Category: Infection Control

Mac Toolkits; Transplant, Transitions, Medications

The National Forum of ESRD Networks has introduced or updated several Medical Advisory Council (MAC) Toolkits. Two new Kits include the Transplant Toolkit and the Medication Conversion Toolkit. The Transitions of Care Toolkit was updated in mid-April. Find them all at http://esrdnetworks.org/resources/toolkits/mac-toolkits-1, along with the existing Home Dialysis Toolkit, Medical Directors Toolkit, QAPI Toolkit, Medication Reconciliation Toolkit, Catheter Reduction Toolkit, Vaccination Toolkit, and Assurance of Diabetes Care Coordination Toolkit.

Making Dialysis Safer for Patients: Optimal Vascular Access

Register now for a free one-hour webinar with continuing education

This World Kidney Day, CDC and the Making Dialysis Safer for Patients Coalition invite you to a webinar presenting the infection risks associated with different vascular access types. Discussion will include strategies and recommendations for successful catheter reduction to prevent bloodstream infections.

Webinar: Making Dialysis Safer for Patients: Optimal Vascular Access
Date: Thursday, March 14, 2019
Time: 2:00 – 3:00 PM EDT
Registration:  Click Here to Register (at no cost)

Join us this World Kidney Day for a presentation on “Incident Vascular Access and Risk of Bloodstream Infection Among New ESRD Patients Receiving Hemodialysis” followed by a conversation about achieving optimal vascular access for patient safety.

Featured Speakers:
Sophia Kazakova, MD, MPH, PhD; Division of Healthcare Quality Promotion, CDC.

Discussants:
• Vandana Dua Niyyar, MD, FASN, FNKF, FASDIN; Professor of Medicine, Division of Nephrology, Emory University.
• Tracy Jonelis, MD; Chief of Nephrology, Kaiser Permanente Northern California, San Francisco Medical Center

Moderators:
Priti Patel, MD, MPH and Ibironke Apata, MD; Division of Healthcare Quality Promotion, CDC.

Continuing Education: Accredited for physicians, nurses, pharmacists, certified health educators, public health professionals and other health professions.

Audio: Please note the audio for this webinar will come through your computer speakers. During the webinar, please ensure that your speakers are turned on and the volume is up. Thank you.

 

NHSN Training

Required Annual Training: The Dialysis Event Module annual training has been updated and moved to a new platform called CDC TRAIN. Self-paced training and post-assessment will remain the same as the previous version, but the CDC TRAIN platform requires you to register with the site, and allows you to save your training certificates after completion. NHSN recommends that all users take this training, but at least one user per facility is required to take and pass this training annually. Find the training course and instruction guide at https://www.cdc.gov/nhsn/dialysis/event/index.html. Email NHSN@cdc.gov with “Dialysis” in the subject line with any questions.

Training Needs Assessment: In taking the NHSN Dialysis Event Module Training Needs Assessment, some users experienced a system error which only permitted them to complete the Demographics section of the survey. If you experienced this, please retake the Assessment, at https://www.surveymonkey.com/r/DialysisEventTNA. NHSN apologizes for the inconvenience and truly values your input. If you have not taken the Assessment yet, please do, to help NHSN better understand training needs for the Dialysis Event Module. The Assessment will remain open until May 31, 2019.

CDC Webinar on BSI and Incident HD Access

CDC will present a March 14, 2019 World Kidney Day webinar on Incident Vascular Access and Risk of Bloodstream Infection Among New ESRD Patients Receiving Hemodialysis, followed by a conversation about achieving optimal vascular access for patient safety. CME, CNE, CEU, CECH, CPE, and CPH continuing education credits are available. Find more information and register at https://cc.readytalk.com/registration/#/meeting=f8wbng3dtcpm&campaign=vq0d1qix86ac.

QIP News: PSSRs, NHSN Deadline, Pain Assessment

PSSRs: CMS has announced that PY2019 Performance Score Summary Reports or PSSRs are now available. The PSSR is a spreadsheet containing the performance values of each facility for PY2019. It provides information about facility performance on each ESRD QIP measure as well as the Total Performance Score. Find the PSSRs at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/Downloads/PY2019-Performance-Score-Summary-Report-.XLSX. It’s a 12+ megabyte file, so it may take several minutes to download and open.

NHSN: CMS has also announced an extension to the NHSN data entry deadline for the ESRD QIP fourth reporting quarter of 2018 (data for October 1 – December 31, 2018) from March 31, 2019 to April 1, 2019.

Assistance regarding PSSRs or the NHSN deadline can be obtained by contacting the ESRD QIP Support Team using the ESRD QIP Q&A Tool at https://cms-ocsq.custhelp.com/app/homeesrdqip/p/960. For questions or concerns regarding use of the ESRD QIP system, contact the QualityNet Help Desk at qnetsupport-esrd@hcqis.org or 866-288-8912 between 5am and 7pm PT Monday-Friday.

Pain Assessment data submission into CROWNWeb will no longer be required by CMS starting March 1, 2019. The Pain Assessment screen will remain active for facilities to review previously reported data. For details see http://mycrownweb.org/2019/02/pain-assessment-submission/.

NHSN Trainings

NHSN will present four training sessions in March, all at 3-4pm EST. Join any of the four by telephone only at 303.248.0285, Access Code 6393927. To join via computer (including audio):

  • Introduction to the NHSN Dialysis Event Surveillance Protocol: NHSN Dialysis Event Surveillance reporting is required for the CMS ESRD QIP. Complete introduction to the NHSN Dialysis Event reporting requirements and surveillance definitions necessary to complete accurate monthly reporting. Both sessions will be held 3-4pm EST.
    o  March 5, 2019 – pre-register and attend at https://cc.readytalk.com/r/nv7i0guhmafn&eom.
    o  Repeated March 6, 2019 – pre-register and attend at https://cc.readytalk.com/r/is7rdbd8gnym&eom.
  •  Advanced NHSN Dialysis Event Surveillance Reporting and Introduction to NHSN Reports: Applying NHSN Dialysis Event Surveillance definitions via case studies that address common reporting questions. Includes introduction to running and interpreting popular NHSN reports to review your facility’s data, including BSI rates. Both sessions will be held 3-4pm EST.
    o  March 12, 2019 – pre-register and attend at https://cc.readytalk.com/r/avggcki49p0g&eom.
    o  Repeated March 13, 2019 – pre-register and attend at https://cc.readytalk.com/r/yzbfurn4zfm2&eom.

January 2019 Learning and Action Network (LAN) Webinars

The ESRD National Coordinating Council will host four January webinars to introduce 2019 QIA projects, all to be held 3-4 PM EST.  Find more information and register at the links provided:

National QIA Webinars

The ESRD National Coordinating Council will host four January webinars to introduce 2019 QIA projects, all to be held at noon PST. Find more information and register at the links provided:

NHSN Data Deadline for PY2020 QIP

NHSN has advised that NHSN data for July 1-September 30, 2018 must be submitted and corrected by December 31, 2018 in order to be applied to PY2020 QIP scores. NHSN recommends:

Contact the NHSN Helpdesk at nhsn@cdc.gov with subject line “Dialysis” if you have any questions.

The NHSN software was updated to Version 9.2 on December 8, 2018, with many additions and changes, including analysis updates. Please carefully review pages 1 and 7-8 of the Version 9.2 release notes at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/NHSN9.2.pdf for important details about these changes. To use any of the new analysis output options you must first Regenerate Datasets. Send any questions to the NHSN Helpdesk at NHSN@cdc.gov.

Using the National Health and Safety Network (NHSN) as a Resource in your Infection Control Efforts.

Bloodstream infections (BSIs) are the second leading cause of death in dialysis patients according to the Centers for Disease Control and Prevention (CDC). Healthcare practitioners can prevent many of these infections by following basic infection guidelines (CDC Core Interventions) and tracking the results. The CDC’s National Healthcare Safety Network (NHSN), the nation’s most widely used healthcare-associated infection tracking system, provides facilities, states, regions, and the nation with data needed to identify problem areas, measure progress of prevention efforts, and ultimately eliminate healthcare-associated infections. Visit the NHSN website for information on training, protocols, forms, support materials, resources and FAQs related to surveillance of BSI events, prevention measures, and vaccination information for facility staff members and patients.

Learn the Signs of Sepsis

According to the CDC, more than 1.5 million people in the United States get sepsis every year. More than 250, 000 Americans die of sepsis each year.  Sepsis is the body’s most extreme reaction to an infection. It is life-threatening, and should be considered a medical emergency. if it not treated in a timely manner and with the appropriate therapies it will lead to organ failure, tissue damage and possibly death.

Anyone can get an infection, and almost any infection can lead to sepsis. Some people are at higher risk of infection and sepsis, including:

  • Adults 65 or older
  • Immunosuppressed populations:
  • People who have chronic conditions
  • Children under one year

Taking the time to learn the symptoms of sepsis can save a life.

There is no single sign or symptom of sepsis. Early signs of sepsis involve a combination of symptoms that can include infection (suspected or confirmed) and* :

  • Confusion or disorientation (the patient that “just isn’t right”)
  • Shortness of breath
  • Rapid heart rate
  • Fever with or without uncontrollable chilling, “can’t get warm”
  • Extreme pain or discomfort
  • Clammy and sweating skin.
  • Patient will often voice that “something is wrong:”

*People with sepsis typically have more than one of these symptoms.

Any individual with this combination of symptoms requires an immediate assessment at an emergency department for evaluation and appropriate treatment. The required treatment cannot be provided in an outpatient ambulatory clinic.

For more resources for staff and patient education please visit the CDC website. https://www.cdc.gov.sepsis

Implementation of the CDC CORE Interventions Saves Lives

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.