Table 1 Implementation status of infection prevention measures at each dialysis facility, before and after the COVID-19 pandemic occurred

1

Medical instruments for hemodialysis are sterilized or disposable for each patient.

2131 (95.7)

2096 (94.1)

< 0.001

2

Staffs can perform hand hygiene before/after hemodialysis operations, using equipment/supplies in appropriate locations.

2161 (97.0)

2167 (97.3)

0.527

3

Disinfection, maintenance, and inspection of hemodialysis machines are managed according to the instruction manual.

2195 (98.6)

2176 (97.7)

0.003

4

An infection control committee, chaired by the facility manager or the person in charge of nosocomial infection control, has been established and is held regularly with staff from various fields.

1974 (88.6)

1998 (89.7)

0.010

5

Staffs with symptoms of infection such as fever and diarrhea are examined by a doctor whether they can work or not before entering the dialysis room.

1559 (70.0)

2092 (93.9)

< 0.001

6

Priming of the hemodialysis circuit is done just before the treatment with sterile technique in accordance with the package insert.

2091 (93.9)

2090 (93.8)

0.898

7

Initiating and terminating operation are performed with two staffs in a way which does not contaminate with blood.

1306 (58.6)

1313 (59.0)

0.327

8

Staffs always perform careful hand hygiene before and after invasive procedures and wear unused disposable gloves.

2152 (96.6)

2162 (97.1)

0.218

9

Staffs who perform initiating and terminating operation are wearing masks.

1937 (87.0)

2186 (98.2)

< 0.001

10

Staffs who perform initiating and terminating operation are wearing disposable, non-permeable gowns or plastic aprons.

1291 (58.0)

1472 (66.1)

< 0.001

11

Staffs who perform initiating and terminating operation are wearing goggles or face shields.

1145 (51.4)

1648 (74.0)

< 0.001

12

Items contaminated with blood are disposed of as infectious waste or cleaned and sterilized according to the manual.

2195 (98.6)

2177 (97.8)

0.045

13

Heparin and erythropoiesis-stimulating agents are pre-filled syringe products, and other injectable drugs are prepared aseptically in a separate area.

1615 (72.5)

1609 (72.2)

0.343

14

Patients are checked for their temperature and symptoms to confirm that they do not have a suspected infection, before entering the dialysis room.

1199 (53.8)

2095 (94.1)

< 0.001

15

Patients with suspected infection are observed before entering the room, and infection measures are modified according to their conditions.

1601 (71.9)

2141 (96.1)

< 0.001

16

Linens are changed for each patient.

653 (29.3)

765 (34.4)

< 0.001

17

Items that are frequently touched by patient’s and staff’s hands (e.g., doorknobs) are wiped or disinfected several times a day.

1165 (52.3)

2007 (90.1)

< 0.001