Toxic Waters

Now that high summer and higher temperatures have arrived, Harmful Algae Blooms (“HABs”) are an increasing threat to recreational and subsistence uses of bodies of fresh- and salt-water.  HABs can impact, sometimes fatally, harvesting of water- and shoreline-dwelling animals and plants, drinking, swimming, wading, and boating.  Pets and children are particularly vulnerable because they can rush into water before you even realize they’re out of the car.  The Oregon Health Authority advises,

“Don’t go into water that looks foamy, scummy, thick like paint, pea-green, blue-green or brownish red.  A good rule of thumb for you and your pet is: When in Doubt, Stay Out!”  (

Bear in mind that most waters are not monitored for toxicity, so the lack of a warning sign is not enough to assure safe use.  The following websites provide information on identifying and responding to toxic waters and their impacts, and include alerts on the few, most popular, waters that are monitored and posted:

The Washington website is also available in Spanish, Somali, and Viet.  As an example of a posted warning, Odell Lake near Willamette Pass, between Eugene and Klamath Falls OR, has recently been posted; see the Oregon website above.

CMS Summary of COVID-19 Waivers as of 4/9

On April 9, 2020 CMS published a document on COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers, summarizing relief during the current emergency from normal requirements, with the intention to allow healthcare facilities to focus more attention on treating COVID-19 patients.  Waivers for dialysis facilities are summarized on pp.17-19, and include adjustments to regulations for water quality testing, fire inspections, patient assessments, plan of care, rounds, home visits, special purpose facilities, PCT certification, transferability of professional credentials, dialysis in nursing homes, and many other details.  Find the document at

NKF PERC Education for Professionals

NKF offers a number of webinars under their Professional Education Resource Center or PERC, many of which offer free continuing education credits for multiple disciplines.  Some examples:

  • Social Work Collaboration for Transplant Patients
  • Evidence-Based Social Work
  • Anemia and Cardiovascular Disease
  • Nephropathic Cystinosis 
  • Western Diets: Are We Killing Our Patients?
  • Ethical Issues When Family Interferes with Transplant
  • Blood Pressure Monitoring
  • Cardiometabolic Diseases
  • Hyperkalemia
  • Living Kidney Donations
  • Early Detection and Prevention
  • Secondary Hyperparathyroidism
  • Hepatitis C
  • Mineral and Bone Disorder
  • Water
  • Minorities, Transplant, and Home Dialysis
  • ESRD Core Survey
  • Polypharmacy
  • Albumin
  • Depression and Pain
  • Nephrotic Syndrome
  • Lipid Management
  • Journal of Renal Nutrition articles

See for information and registration.

Free CE Courses

The American Kidney Fund offers a number of free NANT, NASW, and CDR continuing education credits on depression, self-care, relationship-building, and a number of other topics. See for more information.

The NKF Professional Education Resource Center also presents free continuing-education courses, for most kidney-related health professions.  Just a few of these courses include prevention, hepatitis (see below), water, cultural sensitivity, pain management, hyperkalemia, and other mineral imbalances.  For more information see .

July 28 is World Hepatitis Day, by the way; for more information see .

3/21 NANT Symposium, Las Vegas

Including the pre-symposium workshops, the 2016 NANT Annual Symposium in Las Vegas NV March 21-24 will include sessions on professional development, water treatment, machine troubleshooting, empathy and patience with patients, patient needs, disaster preparedness, body and dialysis chemistry, cyber security, infection control, fluid management, vascular access, dialysis modalities, reuse, biofilms, and dialysate composition.  For details and registration see .

Webinar: Water & Dialysate Safety, 12/8

The ESRD Network Coordinating Council will present a free webinar on Water and Dialysate Safety; A Key Infection Prevention Strategy in Dialysis December 8, 2016.  The webinar, developed in collaboration with CDC, CMS, and the ESRD Networks, will offer 1.0 CE for nurses and technicians, and feature case studies and prevention measures.  For full details see:

Network Annual Provider Meeting 10/25

Join us at the Seattle airport for the Annual Network Provider Meeting on October 25, 2015.  Our Provider Meeting is a great continuing education (6.5 hours) and networking opportunity.  Meet the Network staff and get to know your colleagues at our annual awards luncheon, where leading-edge facilities in patient engagement, vascular access, home dialysis innovation, healthcare-associated infection, and data processing receive recognition for exemplary service.  Nationally-known speakers will cover the basics and the latest on fluid management, patient engagement, safety, water treatment, survey citations, and the QIP.  Find all the details and register at the Network home page:

Annual Network Meeting, 10/25, Seattle Airport

Don’t miss out on our 2015 Annual Network Provider Meeting, on October 25, 2015 at the Seattle airport.  Earn 6.5 CEUs for nurses, technicians, social workers and dietitians, and hear nationally known speakers on topics that can enhance patient outcomes.

Danilo Concepcion will speak on Water Treatment, for example.  Danilo is a prolific speaker nationally and internationally, has published in numerous professional journals, and has served on the Association for the Advancement of Medical Instrumentation (AAMI) advisory board since 2000.  Also, Dr. Suhail Ahmad will speak about Fluid Management, Frank Schitoskey about Surveyor Citations, Katrina Russell about the QIP, Bonnie Greenspan about Culture of Safety, and Beth Witten about Patient Engagement.

Get all the details at , and register at – $25 discount before October 22.

Network Meeting 10/25, Seattle

The Network’s 2015 Annual Provider Meeting will be held near the Seattle-Tacoma International Airport on October 25, 2015.  Speakers will include:

  • Beth Witten on Patient Engagement in Action.  Beth contracts with the CMS Survey and Certification Group, where she serves on the ESRD Training and Support Team that develops guidance, policies, and training materials, and trains ESRD surveyors nationally.  Renal social workers will recognize Beth from her mentorship on the CNSW Listserv.
  • Bonnie Greenspan on Culture of Safety.  Bonnie is a consultant to independent and corporate dialysis providers for active facility oversight and performance improvement, and consults with CMS in several ESRD projects, including CMS Surveyor Training.  She authored the chapter on Culture of Safety and QAPI for the 2015 ANNA Core Curriculum for Nephrology Nursing.
  • Danilo Concepcion on Water Treatment.  Danilo is a prolific speaker nationally and internationally, has published in numerous professional journals, and has served on the Association for the Advancement of Medical Instrumentation (AAMI) advisory board since 2000.

Additional speakers will cover fluid management, survey citations, water treatment, and the QIP.  Nurses, technicians, social workers, and dietitians can earn 6.5 CEUs.  Be sure to register before October 22 to save $25.  Find full details at .  Register at .