NHSN has published their September NHSN Newsletter.  Dialysis-related news is found on pages 15-16, but some of the general NHSN information on pages 17-20 also applies to dialysis.  News includes:

  • A revised “NHSN Agreement to Participate and Consent” (“Re-Consent” for short) will be published in December, and all facilities must respond by February 24, 2018.
  • After January 1, 2018, including AKI patients will be mandatory, but they will be entered into a separate “AKI Location.”  Some information is included below, but full details will be included with release of Version 8.8.
  • NHSN Version 8.8 is scheduled to be released in December 2017.  Two webinars will introduce it:
  • Volunteers are solicited for beta testing of Version 8.8 with simulated data.
  • A plea for NHSN users to keep their User Contact Information current (pp.18-20).

Find a copy of the Newsletter at https://www.cdc.gov/nhsn/newsletters/index.html .

In a separate bulletin, CDC has published some instructions for dealing with AKI patients in NHSN in 2018:

Beginning January 1, 2018, dialysis facilities should include AKI patients in NHSN Dialysis Event Surveillance.  Reporting AKI patient data to a new, separate NHSN location will enable CDC to exclude AKI patient data from NHSN BSI information shared with CMS for purposes of the ESRD QIP.

The “AKI Location” should be used to report Dialysis Events and denominator data for patients who have AKI and do not have an ESRD diagnosis at the time of the Event, or denominator data collection.  The “AKI Location” will be released as part of the NHSN version 8.8 update.  Instructions for using the “AKI Location” are forthcoming.

Among patients included in the NHSN Dialysis Event Surveillance population, the following criteria should be used to identify patients who have acute kidney injury:

  • No diagnosis of ESRD in the patient medical record, or through the ESRD Medical Evidence Form (Form CMS-2728-U3)  AND
  • Physician-diagnosis of AKI listed in the patient medical record (e.g., nephrologist consult or referral form)  AND
  • The event date or date of denominator data collection is not more than 6 months after the date the patient initiated outpatient hemodialysis.

9/30 NHSN QIP Deadline

In order to be considered in your QIP Performance Score, infection surveillance data for April through June 2017 must be entered, and corrections made, in NHSN by September 30, 2017.  Entries into NHSN made after that date will not be sent to CMS.  While you can find everything you need to know about NHSN for dialysis at https://www.cdc.gov/nhsn/dialysis/event/index.html , CDC recommends these shortcuts:

10/22 NW18 ANNA/NANT Renal Update

ANNA, NANT, and NKF will collaborate to present an October 22, 2017 Annual Renal Update 2017 in Irvine CA.  Sessions will include Interventional Radiology and the HD Access, Preventing & Reporting BSI, From Battling Burnout to Finding Joy, Understanding Technology, Friendly Renal Meals, Transplantation, and Outpatient AKI.  Register by October 12, 2017.  Breakfast and lunch are included in the conference fee, and seven contact hours will be given.  For full details see https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/18RenalUpdate1017.pdf .

NHSN Newsletter

The NHSN June Newsletter can be found at http://www.cdc.gov/nhsn/newsletters/index.html .  The Newsletter includes articles on AKI, Release 8.7 updates, Prevention Process Measures analysis, Release 8.8 beta testing volunteer opportunities, and training updates.  Find material specific to dialysis on pages 16-17, and information relevant to all NHSN users on pages 2 and 18ff.

8/3+ NHSN Webinars

NHSN will twice present a webinar on Introduction to the NHSN Dialysis Event Surveillance Protocol, once on August 3, 2017 and again on August 4, 2017.  NHSN Dialysis Event Surveillance reporting is required for the CMS ESRD QIP.  This webinar will provide a complete introduction to the NHSN Dialysis Event reporting requirements and the surveillance definitions necessary to complete accurate monthly reporting.  CDC subject matter experts will be available to answer questions, and continuing education credits will be provided.  Pre-registration is required, at:

Continuing education credits are also available for NHSN’s recorded presentations.  Find these, with instructions for obtaining CE credits, at https://www.cdc.gov/nhsn/Training/continuing-edu.html .

10/23 NHSN Beta Testing

CDC is soliciting volunteer clinics to beta test version 8.8 of NHSN, currently scheduled for full release on December 9, 2017.  The beta testing period will be open from October 23, 2017 to November 3, 2017.  During this time, dummy data will be populated into the beta website for testers to manipulate within NHSN 8.8.  New data will be available each morning after a purge of all data submitted the previous day.  Beta testing will provide an opportunity for NHSN users to explore new NHSN features and potentially identify issues that can be resolved prior to the full release.  If you have any questions or want to volunteer for beta testing, contact NHSNBeta@cdc.gov with “Dialysis Component” in the subject line.

8/28 QIP PY2019-21 Revisions

CMS has proposed a new rule that modifies the QIP for PY2019-21.  Comments on the rule will be accepted until August 28, 2017.  The proposed rule includes updates to reimbursement rates, the ESRD QIP Extraordinary Circumstances Exception Policy (ECE), PSC, NHSN dialysis event data validation sampling methodology, and quality measures.  The rule also requests comments on how to include individuals with AKI in the ESRD QIP, and on the feasibility and appropriateness of accounting for social risk factors in the program.  Find an advance copy of the proposed rule at https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-13908.pdf .  The proposed rule is scheduled for the July 5, 2017 Federal Register.  A copy of the CMS press release on the proposed rule can be found at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-06-29.html .

A CMS Fact Sheet summarizes the various changes and proposals in the rule, and also introduces a planned CMS RFI that will welcome continued feedback on the Medicare program with the aim of increasing efficiency, transparency, flexibility, program simplicity, and innovation.  Find the Fact Sheet at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-06-29.html .