This ESRD facility monthly newsletter highlights the latest ESRD insights and resources. Our goal is to provide you with a resource that makes it easy for you to stay on top of trends and support you in providing the best possible care for those you work with and serve.
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In This Issue:
- News You Can Use
- Patient Services
- Home Dialysis
- Hospital Admissions, Readmissions and Emergency Visits
- Transplant
- Vaccinations
- Patient and Family Engagement
- EQRS
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“And all at once, summer collapsed into fall.” ― Oscar Wilde
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News You Can Use
We can’t let September’s Sepsis Awareness Month pass without sharing important resources. Early warning signs of sepsis and the urgency for timely intervention cannot be over-emphasized. The CDC notes that “sepsis is a leading cause of hospitalization and hospital mortality, contributing to over a third of all hospital deaths.” Those who survive sepsis may have devastating consequences, as noted in this blog post on September 13, 2023, by Katy Grainger, sepsis survivor, double amputee, patient advocate and Sepsis Alliance Board of Directors member.
“In 2018, I got a small infection on my thumb that looked unusual, so I visited an emergency room. All my vital signs were strong at the time, and there was no indication that the infection had progressed or that my body had developed sepsis. Over the next 36 hours, I developed several of the signs and symptoms of sepsis, but I didn’t realize that I was experiencing more than just the flu.
Because I did not know the signs and symptoms of sepsis, I did not realize I needed immediate medical care. My infection had gotten worse over time and had become life-threatening. I ended up losing both of my lower legs and seven partial fingers due to complications from septic shock, and I nearly lost my life.”
Read the rest of Katy’s story and find additional resources here.
“In 2018, I got a small infection on my thumb that looked unusual, so I visited an emergency room. All my vital signs were strong at the time, and there was no indication that the infection had progressed or that my body had developed sepsis. Over the next 36 hours, I developed several of the signs and symptoms of sepsis, but I didn’t realize that I was experiencing more than just the flu.
Because I did not know the signs and symptoms of sepsis, I did not realize I needed immediate medical care. My infection had gotten worse over time and had become life-threatening. I ended up losing both of my lower legs and seven partial fingers due to complications from septic shock, and I nearly lost my life.”
Read the rest of Katy’s story and find additional resources here.
Resources:
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Patient Services
Network 8 and Network 14 take your clinic safety seriously. Health care violence has increased at the same rate as violence in society. With ongoing high staff turnover, many facilities are focused on retaining and hiring new staff. These new staff members should be trained to handle difficult patient situations professionally and confidently.
Consider holding multiple conflict resolution training courses with your staff. Repeated exposure to the training and self-awareness increases the likelihood that your staff will handle challenging situations effectively. The DPC Addendum can be downloaded and used for huddles and homeroom meetings. To review the material with Network staff, contact the contacts listed below.
Consider holding multiple conflict resolution training courses with your staff. Repeated exposure to the training and self-awareness increases the likelihood that your staff will handle challenging situations effectively. The DPC Addendum can be downloaded and used for huddles and homeroom meetings. To review the material with Network staff, contact the contacts listed below.
Contacts:
Network 8: ericka.webb@allianthealth.org
Network 14: cassandra.hanna@allianthealth.org
Network 8: ericka.webb@allianthealth.org
Network 14: cassandra.hanna@allianthealth.org
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Home Dialysis
According to dialysis staff, patient fear remains among the top reported barriers to home dialysis. As with any fear, it takes time to process and overcome. Hearing stories of home dialysis success may help some patients who are interested but fearful. Two additional strategies to help patients overcome fear are:
- Whenever possible, encourage patients to participate in some level of self-care. Success in these activities could boost a patient’s confidence, leading to a renewed consideration of home dialysis and home dialysis transition. Many successful home programs begin to teach self-cannulation while patients are in-center with a familiar, trusted CCHT leading them through mastering this skill.
- Ask your patients the question, “Do you drive?” Driving requires several key cognitive attributes: conceptualization, problem-solving, multitasking, decisions at speed, rapid responses, adequate vision and manual dexterity, and, above all, confidence, self-belief, and bravery. These attributes may indicate that a patient is also a potential candidate for home dialysis.
*To view all stories, choose treatment type only*
Home Dialysis Contact: grace.robbins@allianthealth.org
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Hospital Admissions, Readmissions and ER Visits
Sepsis is common in ESRD patients and is the second leading cause of death in patients with ESRD. Sepsis is the number one diagnosis for both hospital admission and re-admission for our Networks. The only way to avoid sepsis is to prevent or quickly identify and treat infections. Everyone should know what sepsis is, understand the signs and symptoms, and know when to seek help. The chances of dying from sepsis increase by up to 8% every hour it is not effectively treated. Persons experiencing a combination of the symptoms listed below should seek urgent medical care, asking, “Could it be sepsis?”
Sepsis Alliance created an initiative, It’s About TIME, to help remember basic symptoms.
T: Temperature – higher or lower than normal
I: Infection – may have signs and symptoms of an infection
M: Mental Decline – confused, sleepy, difficult to rouse
E: Extremely Ill – severe pain, discomfort, shortness of breath
Other symptoms of sepsis can include a drop in blood pressure, rapid heartbeat, rapid respirations (breathing), chills (shivering), little or no urine output, and skin rash or change of skin color.
To learn more about sepsis and find educational materials for your patients, view the resources below.
Sepsis Alliance created an initiative, It’s About TIME, to help remember basic symptoms.
T: Temperature – higher or lower than normal
I: Infection – may have signs and symptoms of an infection
M: Mental Decline – confused, sleepy, difficult to rouse
E: Extremely Ill – severe pain, discomfort, shortness of breath
Other symptoms of sepsis can include a drop in blood pressure, rapid heartbeat, rapid respirations (breathing), chills (shivering), little or no urine output, and skin rash or change of skin color.
To learn more about sepsis and find educational materials for your patients, view the resources below.
Hospitalization Contacts:
Network 8: kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8: kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Transplant
The estimated glomerular filtration rate, or eGFR for short, measures how slowly or quickly kidneys remove a waste product called creatinine from the blood. This calculation helps doctors understand how sick a kidney patient is. There are several different eGFR calculations, and they don’t all use the same factors. Transplant centers are assessing their waiting lists and correcting waiting times for any Black kidney candidates disadvantaged by having their kidney function overestimated due to the use of a race-inclusive calculation.
As patients are referred to a transplant center for transplant consideration, ensure the race-neutral eGFR calculations are used for Black patients on their transplant application. To learn more about race-neutral eGFR calculations, read Organ Procurement & Transplantation Network’s (OPTN) article on Understanding Race & eGFR below.
As patients are referred to a transplant center for transplant consideration, ensure the race-neutral eGFR calculations are used for Black patients on their transplant application. To learn more about race-neutral eGFR calculations, read Organ Procurement & Transplantation Network’s (OPTN) article on Understanding Race & eGFR below.
Transplant Contact: arlandra.taylor@allianthealth.org
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Vaccinations
NHSN Vaccination Data Reporting
Facilities should report the following vaccination data monthly to NHSN.
Facilities should report the following vaccination data monthly to NHSN.
Updated COVID-19 vaccinations should be captured in the “up to date field.” More information can be found here.
2023-2024 Influenza Season
The 2023-2024 flu season is fast approaching. The Centers for Disease Control and Prevention (CDC) has published updated information regarding the composition of flu vaccines. To view the latest information, click here. To help promote flu vaccine, share the resources below with patients in your facility.
2023-2024 Influenza Season
The 2023-2024 flu season is fast approaching. The Centers for Disease Control and Prevention (CDC) has published updated information regarding the composition of flu vaccines. To view the latest information, click here. To help promote flu vaccine, share the resources below with patients in your facility.
Vaccination Contacts:
Network 8:kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8:kristi.durham@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Patient and Family Engagement (PFE)
CMS expects in-center and home dialysis centers to successfully develop and support a Patient-to-Patient support program. Facilities can use the peer mentoring program from the ESRD Network Coordinating Center to train patients to become peer mentors. Facilities can also use the National Kidney Foundation peer mentoring program to support their patients.
Health equity barriers may play a role in the lack of patient participation within the peer support programs. Some health equity barriers may include the inability to afford a computer, lack of computer skills, or lack of transportation for additional trips to the dialysis facility. The Network has created a list of virtual support groups to assist with overcoming these barriers. We hope these resources will benefit your patients and help your facility align with CMS expectations.
Health equity barriers may play a role in the lack of patient participation within the peer support programs. Some health equity barriers may include the inability to afford a computer, lack of computer skills, or lack of transportation for additional trips to the dialysis facility. The Network has created a list of virtual support groups to assist with overcoming these barriers. We hope these resources will benefit your patients and help your facility align with CMS expectations.
Resources:
- Dialysis Patient Citizens – Meets on the second Tuesday of the month at 3 p.m. ET for one hour. Dial 866-808-5953, meeting code 253 841 3353
- Renal Support Network
- National Kidney Foundation (peer mentoring program)
Patient and Family Engagement Contacts:
Network 8: casey.rich@allianthealth.org
Network 14: debbie.odaniel@allianthealth.org
Network 8: casey.rich@allianthealth.org
Network 14: debbie.odaniel@allianthealth.org
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EQRS
We continue to make progress towards the three EQRS goals that CMS has tasked us with. As a reminder, CMS has directed us to:
As a reminder, when emailing the Network about a specific patient issue, ONLY provide the EQRS patient ID. Never use patient names or other identifiers in the email.
- Increase the number of 2746 forms submitted on time.
- Increase the number of 2728 forms submitted on time.
- Increase the submission of forms that are greater than a year old.
- No signature date for physician and/or patient. Please get these forms signed as soon as possible once the patient is admitted to ensure timely submission. If the patient died prior to signing the form, update the attribute page with death information. You can then submit the form without the patient's signature. An MD signature is still required.
- Creatinine value outside of the acceptable window. Creatinine is the only required lab value and must be drawn within 45 days of treatment start. A value obtained more than 45 days before treatment starts or one obtained after treatment start is unacceptable.
- Only ESRD patients should have a 2728 form. If a patient is admitted for treatment of Acute Kidney Injury, DO NOT complete a 2728 form. If an acute patient is determined to be chronic after admission, use the date that the patient was determined to be ESRD for “date chronic dialysis began.”
As a reminder, when emailing the Network about a specific patient issue, ONLY provide the EQRS patient ID. Never use patient names or other identifiers in the email.
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Our mailing address is:
ESRD Network 8
775 Woodlands Parkway, Suite 300
Ridgeland, MS 39157
ESRD Network 14
4099 McEwen Rd., Suite 820
Dallas, TX 75244
Our mailing address is:
ESRD Network 8
775 Woodlands Parkway, Suite 300
Ridgeland, MS 39157
ESRD Network 14
4099 McEwen Rd., Suite 820
Dallas, TX 75244