019 and 2022, with responses obtained from all 42 hospitals. Results All facilities used disposable gloves for cannulation and VA connection. Nonsterile gloves were more frequently used than sterile gloves for arteriovenous fistula (AVF), arteriovenous graft (AVG), subcutaneously fixed superficial artery, noncuffed catheters, and cuffed catheters. In 2019, nonsterile gloves were reported in 67% of facilities for AVF, 60% for AVG, 71% for subcutaneously fixed superficial arteries, 74% for noncuffed catheters, and 73% for cuffed catheters. In 2022, rates were 81%, 60%, 67%, 64%, and 67%, respectively. Disinfectant selection differed by VA type. In 2019, chlorhexidine gluconate (CHG) was most commonly used for AVF, povidone‐iodine (PI) for AVG and subcutaneously fixed superficial arteries, and alcohol for both noncuffed and cuffed catheters. In 2022, CHG–alcohol predominated for AVF, while PI remained a common disinfectant for AVG and subcutaneously fixed superficial arteries. PPE use increased from the first to the second survey. Conclusions Infection control practices during VA cannulation and connection varied even among national university hospitals. Further studies evaluating associations with infection outcomes are needed.

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