Category: Patient Safety

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 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.

When Disaster Strikes: Help for Patients Who Rely on Durable Medical Equipment

When durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) are lost, destroyed, or damaged to the extent that they can’t be used anymore due to an emergency, Medicare

will pay for the replacement DMEPOS that a Medicare beneficiary owns or purchased. Examples of DMEPOS include: home oxygen equipment, diabetes testing supplies, wheelchairs, canes, walkers, artificial limbs, braces, and enteral nutrients and supplies. The link below can help you guide medically vulnerable patients should an emergency cause them to lose use of DMEPOS.

https://www.cms.gov/About-CMS/Agency-Information/Emergency/Downloads/Emergency-DME-Beneficiaries-Hurricanes.pdf

Education: A Critical Factor in Understanding De-escalation Techniques

Health care workers have an increased risk of workplace violence compared with workers in private industry, with nurses as the most common victims, and patients as the most common perpetrators, according to an article “Aggression Management Education for Acute Care Nurses: What’s the Evidence?” Risk factors include influences such as ongoing aggressive behaviors, psychiatric disorders, substance abuse, stress/frustration/anxiety, a sense of powerlessness, perceptions that violence is tolerated, inadequate security, long wait times, and lack of awareness. The article offers great tips on how education about aggression management was successful in building confidence in areas such as situational awareness, de-escalation practices and early intervention.
Click here to learn more about de-escalation techniques as presented by Margo Halm, RN, PhD, NEA-BC in the article “Aggression Management Education for Acute Care Nurses: What’s the Evidence?” and contact your Network whenever you need further guidance on managing a difficult patient situation.

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

Shortcut to Resources for National Healthcare Safety Network (NHSN)

Have you been to the National Healthcare Safety Network (NHSN) section of the Network web site? You’ll find a shortcut to your most frequently needed NHSN resources that include:

  • Required Training
  • Enrollment Steps
  • NHSH Event Protocol
  • NHSN Dialysis Event Surveillance Data
  • CMS ESRD QIP Rule Report
  • Health Care Personnel Safety Components
  • NHSN Contact Information

New Priorities and Goals Planned for ESRD Stakeholders

The Department of Health and Human Services (HHS) National Quality Strategy (NQS) is a national effort to align public- and private-sector stakeholders to achieve better health and healthcare for all Americans. It was developed “through a transparent and collaborative process with input from a range of stakeholders. More than 300 groups, organizations, and individuals, representing all sectors of the health care industry and the general public, provided comments.”

The Centers for Medicare & Medicaid Services (CMS) contracts with End Stage Renal Disease (ESRD) Networks to implement the NQS principles and HHS Secretary’s priorities in the ESRD community. Starting in December 2017, Networks will launch a set of new quality improvement activities, data reporting requirements, and educational programs that reflect updated priorities and goals.

HHS Secretary’s Priorities

  1. Reform, Strengthen, and Modernize the Nation’s Health Care System
  2. Protect the Health of Americans Where They Live, Learn, Work, and Play
  3. Strengthen the Economic and Social Well-Being of Americans Across the Lifespan
  4. Foster Sound, Sustained Advances in the Sciences
  5. Promote Effective and Efficient Management and Stewardship

CMS Goals

  1. Empower patients to make decisions about their health care
  2. Usher in a new era of state flexibility and local leadership
  3. Support innovative approaches to improve quality, accessibility, and affordability
  4. Improve the CMS customer experience

Addressing Patient Placement Challenges: 30 Day Trial Period

In 2016, the IPRO ESRD Network of New York introduced an innovative program to help facilities accept patients who had been previously involuntarily discharged from their dialysis facility.  As reported in the April 6, 2016 issue of Nephrology News and Issues, through the program prospective dialysis units are offered a 30-day trial period during which they may accept a patient for treatment as if he or she is a “transient” patient. The unit accepts the patient with the understanding that there is no commitment to continue treatment after 30 days; should the patient cause excessive disruption to the unit or exhibit threatening or violent outbursts. Participating units agree that if the patient refrains from these behaviors, the unit will accept the patient as permanent after the 30th day or the 12th treatment. In 2017 the program continues to help patients who have been involuntarily discharged from their dialysis facility, with five patients being accepted permanently in a new dialysis facility, to date.  This program helps those patients who have been involuntarily discharged from their unit receive a second chance.  Through this second chance, the patient and facility get to know one another and the patient has an opportunity to gain a sense of stability and reliable access  to the treatments needed to stay healthy and to survive.

Click here, to read the complete article, An innovative approach in addressing dialysis patient placement challenges.