Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
for Haemodialysis Facilities) were consulted in order to establish
international best practice standards.
This provided a broad interdisciplinary knowledge base and
expanded the author’s knowledge on the topic on which to build the
review.
Abstracts were then reviewed, and those articles appearing to be of
further interest were read in full. A review of blood borne virus
epidemiology and transmission was first undertaken.
This led to an in-depth exploration of research into transmissions in
haemodialysis environments, possible causes, and the standards of
prevention mechanisms applied in this environment.
Analysis:
Research examining the causes of transmission, infection control
practice and variables surrounding such transmissions were
reviewed in detail. Seminal papers examining large cohorts of
patients were included e.g.(Jadoul et al 1998, Petrosillo et al 2000,
Schneeberger et al 2000, Hinrichsen et al 2002, Fissell et al 2004).
This allowed for the emergence of recurrent variables of statistical
association or significance.
A number of smaller studies of specific outbreaks were also
examined e.g.( Cristina et al 1997, Mclaughlin et al 1997, Norder et
al 1998, Furusyo et al 2004, Savey et al 2005). These papers
demonstrated possible failures of practice or policy which resulted in
HCV transmission, and highlighted the potential for nosocomial
transmission of BBV’s in this environment.
Summary of Key Findings:
The development of phylogenetics (the analysis of RNA structures of
viruses) has allowed researchers to identify the particular viral
genotypes of each infected patient and compare it with others in an
outbreak.
This information allows the identification of:
� the source of the infection
� the most likely mode of transmission
� the sequence of multiple infections.
It emerged from such analysis that the adherence to CDC guidelines
to prevent the transmission of Hepatitis B, appear to be effective
when implemented (CDC 1996, CDC 2001). The introduction of
those guidelines resulted in an 80% reduction in transmissions, and
the results of CDC investigations into more recent outbreaks have
shown failures in the implementation of the guidelines as the causes
of transmission of the virus(CDC 1996,CDC 2001).
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