Key Insights to Improve Infection Prevention in Dialysis Settings

January 12, 2026 | Shalini Nair

Dialysis-related infections remain a serious and preventable threat to patient safety. Each year, thousands of patients on hemodialysis experience bloodstream infections that can lead to hospitalization or death. These infections strain both patients and public health systems, underscoring the need for strong prevention efforts. Health departments play a vital role in promoting evidence-based practices and partnerships that keep dialysis care safe.

CDC’s Making Dialysis Safer for Patients Coalition brings together health departments, dialysis providers, other partners, and professional and patient organizations to reduce infections and improve outcomes for patients on dialysis. By promoting collaboration, education, and evidence-based practices, the Coalition supports safer care nationwide. In June 2025, ASTHO and CDC hosted small-group sessions with frontline staff (i.e., technicians, nurses, and nephrologists), facility leadership, and patients to explore successes and ongoing challenges in infection prevention (IP) — informing three key takeaways that will help health departments strengthen their dialysis safety efforts:

• Creating a Culture of Safety: Fostering a transparent, “see it, say it” environment strengthens shared accountability and supports early identification of infection risks.
• Educating and Empowering Dialysis Staff: Providing engaging, role-specific training and constructive feedback equips staff to consistently apply infection-prevention practices.
• Being an Engaging Leader: Visible, supportive leadership that prioritizes staff development and models best practices drives stronger safety culture and sustained IP improvements.

Creating a Culture of Safety

A recurring theme across all sessions was the critical role of workplace culture in supporting effective IP practices. Participants emphasized fostering a “see it, say it” philosophy, where infection prevention and control remain priorities, resulting in shared accountability. Leveraging real-time teaching moments helps frontline staff immediately apply and adopt lessons, while understanding the “why” behind IP practices promotes safer behaviors. Positive reinforcement, celebrating successes, and rewarding contributions that improve patient outcomes are essential to sustaining a culture of safety. Participants also highlighted the importance of empowering patients as active partners in IP — encouraging them to speak up, ask questions, and understand IP practices helps to identify risks early and reinforce best practices.

Health Department Takeaways

These insights underscore health departments’ role in supporting dialysis facilities to build and sustain a culture of safety. They can enhance staff engagement, boost patient participation, and improve IP outcomes across dialysis care by encouraging collaboration, offering technical assistance, and celebrating facilities that model strong IP practices.

Educating and Empowering Dialysis Staff

Participants also highlighted the need for accessible, engaging, and role-specific educational resources tailored to the dialysis setting — underscored by barriers like time constraints, staffing shortages, and limited managerial support. They shared that short, interactive formats and simulation-based learning are seen as most effective for linking education to practice and improving retention.

In addition to initial and ongoing IP education opportunities, participants emphasized the importance of ongoing evaluation (i.e., unscheduled observation visits, audits, daily huddles and debriefings, and Infection Control Assessment and Response visits). Staff value feedback on IP practices that is…

1. Constructive.
2. Non-disruptive to patient care.
3. Focused on encouraging positive practices rather than punishing mistakes.

Evaluating knowledge retention through annual competency assessments, longitudinal evaluations, and outcome-based measures (e.g., bloodstream infection rates) can help monitor both learning effectiveness and practice changes over time. Empowered staff who understand the rationale behind IP practices are more motivated to follow protocols consistently and can serve as strong advocates, reinforcing a culture of safety and accountability throughout the facility.

Health Department Takeaways

These insights are crucial for health department staff to tailor supportive interventions (e.g., Infection Control Assessment and Response visits) to resonate with dialysis facility staff and meet their unique needs. Understanding staff motivations, preferred learning formats, and effective evaluation methods can help health departments promote lasting improvements in IP and patient safety across dialysis settings.

Being an Engaging Leader

Breakout session participants emphasized that leadership buy-in is critical for both staff development and maintaining a strong culture of safety. When leaders actively support training opportunities, provide resources, and model safe practices, staff feel valued, empowered, and motivated to uphold IP standards.

Participants identified several areas where managerial support can be stronger to improve ongoing learning and staff development:

• Technicians expressed the need for greater recognition, clearer advancement pathways, and compensation that reflects their responsibilities.
• Nurses and nephrologists emphasized the importance of leadership allocating dedicated time and resources for staff education and development. Additionally, they expressed that providing managers with targeted training on addressing repeated lapses in infection control could enhance accountability and reinforce a focus on safe care.

Health Department Takeaways

Health departments can play a key role in strengthening leadership support for staff development and safety by providing guidance, sharing best practices, offering training resources, and supporting accountability frameworks. They can also help facilities improve staff satisfaction and engagement, enhance infection prevention practices, and sustain improvements over time.

Join the Coalition to Drive Better Care for Patients on Dialysis

Fostering a culture of safety, educating and empowering frontline staff, and promoting leadership level support of IP training and improvement are critical to the advancement of patient safety practices in dialysis settings. Health departments play a leading role in collaborating with dialysis facilities to drive positive change.

The CDC’s Making Dialysis Safer for Patients Coalition offers a collaborative platform for health departments and facility partners to access best practices, training tools, and technical support. Joining the Coalition provides health department staff opportunities to learn from peers and stay up to date on evidence-based strategies that support patient safety — which can aid and inform stronger engagement with dialysis facilities. To become a member of the Coalition, visit CDC’s Coalition webpage and complete the form.