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News Bulletins 2010 |
The AVF-in-place rate for incident patients rose to 41.5% in the July-to-September quarter, highest since we’ve been counting! Congratulations and thank you! The higher the prevalent-patient AVF rate gets, the more important the incident-patient rate becomes, simply because there are fewer prevalent patients to convert. A number of Network facilities, with diverse circumstances, do meet the 60% goal for incident patients, so we know it’s possible. Trade in your excuses for creative ideas, and let us know which ones work!
We’ve updated our progress graphs at http://www.nwrenalnetwork.org/fist1st/fist1st.htm#progress.
There are earlier articles on Vascular Access.
CMS has announced that Phase III, the next release of CROWNWeb, will begin January 2011. Currently Network 16 is taking requests for volunteers
from its facilities in Alaska, Oregon, Idaho, Montana and Washington. There will be a minimum of 20 facilities participating in each Network for
a total of 360 facilities across the nation.
Phase III will continue with many of the features and responsibilities that were present in Phase II including:
New to Phase III: The QIMS System will be replacing the QIPS System. Due to security guidelines, CMS plans to implement a multi-factor
authentication process in the Phase III release of CROWNWeb. This verification process will involve providing users with a one-time pass code
via text message, e-mail, or phone call. More details will be released as this process is finalized.
A volunteer form has been faxed to the attention of each facility administrator in Network 16. You may also print a copy of the volunteer form
from http://www.nwrenalnetwork.org/N/CW3VolunteerForm.pdf. The Network is
requesting responses by October 8, 2010.
There are earlier articles on CrownWeb.
Topic Index
Topic Index
NANT Webinars on Buttonhole in January 2011
On January 12, 2011, NANT will sponsor a Webinar (online seminar) on the Vascular Access Buttonhole Technique, and on January 26, a Webinar on Buttonhole Complications, both presented by the Network’s Quality Improvement Director, Lynda Ball, MSN, RN, CNN. Registration must be completed by January 10. Continuing education contact hours are available, but only for NANT members. The Webinars will be recorded for later use. Find details on the postable flyer at
http://www.nwrenalnetwork.org/N/Jan2011NANTWebinars.pdf, and a registration form at
http://www.nwrenalnetwork.org/N/Jan2011WebinarReg.pdf.
There are earlier articles on Professional Meetings and on
Patient Care Technicians.
ANNA Webinars on "Save the Vein" and GI Inflammation in January and February 2011
ANNA is presenting two online Seminars or "Webinars" in January and February 2011, "Save the Vein: What Nurses Need to Know" on January 11 and 12 and "Inflammatory Gastrointestinal Disorders in Patients with CKD" on February 15 and 22. The January Webinar is free, and the fee for the February session is nominal. For more information, see
http://www.prolibraries.com/anna/?select=webinar_register.
There are earlier articles on Professional Meetings and on
Vascular Access.
ANNA PD Workshop in April 2011 in Seattle
Save April 17, 2011 for the ANNA Regional PD Workshop at Seattle Children's Hospital. There's a postable flyer at
http://www.nwrenalnetwork.org/N/AnnaPDWorkshop.pdf.
There are earlier articles on Professional Meetings.
Renal Update 2011 February 3-4 in Lynnwood, WA
The Greater Puget Sound Chapter of ANNA is presenting the Renal Update 2011 conference in Lynnwood Washington February 3-4, 2011. Topics include transplantation, pediatric dialysis and quality of life, liver dialysis, communication, infection control, vascular access, optimizing first-year outcomes, and disaster preparedness. There are discounts for registering before January 5, 2011. For details, see
http://www.nwrenalnetwork.org/N/RenalUpdate2011.pdf.
There are earlier articles on Professional Meetings.
Abbott Glucose Test Strips Recall
The FDA has announced the recall of 359 lots of glucose test strips made by Abbott Diabetes Care and sold under the brand names Precision Xceed Pro, Precision Xtra, Medisense Optium, Optium, OptiumEZ and ReliOn Ultima, because they may give falsely low blood glucose readings. For full details see
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm237910.htm.
There are earlier articles on Insulin-Related Recalls.
Fresenius Kabi RBC Exchange Sets Class I Recall
Updated Patient Education Materials Catalog
We’ve updated our list of free Patient Education Materials, at
http://www.nwrenalnetwork.org/P/PtEdMaterials.pdf, as well as the accompanying order forms - in English at
http://www.nwrenalnetwork.org/P/FreeEdMats.pdf and in Spanish at
http://www.nwrenalnetwork.org/P/gratuitos.pdf. There are additional resources for patients on our Patient Page at
http://www.nwrenalnetwork.org/P/PTS.htm.
There are earlier articles on Patient Education.
NANT Symposium March 8-10, 2011 in Las Vegas
The 2011 NANT Symposium will be held March 8-10, 2011 in Las Vegas. You can find complete details, including program schedule, faculty,
hotel information, registration form, continuing education information, and scholarship application information, at
http://dialysistech.net/uploads/NANT%202011%20Symp%20Brochure%20web.pdf. Scholarship application deadline is December 31, 2010. You
can also find a one-page flyer to post at http://www.nwrenalnetwork.org/N/2011NANTSym.pdf.
There are earlier articles on Professional Meetings and on
Patient Care Technicians.
Annual Dialysis Meeting and Disasters Meeting
The 31st Annual Dialysis Meeting will be held February 20-22, 2011 in Phoenix. You can find details at
http://som.missouri.edu/dialysis/. In conjunction with this meeting, the Kidney Community Emergency Response Coalition (KCER) will
sponsor their Community Partner Meeting: Disaster & Dialysis on February 22. This free public meeting will bring together emergency managers and dialysis/transplant providers with
the intention of ensuring effective preparedness and efficient response to disasters impacting the kidney community, and proactively brainstorming acute kidney injury protocol. Find a
"Save-the-Date" poster at http://www.nwrenalnetwork.org/N/ADC.KCER.Save.pdf, and a registration form at
http://www.nwrenalnetwork.org/N/ADC.KCER.Reg.pdf.
There are earlier articles on Emergency Preparedness and on
Professional Meetings.
October AVF-in-Use Rate 65.9%!
The official numbers won’t be out till the end of the December, but our unofficial calculations for October show the Network prevalent-patient AVF-in-Use rate jumping to 65.9%, a full half-point
higher than it was at the end of September! Congratulations and Thank You!! Only sixteen catheter-to-AVF or graft-to-AVF conversions
to go to reach the Network’s 66% goal! Of course, then we’ll have to sustain it, which isn’t effortless, due to patient turnover. Since educating incident patients early enough to have
them start dialysis with an AVF in place will be a big part of that, we’re starting a new monthly data series, the incident-patient AVF-in-place rate over the prior four months. We’ve added it
to our Monthly Snapshot of AVF Rates at http://www.nwrenalnetwork.org/fist1st/fist1st.htm#progress, along with a
historical time series for it so we can enjoy watching it march from its current 41.7% value, up to the 60% Network and CMS goal, and beyond. A four-month running average gives us about
a thousand incident patients, enough to make a four-percentage-point cumulative gain statistically significant, while still being reasonably timely.
There are earlier articles on Vascular Access.
2009 ELabs Final Report and Comparison Tools
We've added the final report from the 2009 ELabs 100% data collection to the Network Website, at
http://www.nwrenalnetwork.org/S/statscpm.htm, our Clinical Performance Measures page. There is also a link to this
CPM page on the QI page, at http://www.nwrenalnetwork.org/QI/QI.htm#cpm. In addition to the final report, we've added
Comparison Tools so you can compare your facility performance to that of the Network and the US, and to Network goals. An MSWord version of the Comparison Tools is also included,
should you want to modify them for your own purposes.
There are earlier articles on Quality Improvement and on
Clinical Performance Measures.
FMC PD Cycler Sets Recall
B.Braun addEase Binary Connector Class I Recall
The FDA has announced a Class I recall for the B.Braun addEASE Binary Connector because fragments of the stopper may enter a patient’s body,
which could lead to serious injury or death. For details see
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm235283.htm.
There are earlier articles on Infusion Devices.
WalkMed Triton Pole Mount Infusion Pumps Update
The FDA has issued an update to the WalkMed Triton Pole Mount Infusion Pump recall
(http://www.nwrenalnetwork.org/news_bulletins10D.htm#tri11c). See
http://www.fda.gov/Safety/Recalls/ucm234902.htm for details.
There are earlier articles on Infusion Devices.
Emergency Manager Section Added to Network Website
We've added a new section to our Emergency Preparedness web page, for Emergency Managers - see
http://www.nwrenalnetwork.org/E/emergency.htm#mgrs - and added links to maps and tables of dialysis population by
county and zip code, along with the first of a series of WebEx online seminars for Emergency Managers.
There are earlier articles on Emergency Preparedness.
New Buttonhole Articles and QI Web Page Updates
We've added two new articles to the Fistula First section of our QI web page
(http://www.nwrenalnetwork.org/QI/QI.htm#ff) and the new Buttonhole Cannulation section of our
Fistula First web page (http://www.nwrenalnetwork.org/fist1st/fist1st.htm#cann),
one on "The Buttonhole Technique: Strategies to Reduce Infections" and the other on "How Do You Prevent Indented Buttonhole Sites?" or "Hubbing."
They're both CNE-available Nephrology Nursing Journal articles by Network QI Director Lynda Ball. The Hubbing article is co-authored by
Stuart Mott. We've also made a number of small improvements to the QI and FF web pages, including the addition of "An Overview of Network QI
Projects for 2009-10" at http://www.nwrenalnetwork.org/QI/QIPOview09.pdf.
There are earlier articles on Vascular Access and on
Quality Improvement.
Introductory Buttonhole Cannulation Document
We've added a new document describing how to cannulate a buttonhole site, for those professionals unfamiliar with the technique, called "Accessing AV Fistulas That Have Buttonhole Sites." We've placed it on our Quality Improvement page at
http://www.nwrenalnetwork.org/QI/QI.htm#ff, and on our Fistula First page at
http://www.nwrenalnetwork.org/fist1st/fist1st.htm#cann.
There are earlier articles on Vascular Access.
AVF Progress Updates
We've also updated the AVF Progress section of our Fistula First page, at
http://www.nwrenalnetwork.org/fist1st/fist1st.htm#progress. We've updated the graphs of incident and prevalent access rates by state, and the graphs of AVF rates by Network, to the latest year-end, and updated the access rates graphs by facility to August 2010.
There are earlier articles on Vascular Access.
SIGMA Spectrum Infusion Pump Class I Recall
The FDA has announced a Class I recall of the SIGMA Spectrum Infusion Pump Model 35700, due to the possibility of pump
failures that could result in serious injury or death. Find details, including relevant serial numbers, at
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm233747.htm.
There are earlier articles on Infusion Devices.
September Patient Census
The September 2010 Modality Reports (Patient Census) are now available, at
http://www.nwrenalnetwork.org/modality/mode0910/modality.htm. For the Network overall, year-over-year growth in the dialysis population was 6.4%, ranging from 2.8% in Montana to 10.8% in Idaho. The Oregon dialysis population grew 7.5%, Washington 5.6%, and Alaska 5.2%. Home dialysis grew 9.0%, while in-center dialysis grew 6.0%, though home dialysis remains only 14.3% of the Network dialysis population. The most recent national numbers are for 2008 (the 2010 USRDS Annual Data Report just arrived today – see http://www.usrds.org/adr.htm), but the national home dialysis percentage was then only 8.0%. The corresponding home hemodialysis rates were 2.3% (Network 2010) and 1.0% (US 2008).
There are earlier articles on Patient Census (Modality Reports).
September AVF Rates
The AVF-in-use rate among Network prevalent hemodialysis patients remains frozen between 65.3% and 65.4%, where it’s been since June. The end-of-September rate was 65.39%. We need 60 new fistulas, net (that is, 60 plus replacements, plus two thirds of new patients) to meet the Network’s 66% goal. The average-size Network facility (60 patients) needs to
convert only one additional graft or catheter patient to a fistula (and replace all lost fistulas) to do their share – that should be easy, right? When we divide the Network up into regions, Idaho (57%), Montana (59%), and the Portland Area (63%) have the most work to do. Eastern Washington has been catching up fast; they’re up to 65.6%, only half a point to go. The rest of Oregon leads the pack, at 71%. Let us know how we can help fire up your Access Team.
Triton Pole Mount Infusion Pump Recall
The FDA has announced a recall of specific serial numbers of WalkMed’s Triton Pole Mount Infusion Pump because the pump may deliver incorrect dosages. See
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm233014.htm for the recalled serial numbers and other details.
There are earlier articles on Infusion Devices.
AVF Education Videos
The Fistula First Breakthrough Initiative and the NIH
National Kidney Disease Education Program have created a series of one- to three-minute videos with examples of a nephrologist explaining various aspects of AVF placement to a patient. You can find them at
http://www.fistulafirst.org/ProviderEducationalVideos.aspx on the FFBI website, and
http://www.nkdep.nih.gov/professionals/providereducation/index.htm on the NKDEP website. We’ve also added links from the ESRD Staff section of our Fistula First page, at
http://www.nwrenalnetwork.org/fist1st/fist1st.htm#staff. The NKDEP page,
http://www.nkdep.nih.gov/professionals/providereducation/index.htm, also includes links to many other educational videos on kidney disease.
There are earlier articles on Vascular Access.
Hospira Symbiq Infusers Class I Recall
The FDA has announced another Class I Recall of Hospira Symbiq One-Channel and Two-Channel Infusers, this
time for motor encoder failures that cause the infuser to stop operating. For full details, including links to earlier recalls, see
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm232568.htm.
There are earlier articles on Infusion Devices.
New B.Braun Heparin Recall
The FDA has announced that B.Braun has recalled seven lots of Heparin injection. Full details can be found at
http://www.bbraunusa.com/news-2010-10-28.html.
There are earlier articles on Heparin.
Online Quality Improvement Presentations on AVF and hgb
The Network has added the following online Web-Ex presentations to the Network website, at
http://www.nwrenalnetwork.org/QI/QI.htm#qip10:
Creating Secondary AV Fistulae from Grafts,
Assessing AV Fistula Maturation,
Reducing Long-Term Catheters, and
Improving Sub-Optimal Hemoglobins.
These were created for the Network Quality Improvement Program, but they are available for use and a good resource for QAPI programs for any facility.
There are earlier articles on Vascular Access and on
Quality Improvement.
CareFusion Alaris PC Units Model 8015 Recall
Excelsior Saline Flush Syringes Recall
Kidney Research Institute Open House October 20
Comments Requested on Transplant Policy Changes
The United Network for Organ Sharing (UNOS, aka OPTN, or the Organ Procurement and Transplantation Network), has proposed six policy changes for your review. Public comment is
sought until February 5, 2011. Review the proposals, and comment, at
http://optn.transplant.hrsa.gov/policiesAndBylaws/publicComment/proposals.asp.
There are earlier articles on Transplantation.
NKF Authors Luncheon November 13 in Portland
The National Kidney Foundation is sponsoring an Authors Luncheon in Portland on November 13, 2010. The fundraiser will allow you to meet and hear stories from nationally known authors
Condoleezza Rice, Armisted Maupin, Tom Lichtenheld, Julie Powell, Stacy Schiff, and Jacqueline Winspear. For details see
http://www.nwrenalnetwork.org/N/NKFAuthors.pdf.
There are earlier articles on Patient Meetings.
Fistulas That Work - Surgeon Training, Chicago, November 12
All surgeons who perform vascular access surgeries for hemodialysis patients are invited to attend the Fistula First Breakthrough Initiative's one-day comprehensive training session on
"How to Make Fistulas That Work," in Chicago on November 12, 2010. The American College of Surgeons will award 8.25 AMA PRA Category 1 Credits to attendees. Since this list
doesn't reach many surgeons, we're depending on you to get this information to your access surgeon(s). Seminar details can be found at
http://www.fistulafirst.org/Calendar/SurgeonTraining.aspx, and registration is at
http://www.esrdnet5.org/FFBIMtg2010.asp.
There are earlier articles on Vascular Access and on
Professional Meetings.
ANNA Audio Conference on Gastrointestinal Complaints November 9
The Greater Puget Sound Chapter of ANNA will present an audio conference on "Common Gastrointestinal Complaints from Patients with Chronic Kidney Disease" on November 9, 2010 in
three Washington locations. The fee is nominal, and contact hours are available. For details, see
http://www.nwrenalnetwork.org/N/AudioGastroCWA.pdf (Wenatchee),
http://www.nwrenalnetwork.org/N/AudioGastroChil.pdf (Seattle), or
http://www.nwrenalnetwork.org/N/AudioGastroPSKCS.pdf (Mountlake Terrace).
For locations in other Network regions, contact your local ANNA chapter.
There are earlier articles on Professional Meetings.
Paired Donation Transplant Pilot Program Beginning
"Paired Donation" occurs when someone needing a transplant has found a donor but they are medically incompatible, and they are able to team up with
another medically incompatible pair to create two compatible transplants. As you can imagine, it's not easy for these two recipient-donor pairs
to find one another. The national Organ Procurement and Transplantation Network (OPTN), operated by the United Network for Organ Sharing (UNOS),
will begin a pilot program this month to match such pairs on a national scale. Candidates for the program should contact one of the three
participating Network transplant centers: Legacy, Swedish, or Virginia Mason. Find contact information for these centers at
http://www.nwrenalnetwork.org/transplant_centers.htm, and more information about the
program at http://optn.transplant.hrsa.gov/news/newsDetail.asp?id=1404.
There are earlier articles on Transplantation.
AAMI Webinars on Hemodialysis Standards
The Association for the Advancement of Medical Instrumentation (AAMI) is presenting a series of four two-hour Webinars (online seminars) on the new hemodialysis standards.
The Webinars cover Dialysate (RD52) on October 5, Water Treatment (RD62) on October 12, Reprocessing (RD47) on October 19, and Concentrates (RD61) on October 26. AAMI
recommends the programs for PCTs, biomedical and reprocessing technicians, RNs, regulatory/compliance personnel, and facility administrators. Find details, including fees,
registration instructions, agenda, faculty, and contact hour details for NANT and ANNA, at
http://www.aami.org/meetings/webinars/web.2010.dialysis.html.
There are earlier articles on Professional Meetings, on
Regulations and Standards, and on
Water Treatment.
CROWNWeb Phase III
CROWNWeb Phase III Announcement – Request for Network 16 Volunteers:
· Entering or Reviewing 100% CPM data for Hemodialysis and Peritoneal patients along with monthly vascular access data,
· Entering 2728 and 2746 form data into CROWNWeb, and
· Admitting and Discharging patients via single user interface or batch process, and verifying data via the CROWNWeb PART (Patient Attribute and
Related Treatments) tool.
Topic Index Page updated April 12, 2011