Information on infections identified in the hospital setting and reported in the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN), is not easily obtained by dialysis providers. Access to these data can improve surveillance of bloodstream infections and patient outcomes. Enrollment in the Health Information Exchange (HIE) can overcome this barrier. A recent article published in Nephrology News & Issues, ” Closing the information gap: Health information exchange in dialysis“, gives an overview of the benefits of HIE and how it provides a vehicle for improving the quality and safety of patient care.
For more information on HIE, go to https://www.healthit.gov/providers-professionals/health-information-exchange/ .
For information on HIE in your state, go to https://www.healthit.gov/policy-researchers-implementers/state-health-information-exchange-cooperative-agreement-program-key
The Centers for Disease Control and Prevention reports infection is the second most common cause of death and hospitalization among dialysis patients. Hemodialysis patients have multiple and frequent exposure to healthcare environments undergoing treatment three times per week with direct access to their bloodstream via venipuncture and catheters. Healthcare expenditures for these infections are staggering. Research has shown that the Implementation of the CDC core interventions reduces infections dramatically, saving lives and reducing healthcare costs. Take a minute to review these interventions, by clicking here, to assure your facility is doing everything possible to be safe and save lives.
Beginning January 1, 2018, dialysis facilities should include acute kidney injury (AKI) patients in National Healthcare Safety Network (NHSN) Dialysis Event Surveillance. Reporting AKI patient data to a new, separate NHSN location will enable CDC to exclude AKI patient data from NHSN Bloodstream Infection (BSI) information shared with CMS for purposes of the ESRD Quality Incentive Program (QIP).
The “Acute Kidney Injury (AKI) Location” should be used to report Dialysis Events, and denominator data for patients who have acute kidney injury and do not have an end-stage renal disease (ESRD) diagnosis at the time of the Event, or at time of denominator data collection.
The “Acute Kidney Injury Location” was released as part of the NHSN version 8.8 update on December 2, 2017. Please click here for instructions on using the “Acute Kidney Injury Location”.
Of those included in the NHSN Dialysis Event Surveillance population, the following criteria should be used to identify patients who have acute kidney injury:
1. No diagnosis of “End Stage Renal Disease” or “ESRD” in the patient medical record, or through the ESRD Medical Evidence Form (Form CMS-2728-U3).
2. Physician-diagnosis of “Acute Kidney Injury: or “AKI” listed in the patient medical record (e.g., nephrologist consult or referral form).
3. The event date, or date of denominator data collection, is not more than 6 months after the date the patient initiated outpatient hemodialysis.
For questions, please contact the NHSN helpdesk: email@example.com with “dialysis” in the subject line.
After the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) system release on December 2, 2017, analysis reports and select alerts were not accessible to some NHSN Dialysis Component group and facility users. This issue has since been resolved, and users are now able to access their reports and receive alerts.
As a result of this issue, outpatient dialysis facilities and groups were unable to review NHSN data for completion and accuracy from December 2, 2017 through December 21, 2017. To provide facilities with ample time to review their NHSN data and make any corrections, CMS has extended the ESRD QIP deadline for facilities to enter third-quarter 2017 NHSN data to January 31, 2018.
For more information on the ESRD QIP, please visit https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/index.html. For more information about NHSN, please visit https://www.cdc.gov/nhsn/dialysis/.
Thank you for your attention in this matter and for entering your facility’s data promptly. If you have any additional questions or concerns, please contact the NHSN helpdesk at mailto:NHSN@cdc.gov or CMS ESRD QIP team at firstname.lastname@example.org.
The Making Dialysis Safer for Patients Coalition is a partnership of organizations and individuals that have joined forces with the common goal of promoting the use of the Centers for Disease Control and Prevention’s (CDC) core interventions and resources to prevent dialysis bloodstream infections. CDC’s core interventions have been proven to reduce the number of infections by half and be sustainable. The CDC has also developed a set of audit tools, checklists, and other resources to help facilitate adoption of these critical core interventions.
The IPRO ESRD Network Program is pleased to announce that we have now joined the CDC Making Dialysis Safer for Patients Coalition.
To learn more about the Coalition and how to become a partner or member please visit: https://www.cdc.gov/dialysis/coalition/index.html.
According to the Centers for Disease Control and Prevention (CDC), more than 30 million children and adults in the United States are living with diabetes. At least 1 out of 3 people will develop diabetes in their lifetime. The American Diabetes Association has selected the month of November to raise awareness of the disease and its serious complications. The following resources can be helpful for dialysis staff and patients to discuss the importance of diabetes prevention and control:
It is that time of year again! Flu season is right around the corner. According to the Centers for Disease Control and Prevention (CDC), the influenza virus can be active year round, but it is most active in the late fall and winter months. Every flu season is different, but in the United States it can begin as early as October and last as late as May. It is recommended that individuals receive their flu vaccination before the end of September. Reminder: Staff members, as well as patients, should be vaccinated against the flu.
There are many myths that surround the flu vaccine. Please review the CDC links below for resources regarding the influenza.
CDC has launched Get Ahead of Sepsis, a national effort to encourage healthcare professionals, patients, and care partners to prevent infections that could lead to sepsis, be alert to the signs of sepsis, and act quickly if sepsis is suspected. Sepsis is the body’s extreme response to an infection. It is life-threatening, and without timely treatment sepsis can rapidly lead to tissue damage, organ failure, and death.
As part of its campaign, the CDC has made available educational materials for patients, care partners and healthcare professionals. CDC encourages you to share these resources and opportunities broadly with your colleagues and partners. Thank you for your help spreading the word that sepsis early recognition and timely treatment saves lives.
Candida auris is a type of yeast infection that can enter the bloodstream and spread rapidly through the body, causing serious invasive infections. Healthcare facilities in several countries have reported a rapid increase in this type of infection. C. auris has been documented to cause infections in patients of all ages, and according to the Centers for Disease Control and Prevention (CDC), individuals with central venous catheters are among those at greater risk than the generation population for becoming infected with C.auris.
Yeast infections do not often respond well to commonly use antifungal drugs making C. auris very difficult to treat. According to the CDC, “C. auris can spread in healthcare settings through contact with contaminated environmental services or equipment, or from person to person. More work is needed to further understand how it spreads.” Good infection control practices and environmental cleaning may help prevent transmission.
REMINDER: NHSN Data Reporting Deadline for Quality Incentive Program (QIP) is Quickly Approaching
September 30, 2017 is the deadline for National Healthcare Safety Network (NHSN) second quarter 2017 Dialysis Event reporting.
Tips for Accurate Reporting of NHSN Data:
If you have any questions, contact the NHSN helpdesk (email@example.com) and include ‘Dialysis’ in the subject line.
Click here to open the June 2017 NHSN Newsletter, which provides helpful resources for data reporting.
The CDC recently hosted webinars that provided a complete introduction to the National Healthcare Safety Network (NHSN) Dialysis Event reporting requirements and the surveillance definitions necessary to complete accurate monthly reporting. NHSN Dialysis Event Surveillance reporting is required for the CMS ESRD Quality Incentive Program (QIP).
If you missed the live webinar, continuing education (CE) credits are available for the recorded presentation, which can be found at https://www.cdc.gov/nhsn/Training/continuing-edu.html.
One of the Network’s priorities is to support facility staff in ensuring that patients receive appropriate vaccinations.
The Centers for Disease Control and Prevention (CDC) provides vaccination recommendations for ESRD patients in the CDC’s Morbidity and Mortality Weekly Report(MMWR); two of the recommended vaccines (pneumococcal pneumonia and hepatitis B) are a focus of one of the Network’s quality improvement activities.
According to the CDC, approximately 18,000 patients die each year from pneumococcal disease, and treatment with antibiotics is becoming less effective, due to drug resistant bacteria. Hepatitis B is a serious disease that affects the liver, with 2,000 to 4,000 patients dying from cirrhosis or liver cancer each year. Vaccines offer a safe and effective way for individuals to protect themselves from serious illness. Please use the information in the resources below as talking points for conversations with your patients and your staff members regarding the importance and the benefits of vaccinations.
Vaccinations and antibodies are tracked in CROWNWeb, and facility vaccination rates are reported to the Centers of Medicare & Medicaid Services (CMS).
For additional information/resources on National Immunization Awareness Month (NIAM):
For CDC Vaccine Information Statements (VIS):