You’ll probably notice it within your first few visits: dialysis staff washing their hands or using sanitizer constantly, before and after almost everything. That’s not excessive caution — it’s one of the most effective tools dialysis units have for preventing a serious complication.
Quick answer
Dialysis patients face a higher risk of bloodstream infection because treatment repeatedly accesses the bloodstream, several times a week, for years. The CDC treats hand hygiene as one of the core, proven interventions for preventing these infections — which is why you’ll see it so consistently from staff, and why it’s worth doing yourself around your own access, too.
Why this gets so much emphasis in dialysis specifically
Bloodstream infections are a serious and costly complication of dialysis — a 2013 CDC report estimated roughly 37,000 bloodstream infections were occurring each year among dialysis patients with central line catheters alone, each one a genuinely dangerous event, not a minor inconvenience. In response, the CDC built a set of “Core Interventions” specifically for dialysis facilities, developed with the Making Dialysis Safer for Patients Coalition. Hand hygiene sits at the center of that list, alongside things like catheter care technique and staff training.
One study following the rollout of these interventions found that consistent use of the practice bundle — including hand hygiene audits — was associated with cutting bloodstream infections roughly in half at participating facilities.
What you’ll see staff do
Infection-control research describes specific moments where hand hygiene matters most in a clinical setting: before touching a patient, before any sterile or aseptic procedure, after any exposure to blood or body fluids, after touching a patient, and after touching anything in the patient’s immediate surroundings. In a dialysis unit, that adds up to hand hygiene happening dozens of times a day around each patient — which is exactly why it can feel constant.
What you can do
DO
Wash your hands before touching your access.
Use soap and water, or hand sanitizer if soap isn’t available, before you touch your fistula, graft, or catheter site — at the dialysis unit and especially at home. Ask visitors and family members to do the same before they’re near your access area.
- Keep your access site clean between treatments, following the specific instructions your care team gave you for your access type.
- If you notice a caregiver, family member, or even staff member skip a hand hygiene step around your access, it’s reasonable to ask — patient engagement is actually one of the CDC’s own recommended prevention strategies, not an overstep.
- Don’t scratch, pick at, or touch needle sites or a catheter dressing with unwashed hands.
It’s okay to ask about it
CDC materials specifically encourage patients to speak up about infection-prevention practices, including hand hygiene, as part of protecting themselves. Asking a staff member “have you washed your hands?” before they touch your access isn’t rude in a dialysis unit — it’s a recognized part of how these programs are designed to work.
Frequently Asked Questions
Is hand sanitizer as good as washing with soap and water?
Alcohol-based hand sanitizer is effective for most everyday situations and is standard practice in dialysis units. Soap and water is preferred when hands are visibly soiled. Either is far better than skipping the step.
Can I really ask staff if they’ve washed their hands?
Yes. Patient engagement in infection prevention is part of the CDC’s own recommended approach, not an unusual request.
What about hand hygiene for my access at home?
Wash your hands before touching a fistula or graft site, and before any catheter dressing care your team has trained you to do. If you have specific home-care instructions from your facility, those take priority over general guidance here.
Related Renal Care Planner Resources
- What Is Infiltration During Dialysis? Signs to Know and What to Do
- How to Protect Your Fistula or Graft: Everyday Do’s and Don’ts
- Can You Shower With a Dialysis Catheter? What Patients Need to Know
Sources
General education only. Renal Care Planner provides general educational information and planning resources. Follow your dialysis facility’s specific infection-prevention and access-care instructions, which take priority over general guidance here.