Vascular access is a potentially fatal vulnerability for hemodialysis patients, and a notable area for improvement for healthcare providers. Hemodialysis central venous catheters (HD-CVC) are associated with increased morbidity and mortality from infectious complications. Clinical practice guidelines on vascular access for hemodialysis and infection control do not provide a standard definition for infection of the HD-CVC exit site. The main aim of this protocol is to establish consensus on the signs and symptoms for preventing CVC exit site infection for patients receiving hemodialysis, based on the opinion of a panel of experts. The secondary study aim is to determine the optimum treatment approach according to the signs and symptoms of infection at the HD-CVC exit site, as prioritized by the panel of experts. For this purpose, a modified ranking-type Delphi technique will be used, with three rounds of evaluation conducted via an online questionnaire: the first two rounds will be used to prioritize, by consensus, the most relevant signs and/or symptoms of infection of the HD-CVC exit site or tunnel. Once this consensus has been achieved, a third round of evaluation will be conducted, asking the participants to ascertain the most appropriate treatment approach. The research team has drawn up a list of signs and symptoms related to infection of the HD-CVC exit site or tunnel, based on the definitions obtained from a previous systematic review. The results of the present study will enable us to design an assessment scale for HD-CVC exit sites, thus facilitating early identification and action if infection occurs. The availability of such an instrument will benefit not only clinical practice, but also research, healthcare education and training programs for professionals in this area.

血管通路对于血液透析患者来说是潜在的致命脆弱性，对于医疗保健提供者来说是值得改善的显着领域。血液透析中心静脉导管（HD-CVC）与感染并发症的发病率和死亡率增加相关。关于血液透析和感染控制的血管通路的临床实践指南未提供HD-CVC出口部位感染的标准定义。该协议的主要目的是根据专家小组的意见，就预防血液透析患者的CVC出口部位感染的体征和症状达成共识。二级研究的目的是根据专家小组的优先考虑，根据HD-CVC出口部位的感染体征和症状确定最佳治疗方法。以此目的，将使用改良的分级型Delphi技术，并通过在线问卷进行三轮评估：前两轮将以共识的方式对HD-CVC感染的最相关体征和/或症状进行优先排序出口站点或隧道。一旦达成共识，将进行第三轮评估，要求参与者确定最合适的治疗方法。研究小组根据先前的系统评价得出的定义，草拟了与HD-CVC出口部位或隧道感染有关的体征和症状清单。本研究的结果将使我们能够设计出HD-CVC出口部位的评估量表，从而有助于在感染发生时及早识别和采取行动。