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Welcome to the May 3 edition of the Quality Insights Renal Network 4 (QIRN4) e-newsletter. In this issue, we bring you information about NHSN QIP reporting deadlines, the Dialysis Event 21 Day Rule, ESRD events, resources and much more. We encourage you to contact us with any questions, concerns or suggestions. 
ProviderAVFAVG Provider offers AVF/AVG Site Cleaning Altnerative
In a recent response to a Centers for Disease Control & Prevention (CDC) listserv request for current processes that facilities use for arteriovenous fistula (AVF)/Arteriovenous graft (AVG) site cleaning, one provider offered the following. 

It is preferable for the patient to first wash his or her access with soap and water at a clean sink; however, this can be challenging for units that treat patients who are unable to access the sinks and in older facilities that have limited sinks. As an alternative, our center utilizes pre-packaged single packets of PDI Sani-Hands, which contain 70% alcohol to wash the patient's vascular access prior to pre-cannulation disinfection at the dialysis station. Some tips include the following: 
  • Clean access arm with sani-wipe if patient has not washed access arm at sink prior to arrival.
  • Use two Chlorascrub pads to disinfect access - one for arterial site and one for venous site. Gently scrub for 15 seconds. Air- dry for 30 seconds.
  • For patients with sensitivity to Chlorascrub pads, use one 2% chlorhexidine swab stick. Follow instructions above.
  • For patients who are sensitive to chlorhexidine swab stick, use one betadine swab and allow to dry for 5 minutes followed by  two alcohol pads that are allowed to dry for 20 seconds to cleanse sites.
  • For patients with sensitivity to chlorhexidine and betadine, use two alcohol pads and allow dry time of 20 seconds.
NephrologyNursingJournalnephrology nursing journal article studies variation of patient fatigue
The March/April 2016 Nephrology Nursing Journal has published an article titled: "A Comparison of Temporal Patterns of Fatigue in Patients on Hemodialysis" by Anne E. Horigan and Julie V. Barroso. The article studies the variation of patient fatigue, one of the most commonly occurring symptom for patients on hemodialysis, and explores the educational implications of this side effect. "Helping patients identify a pattern in their fatigue experience may help them in scheduling activities and time with family." The article encourages education of patients who are new to hemodialysis about fatigue so they are able to "navigate the changes that kidney failure and dialysis schedules have on their lives." The article offers 1.2 CEUs. ANNA members pay $15 and nonmembers pay $25. 
NHSNQIPDeadlineNHSN QIP Deadline: Vaccination Data
To meet the CMS ESRD QIP NHSN reporting requirements for PY2018, dialysis facilities must submit their 2015/2016 healthcare personnel (HCP) influenza vaccination summary data, collected from October 1, 2015 through March 31, 2016, by Sunday, May 15. New or revised 2015/2016 HCP influenza vaccination data entered into NHSN after May 15 will not be sent to CMS. Any changes or corrections to this data should be made prior to the reporting deadline. May 15 is a Sunday. Regardless, data must be submitted by 11:59 p.m. PT on May 15. The NHSN Helpdesk is not staffed on weekends, so please plan data entry/review accordingly. Review the training slides for information to help ensure your data are complete and accurate before the May 15 deadline.

At least one individual at your facility must be able to access NHSN via SAMS and has appropriate user rights in NHSN so they may enter and view your facility's data. Required data include your 2015/2016 influenza season monthly reporting plan and your 2015/2016 HCP influenza vaccination summary record. All missing flu summary alerts must be cleared from your NHSN facility homepage.  Get additional guidance on ensuring that your data are accurately sent to CMS for QIP purposes. Contact the NHSN Helpdesk with any questions.
NHSNNewsblast3Nhsn Newsblast focuses on how to apply the nhsn dialysis event 21 day rule
This month's    National Healthcare Safety Network (NHSN) newsblast is Part 1 of a series on how to apply the NHSN Dialysis Event 21 day rule. Complete and accurate surveillance data are essential to facility, regional, and national infection prevention efforts.  Read each newsblast in this 4-part series to learn how to prevent over-reporting of dialysis events. Newsblasts are disseminated once monthly, towards the end of each month.

AAKPAAKP Hosts National Patient Meeting
The American Association of Kidney Patients (AAKP) will hold its 2016 National Patient Meeting in Nashville, TN, September 23-25. AAKP is looking forward to returning to Tennessee to build on the excitement, success, and education of last year's meeting. Registration opens in early spring.

PKDPKD National Convention to be Held in June
The Polycystic Kidney Disease (PKD) National Convention will be held June 24-26 in Orlando, FL. The registration fee is reduced if you register by May 5. For ongoing details, visit the PKD Foundation website
HandHygieneDay2May 5 is Hand Hygiene Day by the World Health Organization
"Save Lives: Clean Your Hands" is the theme of Hand Hygiene Day on May 5. Hand Hygiene Day is the World Health Organization's call to action for health care workers, recognizing that hand hygiene is a highly effective way to reduce health care-associated infection and promote patient safety. Check out the CDC Hand Hygiene Guidelines and other tools. The CMS Medicare Learning Network also offers a web-based continuing-education training course on Infection Control: Hand Hygiene. 

KFCPKFCP Encourages Participation in Highmark's Walk for a Healthy Community
The Kidney Foundation of Central Pennsylvania (KFCP) is taking part in the annual Highmark Walk for a Healthy Community on Saturday, May 21 at the main campus of the Harrisburg Area Community College. Highmark underwrites the cost of the Walk, so each participating nonprofit organization keeps 100 percent of the funds raised by its walkers. 

Proceeds from this important event help strengthen the KFCP's Patient Programs and Services. One important KFCP program in need of support this year is the Patient Emergency Assistance Fund. KFCP works closely with dialysis social workers who identify those patients in dire need of financial assistance, and temporary emergency funds are made available to help with prescription co-pays, nutritional supplements, or transportation costs to dialysis treatments. Due to fundraisers like the Highmark Walk, last year KFCP was able to assist over 350 patients when they needed it the most.

Please use the link below to make a donation or sign up to walk with the KFCP on May 21. Call (800) 762-6202 with any questions. Learn more

NRAANRAA Presents Pediatric Dialysis Education Series
The NRAA Pediatric Dialysis Education Series is geared to pediatric dialysis providers, and will feature a four-part webinar series and additional education opportunities at the 2016 NRAA Annual Fall Conference. Join the May 4 session on Quality of Life: Measurement to Intervention in Pediatric DialysisLearn more
ESRDResourcesESRD resources  
American Nephrology Nurses Association to Hand Out $93K in Grants, Scholarships
Each year, the American Nephrology Nurses Association (ANNA) offers scholarships that provide funding to support members in their pursuit of higher education, as well as grants for clinical practice or research projects. The recipients of these scholarships and grants are recognized each year at the ANNA National Symposium; this year, it will be held May 1-4 in Louisville, KY. The categories are research grants and awards, outstanding achievement, and scholarships and grants. All awards include a plaque and publication of the achievement in the ANNA Update. The research grants range from $350 - $15,000 and include grants for sharing research that is used to change practice. Along with offsetting some of the financial costs of research, recognition of the body of work and the promotion of nurses as researchers is a gain for our patients and nephrology nursing.

The outstanding achievement awards encompass chapter awards as well as individual nurses who have made a difference in clinical practice, education, management, quality care, research, collaboration, and health policy advocacy. The awards range from $1,000 to a lifetime ANNA membership (Outstanding Contribution to ANNA award).

If you or your staff are pursuing nursing degrees, a scholarship helps takes the bite out of the costs of education. There is one grant for technicians in collaboration with the National Student Nurses Association. The scholarships range from $1,000 to $2,500 and nearly $20,000 is awarded each year. The Nurse in Washington Internship (NIWI) is awarded to two members and includes all costs to attend this advocacy workshop with nurses from many specialties.

The ANNA applications are completed online.

New Education Program for Pediatric Dialysis Professionals
In the coming weeks, NRAA will launch an education program tailored to the pediatric dialysis community. The Pediatric Dialysis Education Series consists of a four-part webinar series approved for CE contact hours. Alongside the webinar series, we will offer two pediatric dialysis education breakout sessions at the 2016 Annual Fall Conference.

Cortney Taylor, PhD, will present the first webinar, "Quality of Life: Measurement to Intervention in Pediatric Dialysis" on Wednesday, May 4 at 1 p.m. EDT. 

In addition to the quality of life webinar noted above, topics to be addressed through the program are:
  • Leadership skills
  • Patient and family education
  • Staffing models
  • Billing issues
  • Transition from pediatric to adult care
"Education will be tailored to address unique challenges and provide solutions for pediatric dialysis professionals," said Valerie Okrend, NRAA Director of Education. "NRAA is pleased to be able to offer professional development opportunities that provide relevant and timely information to this dedicated group of learners. In addition to the live quarterly webinars and breakout sessions at the 2016 Annual Fall Conference, those who wish to access this education on-demand, will have the opportunity to do so via Education Station, NRAA's online learning platform."

LIVE: Live webinars are $25 for members and $35 for non-members and it includes CE.
ONLINE: Registrants who participated in the live activity may review the recorded webinars at no cost. For first-time access and CE, the member fee is $35 and non-member fee $45. Online offerings are approved for CE contact hours.

Learn more about the Pediatric Dialysis Education Series.

Check out the ESRD NCC Information Exchange 
The ESRD Network Coordinating Center (NCC) provides centralized coordination and support for the Medicare ESRD Network program. Each month, the ESRD NCC distributes an e-newsletter, known as the Information Exchange, that compiles the most important information from numerous ListServs and publications related to renal health. To sign up to receive this informative newsletter, please contact the ESRD NCC at or visit the ESRD NCC website

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This bi-weekly e-newsletter will serve as our primary method of communicating important news and updates. We encourage you to visit our Web site for the most up-to-date information or to contact us with questions, comments or suggestions.

This material was prepared by Quality Insights Renal Network 4 under contract with the Centers for Medicare & Medicaid Services (CMS). The contents do not necessarily reflect CMS policy.

Publication No. ESRD4-050316