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News Bulletins 2009 |
The first two documents listed below were mentioned in an earlier bulletin
(http://www.nwrenalnetwork.org/news_bulletins09A.htm#ssa3e), but have been updated since that bulletin was issued (March 17). If you downloaded documents from that bulletin, please download them again and discard the earlier copies.
The documents at http://www.nwrenalnetwork.org/CfC/Survey.htm include:
Measures Assessment Tool or MAT (updated): http://www.nwrenalnetwork.org/CfC/MAT.pdf.
Infection Control, and
Correlation Grid for Patient Assessment and Plan of Care, and
AAMI RD 52: Monitoring Guidelines for Water Purification Equipment and Distribution Systems and Dialysis:
http://www.nwrenalnetwork.org/CfC/MAT/BlueAAMI.pdf.
Chemical Contaminant Levels in Water Used to Prepare Dialysate, and
Personnel Requirements, and
Dialysis Lab Tests At A Glance: http://www.nwrenalnetwork.org/CfC/MAT/PinkLabs.pdf. ESRD Facilities V-Tags & Identifiers:
http://www.nwrenalnetwork.org/CfC/MAT/GreenVTags.pdf.
Principles of [Survey] Documentation Overview:
http://www.nwrenalnetwork.org/CfC/MAT/CoralDocs.pdf.
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the renal CROWNWeb system will move from its testing environment to a
production/implementation environment on February 1, 2009. At that time, CMS will launch CROWNWeb to a small, select group of providers across the country, representing both large- and small-dialysis organizations, as well as independent dialysis facilities across the country. CMS will expand implementation as it learns more about how the system functions within individual facilities.
Until facilities are phased in to CROWNWeb implementation, they should continue with their normal business operations and reporting requirements, including using the SIMS, VISION, and paper-based data submissions. Facilities that are not part of the first phase of implementation may continue to meet their requirements under the ESRD conditions for coverage by continuing to use these submission methods.
CROWNWeb is a secure, web-based system that will capture clinical and administrative data from dialysis facilities across the country, supplanting the paper-based data collection methods that CMS currently uses.
CROWNWeb is CMS’ first step in leveraging the benefits of health information technology for the dialysis population, and will help us improve the quality of data we receive about dialysis treatments; help providers focus on providing optimal patient care; drive innovations and quality improvement of care practices; and equip CMS with more data in order to develop a more refined and responsive ESRD bundled payment system and ESRD value-based purchasing framework.
More support will be available to dialysis facilities from their local ESRD Network Organizations. A list of Networks is online at
http://www.medicare.gov/Dialysis/Static/ContactList.asp?dest=NAV|Home|Resources|ESRDContacts|Contacts&ContactType=ESRD. Facilities can also call the CROWN Help Desk at 888-ESRD-HD1 or email ESRDHD1@esrd.net.
Consumers who wish to learn more about dialysis facilities in their communities can visit the Dialysis Facility Compare website at
http://www.medicare.gov/dialysis for information.
Topic Index
Topic Index
New AVF Brochures
We’ve mailed sample copies of three new AVF brochures to facilities, and placed them on the Network website, in the For-Patients section of our Fistula First page (http://www.nwrenalnetwork.org/fist1st/fist1st.htm#patients). We’ll mail a printed copy to patients who call to ask. We invite facilities to download them from our website and print them for distribution to their patients. The first brochure is called simply ArterioVenous Fistula, and it includes advantages and disadvantages of various types of access, a list of frequently asked questions, and other useful information. It can be found at
http://www.nwrenalnetwork.org/fist1st/AVFBro.pdf. The second brochure is the same, but in Spanish – Fístula Arteria Venosa, at http://www.nwrenalnetwork.org/fist1st/AVFBroEsp.pdf. The third is called Caring for & Developing Your New Fistula, and includes some easy-to-do exercises to help a new fistula mature. Find it at
http://www.nwrenalnetwork.org/fist1st/AVFCare.pdf. We created the first two; the third was developed by the
Heartland Kidney Network.
There are earlier articles on Vascular Access.
ID Cards for Patients Using Buttonhole Cannulation
The Network has created a pocket ID card for patients who use the buttonhole technique to carry, to inform other healthcare providers. The AVF brochure mailing included a form that facilities can fax back to us to order copies of the card. We’ve added the form to our “On Course with Cannulation” page at
http://www.nwrenalnetwork.org/fist1st/ffcannu.htm. You can also download the form directly, from
http://www.nwrenalnetwork.org/fist1st/cannu/BHID.pdf.
There are earlier articles on Vascular Access.
Network AVF Rate Reaches 64%
Congratulations are in order: the Network prevalent-patient AVF rate for January 2009 was 64.3%, and for February 64.0%, well on our way toward the goal of 66%. The new Conditions for Coverage expect each facility to strive for the goal that 65-66% of their prevalent hemodialysis patients use an AVF, as outlined on the Measures Assessment Tool or “MAT” at
http://www.nwrenalnetwork.org/CfC/MAT.pdf (see Tag V633). Currently, facility AVF rates range from 29% to 83%, so some facilities have a ways to go toward meeting this goal. The February rate for long-term catheters was 8.8% for the Network as a whole, well within the goal of 10% or less. At individual
facilities, however, this rate varies from 0% up to 40%, and surveyors will expect all facilities to strive to bring this rate down to 10% or less.
There are earlier articles on Vascular Access, on
Conditions for Coverage, on
Quality Improvement and on
Survey and Certification.
Patient Newsletter on Emergency Preparedness
The new issue of Network Consumer News is on emergency preparedness. If your dialysis facility hasn’t provided one to you, let us know. This issue includes an emergency preparedness crossword puzzle, and a feedback form,
“Tell Us What You Think,” to help us know/learn whether our new format is helpful. You can find a copy of this issue at
http://www.nwrenalnetwork.org/P/NCN/NCNv2.4.pdf in the two-page edition, and
http://www.nwrenalnetwork.org/P/NCN/NCNv2.4big.pdf in the large-print edition. The crossword puzzle is at
http://www.nwrenalnetwork.org/P/NCN/crossword.pdf and the feedback form at
http://www.nwrenalnetwork.org/P/NCN/TellUs.pdf. For earlier issues of Network Consumer News, see
http://www.nwrenalnetwork.org/P/NCN.htm.
There are earlier articles on Network Consumer News and on
Emergency Preparedness.
Resources for State Survey Guidance under New Conditions for Coverage
We've mailed to all Network dialysis facilities a selection of short documents that provide detail about what State Surveyors will look for under the new Conditions for Coverage. You can download all of those documents, plus additional documents that were not mailed, from the menu at
http://www.nwrenalnetwork.org/CfC/Survey.htm. We've also linked to several of these documents from relevant portions of other menus on the Network website.
Outline of the Basic ESRD Survey Process (updated):
http://www.nwrenalnetwork.org/CfC/SurveyProcess.pdf.
There are earlier articles on Survey and Certification, on
Conditions for Coverage, and on
Water Treatment.
Requirements for Isolation Room/Area:
http://www.nwrenalnetwork.org/CfC/MAT/TanIsolation.pdf.
Timelines for Patient Assessment and Plan of Care:
http://www.nwrenalnetwork.org/CfC/MAT/LilacCMPA.pdf.
Water System Flow Diagram: http://www.nwrenalnetwork.org/CfC/MAT/BlueWater.pdf.
National Commercial Dialysis Technician Certification Organizations:
http://www.nwrenalnetwork.org/CfC/MAT/GoldStaff.pdf.
Myfortic Medication Guide
Novartis has completed the Myfortic Medication Guide for patients, which the FDA asked it to prepare, and pharmacists will dispense it with the medication by May 15, 2009. A copy can also be found at http://www.fda.gov/cder/foi/label/2008/050791s004lbl.pdf. For more information see http://www.fda.gov/medwatch/safety/2009/safety09.htm#CellCept.
There are earlier articles on CellCept and Myfortic.
New Labels on Heparin and Prograf
The FDA has announced safety labeling changes for Heparin Sodium and Prograf (tacrolimus). For details see
http://www.fda.gov/medwatch/safety/2009/feb09.htm.
There are earlier articles on Heparin.
FDA Warns Against Sharing Insulin Pens or Cartridges
The FDA has warned patients and providers that insulin pens and insulin cartridges should never be shared between patients. Even if needles are changed, the pen reservoir can still harbor and communicate serious disease pathogens, including HIV and Hepatitis. For details see http://www.fda.gov/medwatch/safety/2009/safety09.htm#Insulin.
There are earlier articles on Insulin-Related Recalls.
Advance Directive Resources; National Healthcare Decision Day April 16, 2009
Free HealthLine Teleconference on Transplantation 101
The AAKP HealthLine, a series of patient education conference calls, is presenting a call on “Renal Transplantation 101,” on March 31, 2009. The call will cover the waiting list, candidacy, referral and evaluation, and management of kidney function to slow disease progression. For details on this call, see http://www.aakp.org/events/HealthLine/Upcoming-Calls/march-2009/. For more information about HealthLine in general, see http://www.aakp.org/events/HealthLine/index.cfm. There are earlier articles on Patient Education and on
Transplantation.
March Is National Kidney Month
State Surveyor Guides for New Conditions for Coverage
We’ve added to the Network website a copy of the outline that State Surveyors will use when surveying dialysis facilities under the new Conditions for Coverage. Find it at
http://www.nwrenalnetwork.org/CfC/SurveyProcess.pdf, along with a copy of the Measures Assessment Tool (MAT) or checklist they will use, at http://www.nwrenalnetwork.org/CfC/MAT.pdf. We’ve also added links to these new pages from
http://www.nwrenalnetwork.org/CfC/CfC.htm, our overview Conditions for Coverage page.
There are earlier articles on Conditions for Coverage and on
Survey and Certification.
QAPI (Quality Assessment and Performance Improvement) Resources for New Conditions for Coverage
We’ve also added a summary of the Quality Assessment and Performance Improvement (QAPI) process that the new Conditions for Coverage require, at
http://www.nwrenalnetwork.org/QI/QAPIProcess.pdf, and a link to it from our overview Quality Improvement page at http://www.nwrenalnetwork.org/QI/QI.htm. The QI page also includes links to useful QAPI tools, including a Root Cause Template at
http://www.nwrenalnetwork.org/QI/RootCausesOf.doc, a QAPI Template (a list of questions to ask yourself when initiating a QI process) at http://www.nwrenalnetwork.org/QI/QITemplate.doc, and a QI Action Plan Template at http://www.nwrenalnetwork.org/QI/QIPlan.doc. The three templates are MSWord documents, so you can download and modify them to fit your own circumstances.
There are earlier articles on Quality Improvement and on
Conditions for Coverage.
Class I Recall of Welch Allen AED 10 and MRL JumpStart Defibrillators
The FDA has announced a class I recall of Welch Allen AED 10 and MRL JumpStart external defibrillators because of several problems which could lead to death of a patient in cardiac arrest. For details see
http://www.fda.gov/medwatch/safety/2009/safety09.htm#AED10.
There are earlier articles on Defibrillator Recalls.
Class I Recall of Baxter Colleague Infusion Pumps
The FDA has issued a Class I recall of "Colleague" brand Single- and Triple-Channel Volumetric Infusion Pumps made by Baxter, model numbers Mono 2M8151 and 2M8153, CX 2M8161 and 2M8163, and CXE 2M9161 and 2M9163, because of potential failures that may lead to serious injury or death. For details see
http://www.fda.gov/medwatch/safety/2009/safety09.htm#Colleague.
There are earlier articles on Insulin-Related Recalls.
AAKP Seeks Nominations for Board of Directors
AAKP is soliciting nominations to its Board of Directors. Directors establish goals and policies for AAKP, exercise management oversight, and facilitate funding. The Board meet three times a year, in addition to conference calls and committee work. AAKP pays for travel to meetings. Directors will be elected in July and seated for a two-year term at the AAKP Annual Convention in September in Denver. Nomination deadline is May 22, 2009. Candidates may be patients (CKD, dialysis, or transplant), health care professionals, or anyone with a serious interest in the health and well-being of the nation's kidney patients. Self nominations are encouraged. For more information, call Emily Carbone at 800-749-AAKP, or see http://www.aakp.org/About-AAKP/board/2009app/.
There are earlier articles on Patient Meetings and on
Volunteering.
Genzyme Replacing Renagel with Renvela
Life Safety Code Component of Conditions for Coverage
The Life Safety Code portion of the new Conditions for Coverage became effective February 9, 2009. The Code requires that dialysis facilities meet the National Fire Protection Association's Ambulatory Health Care Occupancies Life Safety Code, 2000 Edition, with certain exceptions on sprinkler systems, emergency power, and fire drills, and with limited provisions for waivers. For full details see
http://www.nwrenalnetwork.org/CfC/LifeSafetyCode.pdf.
There are earlier articles on Conditions for Coverage.
CellCept and Myfortic Medication Guides
The FDA is requiring that pharmacists distribute a copy of Roche's new CellCept Medication Guide to all patients filling a CellCept (mycophenolate mofetil) prescription. The Guide is intended to provide important safety information in language that patients can easily understand. The FDA is also requiring a Medication Guide for Novartis's Myfortic (mycophenolic acid). For more details see
http://www.fda.gov/medwatch/safety/2009/safety09.htm#CellCept.
There are earlier articles on CellCept and Myfortic.
New HIPAA Web Site
The HHS Office for Civil Rights (OCR), which is responsible for enforcing the HIPAA Privacy Rule and the confidentiality provisions of the Patient Safety Act, has reorganized their website, and included much new content. The new pages, for both consumers and providers, can be found at http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html. There are earlier articles on HIPAA.
Network Prevalent-Patient AVF Rate Finishes December at 63.9%
The Network finished 2008 with an AVF-in-use rate for prevalent patients of 63.9%. Our goal remains 66%. We post our AVF progress at
http://www.nwrenalnetwork.org/fist1st/fist1st.htm#progress. We'd particularly like to see the Network catheter rate improve. While the catheter rate for the Network as a whole is below our goal of less than 10% long-term catheters, some facilities still have rates above 30%. Facility AVG rates of 30-40% and more are also common. In one study
(http://www.nature.com/ki/journal/v60/n4/abs/4492564a.html), diabetic patients using AVG had 41% higher mortality than those using AVF, and those using a catheter had 54% higher mortality. For non-diabetic patients, mortality was 70% higher among those using a catheter than among those using AVF.
There are earlier articles on Vascular Access.
December 2008 Modality Reports Show 4.3% Annual Growth
The December 2008 Modality Reports (patient census) are available at
http://www.nwrenalnetwork.org/modality/mode1208/modality.htm. For the Network as a whole, the patient population grew 4.3% over December 2007, though growth in Alaska and Idaho was more than 6%. For historical data, see http://www.nwrenalnetwork.org/modality.htm.
There are earlier articles on Modality Reports.
Class II Recall of Fresenius CombiSet True Flow HD Blood Tubing
New Transplant Selection Criteria Web Page
To help dialysis facilities meet the new
Conditions for Coverage, we've added a new page to the Network website, to collect in one place the Transplant Selection Criteria for all Network transplant centers. You can find the new page at
http://www.nwrenalnetwork.org/T/SelectionCriteria.pdf, or through our Clinical Staff page at http://www.nwrenalnetwork.org/staff.htm.
There are earlier articles on Conditions for Coverage, and on
Transplants.
New Patient Newsletter on Voicing Concerns
Copies of the new Network Consumer News on the topic of “Voicing Concerns” have been mailed, including copies of our
flyer on The Role of the Northwest Renal Network in Handling Complaints and Grievances, in English
(http://www.nwrenalnetwork.org/G/ComplaintsGrievances.htm) and en español
(http://www.nwrenalnetwork.org/G/QuejasProtestas.pdf). The newsletter can be found at
http://www.nwrenalnetwork.org/P/NCN/NCNv2.3.pdf in two-page format, and
http://www.nwrenalnetwork.org/P/NCN/NCNv2.3big.pdf in four-page, large-print format.
There are earlier articles on Complaints and Grievances, on
Conflict Resolution, and on
Network Consumer News.
CME/CEU Workshop on New End-of-Life Law February 23 in Seattle
The Washington End-of-Life Consensus Coalition and the
Washington State Hospice and Palliative Care Organization are jointly sponsoring a CME- and CEU-eligible workshop on Washington's Initiative 1000. The conference title is INITIATIVE 1000: Implications for practice and opportunity for improving end-of-life discussions. The Initiative becomes law on March 4, 2009, and allows terminally ill adults to request and self-administer lethal medications prescribed by a physician. The all-day workshop will be near the Seattle-Tacoma International Airport on February 23, 2009. Space is limited, and the registration deadline is February 15. For full details, including schedule, faculty, registration instructions, and more information, see
http://www.wsma.org/patients/weolcc.html.
There are earlier articles on Continuing Education, on
Professional Meetings, and on
End of Life.
FDA Announcement on Possible Plavix (Clopidogrel) Interactions
Summary of Peanut Recalls
New Conditions Require Notification of Involuntary Discharge and Transfer
The new Conditions for Coverage require dialysis facilities to notify both the Network and their State Survey Agency when a patient is involuntarily discharged or transferred. We've prepared a summary of this requirement, including what must be reported, where to report it, answers to frequently asked questions, and a copy of the relevant excerpt from the Conditions. Find the summary at
http://www.nwrenalnetwork.org/G/Involuntary.pdf.
There are earlier articles on Patients' Rights, on
Conflict Resolution, and on
Conditions for Coverage.
Recall of Nutrition/Energy Bars and Other Products Containing Peanut Butter
The FDA has announced recalls of many products containing peanut butter, including nutrition and energy bars and many other food products such as cookies, crackers, frozen dinners, and ice cream. The products may be contaminated with Salmonella, which can cause serious and sometimes fatal infection. A partial list of national and local brand names with products recalled to date includes Premier Nutrition, Twisted, Titan, Abbott Nutrition, ZonePerfect, NutriPals, Clif, Luna, Nature’s Path, Optimum Energy, NutriSystem, Dinners Ready, Evening Rise, WalMart Bakery, Trader Joe’s, Meijer, Private Selection, Kellogg, Austin, Keebler, Famous Amos, Hy-Vee, Blanton, Country Maid, Classic Breaks, Ready Pac, Eating Right, Boca Grande, Poco Pac, Grande Gourmet, McKee, Little Debbie, Ralcorp, Lofthouse, Parco, Chuck’s Chunky, and Pastries Plus. For details of each recall, including specific products and lot numbers, see
http://www.fda.gov/opacom/7alerts.html.
Warnings on Topical Anesthetics
CROWNWeb Implementation - Important CMS Announcement
Please refer to the following information, released today by CMS on the NIH listserv. Additional information regarding implementation of CROWNWeb in phases will be provided by CMS in the near future.CMS Announcement 1/16/09
There are earlier articles on CROWNWeb, and on
Conditions for Coverage.
March NW Renal Dietitians Conference Brochure
The brochure for the 2009 Northwest Renal Dietitians & Canadian Association of Nephrology Dietitians Annual Conference, in Vancouver BC on March 5-6, is now available, at
http://nwrenalnetwork.org/N/NWRD09Brochure.pdf. It includes the final schedule and faculty, location information, and registration form. A request for stipend can be also be found at
http://nwrenalnetwork.org/N/NWRDStipend.pdf, and a menu for the conference dinner at
http://nwrenalnetwork.org/N/NWRDMenu.pdf.
There are earlier articles on Professional Meetings.
NKF Patient Education Symposium in Portland in March
The National Kidney Foundation is sponsoring an all-day Patient Education Symposium near the Portland Airport on March 15, 2009. The Symposium, and lunch, are free to patients, and to one guest per patient. Since space is limited, advance registration is advised. For details see http://www.nwrenalnetwork.org/N/NKFPtEdSym309.pdf.
There are earlier articles on Patient Education and on Patient Meetings.
Warning on Innohep
Celgene has issued a warning letter describing a controlled clinical study suggesting that Innohep may increase the risk of death, compared to unfractionated heparin, when used to treat patients age 70 and older with renal insufficiency. Celgene recommends consideration of alternatives to Innohep when treating these patients for deep vein thrombosis with or without pulmonary embolism. For details see http://www.fda.gov/medwatch/safety/2008/safety08.htm#Innohep.
There are earlier articles on Heparin.
Topic Index Page updated July 15, 2010