OBJECTIVE To explore the application effect of the "monitoring-intervention" chain reaction model, constructed based on the national "Standard for healthcare associated infection surveillance" (WS/T312-2023), in infection management of outpatient hemodialysis, providing practical evidence for healthcare institutions to implement the new standard.

METHODS A prospective and continuous investigation was conducted, involving 4 569 outpatient cases at the Hemodialysis Center of Nanjing Lishui People′s Hospital from Mar. 2024 to Feb. 2025. The control group (n=2 265) included cases from Mar. to Aug. 2024, while the intervention group (n=2 304) included cases from Sept. 2024 to Feb. 2025. Monitoring content covered vascular access types and the occurrence of outpatient hemodialysis-associated infection events. Interventions were implemented through an information-based interconnection and multi-department collaboration mechanism. The incidence rate of outpatient hemodialysis-associated infection events was compared between the two groups before and after the intervention.

RESULTS In the control group, 129 outpatient hemodialysis-associated infection events occurred, compared to 99 in the intervention group. The overall incidence rate of outpatient hemodialysis-associated infection events decreased from 5.70% to 4.30% after the intervention (χ²=4.712, P=0.030), with a relative risk reduction (RRR) of 24.53%. No statistically significant difference was observed in the overall antibacterial agent use rate between the intervention and control groups. However, the use structure of antibacterial agents shifted. Compared with the control group, the proportion of oral antibacterial agent use in the intervention group increased from 36.84% to 67.02% (χ²=18.771, P < 0.001), with an RRR of 81.92%, while the proportion of intravenous antibacterial agent use decreased from 55.26% to 26.60% (χ²=17.346, P < 0.001), with an RRR of 51.86%.

CONCLUSIONS The "monitoring-intervention" chain reaction model effectively reduces the incidence rate of outpatient hemodialysis-associated infection events, optimizes the use structure of antibacterial agents, and enhances infection management efficacy, providing a replicable practical pathway for the implementation of the new national standard.