The FDA has warned that certain Medtronic MiniMed Insulin Pump models are not protected from hackers, who could alter the insulin settings. Medtronic is replacing the inadequately protected pumps. For recommendations on protecting yourself while awaiting a replacement, a list of models and software versions involved, and more information, see https://www.fda.gov/medical-devices/safety-communications/certain-medtronic-minimed-insulin-pumps-have-potential-cybersecurity-risks-fda-safety-communication.
A recent study published in the American Diabetes Association’s (ADA) journal Diabetes Care (http://care.diabetesjournals.org/content/early/2019/05/28/dc19-0296) using 2000-2015 USRDS data has shown that the rates of nontraumatic lower-extremity amputation (NLEA) among adults with ESRD and diabetes fell 44% between 2000 and 2013 from 7.5 to 4.2 NLEA per 100 person-years, while NLEA among ESRD patients without diabetes declined 31% over the same period, from 1.6 to 1.1 per 100 person-years. Both reductions were highly statistically significant. However, both rates flat-lined after 2013.
We want to stress the importance of improving patient and staff education on diabetes self-management and preventive foot care, in order to resume the reductions in these rates. CDC’s recommendations on diabetic foot care can be found at https://www.cdc.gov/features/diabetesfoothealth/index.html. The ADA’s input is at http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html in English and http://www.diabetes.org/es/vivir-con-diabetes/complicaciones/el-cuidado-de-los-pies.html in Spanish.
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.
- In mid-June 2019 a series of presentations on Infection Control, offering free CME/CE credits to physicians, nurses, and pharmacists, will expire. CDC and Medscape produced them in 2017 with the intention that they’d be valid for two years. The six presentations include Risk Recognition, Environmental Services, Medical Equipment, Nonsterile Gloves, Hierarchy of Controls, and Injection Safety. Find them at https://www.cdc.gov/infectioncontrol/training/cme-info.html.
- The Joint Commission Speak Up series includes a poster and short video in English and Spanish on Infection Prevention. Find these tools and many more at https://www.jointcommission.org/topics/speak_up_infection_control.aspx. The Speak Up series also includes resources on Five Ways to Be Active in Your Care at the Hospital for dialysis and diabetes patients, on Avoiding a Return Trip to the Hospital, on Depression, on Organ Donation, on Pain, and many other topics. Find them all at https://www.dropbox.com/sh/3e5uml0tk6myy4s/AAB0a91UJK8p8-VkokWD0q2Ga?dl=0.
- The Oregon Patient Safety Commission suggests giving your facility a Patient Safety Culture Survey, such as those provided by the HHS Agency for Healthcare Research and Quality (AHRQ). While they don’t have a Survey specifically for dialysis facilities, most of the questions on any of their surveys are directly applicable or can easily be adapted. For details see https://oregonpatientsafety.org/news-information/patient-safety-alerts/add-patient-safety-culture-surveys-to-your-prevention-toolbox/945/.
- AHRQ will present a June 12, 2019 webinar on Best Practices for Web-Based Surveys on Patient Safety Culture; register at https://westat.webex.com/mw3300/mywebex/default.do?nomenu=true&siteurl=westat&service=6&rnd=0.14765443759873476&main_url=https%3A%2F%2Fwestat.webex.com%2Fec3300%2Feventcenter%2Fevent%2FeventAction.do%3FtheAction%3Ddetail%26%26%26EMK%3D4832534b00000004055fc9090fc824db69d4fc807faaa82be8a7e2f6b039075465c816eb25f825d0%26siteurl%3Dwestat%26confViewID%3D123809633363065597%26encryptTicket%3DSDJTSwAAAARxY3pJMqWtIxlWNZjpy6DEzK3qsti–1Bsvb7DlIp51Q2%26#utm_source=SOPSanc&utm_medium=Email&utm_campaign=20190422.
- The CDC Safe Healthcare Blog makes a good frequent reminder about the ever-present danger of infection, and how to respond to it effectively. It’s post for this week is titled Clean Hands Count to Keep Patients Safe from Healthcare Associated Infections. Find the post and the Blog at https://blogs.cdc.gov/safehealthcare/clean-hands-count-to-keep-patients-safe-from-healthcare-associated-infections/.
CMS and NKF will present a May 22, 2019 webinar on on Population Health Strategies for Kidney Disease Risk Reduction, at noon PST. Nephrologists, dialysis facility medical directors and renal care providers are invited and encouraged to attend. The NKF CKD Change Package will be introduced, systematic strategies for improving identification and management of CKD will be described, and a population health strategy for registry function, QI, and patient engagement for people living with CKD will be presented. Register for the webinar at https://meetings-cms.webex.com/meetings-cms/onstage/g.php?MTID=e06e8b0a5642756b1b7a7e0998d0eeeb8. Find the NKF CKD Change Package at https://www.kidney.org/sites/default/files/02-11-8036_JBI_CKD_ChangePackV17.pdf.
The National Kidney Foundation 2019 Spring Clinical Meetings (SCM19) present a unique opportunity for renal health care providers to learn new developments related to all aspects of nephrology. An important objective of SCM19 is to present the latest insights into CKD care through a combination of interesting courses, practical workshops, thought-provoking symposia and insightful debates. SCM19 will be held May 8-12, 2019 in Boston MA. In-person registration is allowed, but many registration fees are discounted if you register online before May 6.
Extra-cost pre-conference course topics on May 8 include dialysis success, vascular access, ultrasound, supportive care, and updates on new developments in transplant, critical care, and glomerular disease. Topics for extra-cost lunch workshops during the conference will include vascular access, electrolytes, hyponatremia, glomerular disease, reproductive health, hypertension, communication, and board review. For those unable to attend in person, live-streamed conference sessions will be available on burnout, obesity, safety, fluid management, opioids, social media, diabetes, community, lifestyle interventions, palliative care, and KDOQI update.
For more information and registration, see https://www.kidney.org/spring-clinical.
The UCLA Health CORE Kidney program will present a February 21, 2019 webinar on Living Kidney Donation. For details and pre-registration, see https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/UKEEP/ucla022119.pdf.
UKEEP will host a February 24, 2019 workshop on Kidney Disease: What You Should Know in Santa Monica CA. See https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/UKEEP/UKEEP022419.pdf for details and RSVP information.
The CORE Kidney program will also present:
- March 2, 2019 Diabetes Patient Conference; see https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/UKEEP/UCLA.dm030219.pdf for details and pre-registration information
- March 10, 2019 UKEEP PKD Update
- March 21, 2019 webinar on PD
- April 11, 2019 webinar on Fabry’s Disease
- May 2 webinar on the Kidney Health Fair
- May 5, 2019 Kidney Heath Fair at the Beach and Spirit Walk; for more information see https://www.uclahealth.org/core-kidney/kidney-health-fair.
Find more information, and recordings of earlier CORE Kidney and UKEEP programs, at https://www.uclahealth.org/core-kidney/, along with information about the UCLA PKD program and other related educational outreach.