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News Bulletins 2009 |
Topic Index
Topic Index
Tamiflu Dosing Errors
The FDA has issued a Public Health Alert to notify prescribers and pharmacists about potential dosing errors with Tamiflu (oseltamivir) for Oral Suspension. Prescriptions for liquid medicines are usually written in milliliters (mL) or teaspoons, while Tamiflu is dosed in milligrams (mg). The dosing dispenser packaged with Tamiflu has markings only in 30, 45 and 60 mg. Errors have been reported where dosing instructions do not match the dosing dispenser. The FDA urges health care providers to assure that the units of measure on prescription instructions match dosing devices provided. For details see
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm183714.htm.
There are earlier articles on Pandemic Influenza.
DFR Revision - SMRs Recalculated
In order to provide more accurate estimates, the methodology for calculating Standardized Mortality Ratios (SMRs), for Dialysis Facility Reports (DFRs) and Dialysis Facility Compare (DFC), has been changed slightly. We don't expect changes at facilities in this Network to be large, but it is possible that your facility's DFC mortality category could change. The revised DFRs will be posted at
http://www.dialysisreports.org on September 30, and comments may be left for CMS and State Survey Agencies until October 15. Only the SMR, expected mortality, and expected survival will change. For more details, including instructions for retrieving modified DFRs and leaving comments, see http://www.nwrenalnetwork.org/S/SMRs909.pdf.
There are earlier articles on Dialysis Facility Reports.
2008 Network Annual Report Published
The Network’s 2008 Annual Report has been added to our website, at
http://www.nwrenalnetwork.org/AR/ARS.htm.
There are earlier articles on Network Annual Reports.
2009 DFRs Summarized
We've summarized the 2009 Dialysis Facility Reports by state on the Network website at
http://www.nwrenalnetwork.org/S/statsdfr.htm.
There are earlier articles on Dialysis Facility Reports.
Promethazine Hydrochloride Injection Warning
CNSW-NW Educational Symposium October 9 in Issaquah
The Northwest Chapter of the
Council of Nephrology Social Workers, CNSW-NW, will hold it's Fall 2009 Educational Symposium in Issaquah WA on October 9, 2009. The Symposium will include sessions on Conditions for Coverage, mandatory reporting, vulnerable patients, end of life, and patient competency. The schedule and registration instructions can be found at
http://www.nwrenalnetwork.org/N/CNSW09Oct.pdf.
There are earlier articles on Professional Meetings.
Class I Recall of Lifepak CR Plus Defibrillators
The FDA has announced a class I recall of certain Physio-Control LIFEPAK CR Plus Automated External Defibrillators (AEDs)
because they may fail to operate in high humidity. Recalled serial numbers are listed at
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm182458.htm. Class I recalls are used when serious injury or death may result.
There are earlier articles on Defibrillator Recalls.
Proposed Bundled Payment System - Public Comment Period
CMS seeks public comment on a proposed new Bundled Payment System rule which would implement a case-mix-adjusted bundled Prospective Payment System (PPS) for Medicare ESRD outpatient dialysis facilities, beginning January 1, 2011. The PPS is required by the Medicare Improvements for Patients and Providers Act (MIPPA) of July 15, 2008. The proposed ESRD PPS would replace the current basic case-mix-adjusted composite payment system and reimbursement methodologies for separately billable outpatient ESRD services. The deadline for comment is November 16, 2009. The proposed rule, and comment instructions, are available at
http://www.federalregister.gov/OFRUpload/OFRData/2009-22486_PI.pdf.
There are earlier articles on Reimbursement.
H1N1 (Swine) Flu Tutorial from NIH MedlinePlus
We've added an NIH MedlinePlus patient-education tutorial on the
H1N1 Flu ("Swine Flu") to our H1N1 page. The tutorial can be found at
http://www.nlm.nih.gov/medlineplus/tutorials/h1n1flu/htm/_no_50_no_0.htm. Our H1N1 page is at http://www.nwrenalnetwork.org/E/H1N1.htm.
There are earlier articles on Patient Education, on
Pandemic Influenza, and on
Emergency Preparedness.
FAQs on Survey & Certification under New Conditions for Coverage
CMS has posted a series of 400 frequently asked questions - and answers - about dialysis facility survey and certification under the new Conditions for Coverage. Find them at
http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter09_56.pdf. Topics include compliance, infection control, water & dialysate quality, reuse, physical environment, the Life Safety Code, patients' rights, patient assessment & plan of care, home care, QAPI, special purpose facilities, personnel, Medical Directors, medical records, governance, acute dialysis, survey & certification, the STAR survey software, and clinical performance measures.
There are earlier articles on Survey & Certification and on
Conditions for Coverage.
UNOS HTLV-Testing Policy-Change Proposal Public-Comment Period Ends September 30
UNOS seeks public comment on a policy change proposal concerning HTLV testing. Review the proposal and submit comments before September 30, 2009 at
http://www.unos.org/PoliciesAndByLaws/PublicComment/Proposals.asp.
There are earlier articles on Transplantation.
New Myfortic Label Warning on PRCA Anemia
NKF Coffee House Conversation on Emergency Preparedness September 15
The National Kidney Foundation’s “People Like Us” hosts free monthly
“Coffee House Conversations” conference calls to empower and educate individuals impacted by chronic kidney disease. The calls include experts and patients, and give you an opportunity to ask questions. The next call will be September 15, on “Get Ready for an Emergency.” For details see http://www.kidney.org/coffeehouse/.
There are earlier articles on Patient Education and on
Emergency Preparedness.
Accusure Insulin Syringe Recall
The FDA has announced the recall of two lots of Accusure Insulin Syringes because the needles can detach from the syringe. The product is 31G Short Needle, 1/2cc or 1cc, and the lot numbers are 6JCB1 and 7CPT1. Call
Qualitest Pharmaceuticals at 800-444-4011 for replacement instructions. See
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm179955.htm for full details.
There are earlier articles on Insulin-Related Recalls.
Renal Financial Resources Network Workshop September 16-18
The Renal Financial Resources Network Fall 2009 Workshop will be held in Leavenworth, Washington September 16-18, 2009. For details, schedule, and registration information, see http://www.nwrenalnetwork.org/N/RFRN2009.pdf.
There are earlier articles on Professional Meetings and on
Reimbursement.
Fishbone Diagram Template Added to Network Website
We've also added a Fishbone Diagram template to the General QI Tools section of our QI page at
http://www.nwrenalnetwork.org/QI/QI.htm#qit. &nbdp The Diagram is at
http://www.nwrenalnetwork.org/QI/Fishbone.doc.
There are earlier articles on Quality Improvement.
QAPI Tools Mailed to Network Nurse Managers
We have mailed a facility-specific Quality Assessment and Performance Improvement (QAPI) binder to Nurse Managers at Network facilities, to help facilities meet the Conditions for Coverage QAPI requirements. Each binder includes:
QAPI tools and action plan template;
An example of how to do a QAPI plan on keeping accesses visible during dialysis;
2009 Network goals;
Your Dialysis Facility Report (these have also been sent to facility Administrators and Medical Directors);
100% Lab Data results reports comparing your facility with state and Network results (100% Lab Data supplants Clinical Performance Measures data); and
Graphs comparing your 2008 prevalent-patient and incident-patient AVF rates, and long-term catheter rates, to other facilities in your region.
There are earlier articles on Quality Improvement, on
Conditions for Coverage, on
Vascular Access, on
Dialysis Facility Reports, and on
Clinical Performance Measures.
New CellCept Label Warning on PRCA Anemia
The FDA has announced that the Warnings and Adverse Reactions sections of CellCept (mycophenolate mofetil) labelling have been changed to reflect a risk of Pure Red Cell Aplasia (PRCA) anemia. For details see
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm177397.htm.
There are earlier articles on CellCept/Myfortic.
Glucose Monitoring Inaccuracies with GDH-PQQ Test Strips
The FDA has warned that glucose test strips using GDH-PQQ (glucose dehydrogenase pyrroloquinoline quinone) methods can give falsely elevated readings in the presence of non-glucose sugars such as maltose, xylose, or galactose. Inaccurate glucose readings can result in inappropriate insulin doses, which can have serious or even fatal consequences. Non-glucose sugars are found in some drugs and biologic formulations - including some PD solutions, and are produced in the body by metabolism of some drugs and therapeutic products. More detail can be found in the FDA's "Advice for Patients" letter at http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PatientAlerts/ucm177189.htm. The FDA alert is at
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm177295.htm.
There are earlier articles on Insulin-Related Recalls.
QAPI Toolkits on Catheters, Vaccination, Diabetes, Medication
The Medical Advisory Council (MAC) of the Forum of ESRD Networks has released four "MAC Toolkits" for use by facilities to help meet the QAPI (Quality Assessment and Performance Improvement) requirements of the new Conditions for Coverage. The Toolkits cover
Catheter Reduction,
Diabetes Care Coordination, Vaccination, and
Medication Reconciliation. A short introduction to the Toolkits can be found at
http://esrdnetworks.org/mac-toolkits. Find links to the four individual Toolkits on our QI page,
http://www.nwrenalnetwork.org/QI/QI.htm#mac, and a link to the Catheter Reduction Toolkit on our Fistula First page at http://www.nwrenalnetwork.org/fist1st/fist1st.htm#staff. The Forum can be found at http://esrdnetworks.org/.
There are earlier articles on Quality Improvement, on
Conditions for Coverage, on
Vascular Access, on
Diabetes, on
Immunization, and on
Medications.
The Journey of Transplant Evaluation Revised; Network Consumer News Mailed
We've mailed to facilities this week a new issue of Network Consumer News, for distribution to all patients - if you don't get one, let us know (see http://www.nwrenalnetwork.org/contact.htm). This issue updates "The Journey of Transplant Evaluation" that we first published in December 2007. This issue also includes a word search puzzle. Find the issue at http://www.nwrenalnetwork.org/P/NCN/NCNv3.1.pdf in the 2-page version, and http://www.nwrenalnetwork.org/P/NCN/NCNv3.1big.pdf for the large-print edition. The puzzle is at http://www.nwrenalnetwork.org/P/NCN/WordSearch3.1.pdf. You can find the solution to the puzzle at http://www.nwrenalnetwork.org/P/NCNP.htm.
There are earlier articles on Transplantation, and on
Network Consumer News.
June 2009 Network Census/Modality Reports Available
The June 30, 2009 Modality Reports are now available, at
http://www.nwrenalnetwork.org/modality/mode0609/modality.htm. The Network patient census has grown 5.5% over the last year – 8.5% in Oregon, 8.3% in Alaska, 7.5% in Idaho, 4.8% in Montana, and 4.5% in Washington. Home hemodialysis has increased by 9.5%, in-center hemodialysis by 5.6%, and home peritoneal dialysis by 4.4%. There are now 7.6% more Network facilities than last year at this time.
There are earlier articles on Modality Reports.
NHPCO Hospice Clinical Team Conference September 22-26
The National Hospice and Palliative Care Organization (NHPCO) will hold their tenth annual Clinical Team Conference in Denver September 22-26, 2009, with the theme of "Soaring to New Heights in Interdisciplinary Care." The first two days comprise a preconference co-sponsored by the Virginia ESRD Network on "Hospice and Palliative Care for Dialysis Patients: Past Successes, Remaining Challenges." CE/CME credits are available for counselors, nurses, pharmacists, physicians, and social workers. The conference also includes content for administrators, volunteers, and volunteer coordinators. Schedules, Registration Forms, and complete details can be found at
http://www.esrdnet5.org/NHPCO9-2009Mtg.pdf. This packet also contains a preliminary notice for NHPCO's sixth annual National Conference on Volunteerism and Family Caregiving in December in Florida.
There are earlier articles on End of Life, on
Professional Meetings, and on
Continuing Education.
Public Comment Period on UNOS Policy Change Proposals Ends September 14, 2009
UNOS is seeking public comment on seven new organ procurement policy change proposals. Review the proposals and submit comments at
http://www.unos.org/PoliciesAndByLaws/PublicComment/Proposals.asp. Comments are due by September 14, 2009.
There are earlier articles on Transplants.
Recall of Medtronic Paradigm Quick-Set Insulin Infusion Sets
The FDA has announced a nationwide recall of
Medtronic Paradigm Quick-Set Infusion Sets that are used with MiniMed Paradigm insulin pumps because the infusion sets may not deliver a proper insulin dose, which could lead to serious injury or death. Find details and recall instructions at
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm171686.htm.
There are earlier articles on Insulin-Related Recalls.
FDA Requires Labeling Changes on Immunosuppressants
The FDA has announced that it is requiring labeling changes for certain immunosuppresant drugs to reflect an increased risk for opportunistic infections, such as activation of latent viral infections, including BK-virus-associated nephropathy. The indicated drugs include Sirolimus/Rapamune, Cyclosporine/Sandimmune and generics, Cyclosporine modified/Neoral and generics, Mycophenolate mofetil/Cellcept and generics, Mycophenolic acid/Myfortic, and Tacrolimus/Prograf. For details see
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm171828.htm.
There are earlier articles on Sirolimus/Rapamune, on
CellCept/Myfortic, and on
Tacrolimus/Prograf.
Free HealthLine Educational Session on Protein and Sodium July 29, 2009
AAKP's HealthLine series of free patient education conference calls will host a session on "Understanding the Effects of Protein and Sodium in Renal Disease" on July 29, 2009. See
http://www.aakp.org/events/HealthLine/Upcoming-calls/jul09/ for full details.
There are earlier articles on Nutrition and on
Patient Education.
New Cultural Awareness Tool for Service Providers Working with American Indian/Alaska Native Patients
A division of HHS, SAMHSA, has produced a brochure to enhance cultural awareness for service providers that work with American Indians or Alaska Natives. The folding pocket-size tool is called "Culture Card: A Guide to Build Cultural Competence: American Indian and Alaska Native." More information, with downloading and ordering instructions, can be found at
http://www.samhsa.gov/SAMHSAnewsLetter/Volume_17_Number_2/AmericanIndianCulture.aspx. The downloaded version has microscopic type; we recommend ordering the folded card by phone. SAMHSA is the Substance Abuse and Mental Health Services Administration.
There are earlier articles on Communication.
FDA Warning on Lantus (Insulin Glargine)
The FDA has issued a warning that Lantus (insulin glargine) may increase the risk of cancer in patients with diabetes. For details see http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm170089.htm.
There are earlier articles on Insulin-Related Recalls.
Topic Index Page updated July 19, 2010