Nat’l EMS Week – Sepsis Awareness

The week of May 19-25, 2019 is National Emergency Medical Services Week, and CDC is celebrating it with a focus on recognizing and responding quickly to sepsis.  Find CDC’s new sepsis tools at https://www.cdc.gov/sepsis/education/hcp-resources.html?s_cid=NCEZID-Sepsis-089.

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.

6/25 CMS Seeks Comment on Rural Hospital Payment Changes

CMS has proposed that they improve their payments to rural hospitals, in an effort to improve rural health in the US.  While this isn’t directly relevant to ESRD, it will certainly be relevant whenever a kidney patient needs services at a hospital in a rural area.  Find the Proposed Rule and Request for Comment at https://www.govinfo.gov/content/pkg/FR-2018-05-07/pdf/2018-08705.pdf, and a Notice of Corrections at https://www.govinfo.gov/content/pkg/FR-2018-06-20/pdf/2018-13152.pdf.  Comments are due by June 25, 2019.  For background information see https://www.cms.gov/blog/putting-our-rethinking-rural-health-strategy-action and https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2019-IPPS-Proposed-Rule-Home-Page-Items/FY2019-IPPS-Proposed-Rule-Regulations.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=ascending.

5/14 CW New User Training, Newsletter

The May 2019 CROWNWeb Newsletter is now available, at http://mycrownweb.org/2019/05/may-2019-newsletter/.  CROWNWeb will also offer a May 14, 2019 New User Training, at http://mycrownweb.org/pcw_lems/may-2019-new-user-training/.

6/12+ Infection Control Tools

• 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/.

MEI Primer on ESRD, SSI, SSDI, and Medicare

The Medical Education Institute has written a blog post on Social Security Policies Related to Medicare: A Primer.  It’s really complicated, so it may be more appropriate for a Social Worker than a patient, but if the Primer is this complex, the Reality must be especially daunting – which makes a Primer all the more valuable.  Find the Primer at https://homedialysis.org/news-and-research/blog/307-social-security-policies-related-to-medicare-a-primer.

NHSN Updates

NHSN was updated to Version 9.3 on April 27, 2019.  There have been many additions and changes with this release, including the following updates to the Dialysis Component:

• CDA Dialysis Monthly Summary – the CDA for version R3D3 of the Dialysis Monthly Summary was updated to allow “Report No Events”.  The functionality is available for both manual CDA import and Direct CDA submissions.

• Analysis and Reporting:
  • Updated dialysis aggregate data from 2016-2017 for rate tables and run charts.
  • Created a new TAP report type and changed report icon for Excess Infections.  A new Excess Infections report type allows for modifications to the TAP report without disturbing functionality used by other NHSN components.
  • In 2018, the Dialysis Component began collecting data using an AKI location.  Now that some data have been collected, data reported to that AKI location are included in dialysis rate tables and run charts so facilities and groups can review AKI-specific rates for the various dialysis event measures.

In order to use any of the new analysis output options you must first regenerate datasets.  As always, send all questions to the NHSN Helpdesk at NHSN@cdc.gov.