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
- Behavioral Health: Palliative Care
- Home Dialysis: Attitude Is Everything
- Hospital Admissions, Readmissions and Emergency Visits
- Transplant
- Vaccinations: Back to Basics
- Patient and Family Engagement: Annual Patient Advisory Committee Recruitment
- EQRS
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“Stop worrying about missed opportunities and start looking for new ones.”― I. M. Pei, a Chinese-American architect
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News You Can Use
Giving Credit Where Credit Is Due
There were two important occasions in March that we should not let pass without notice: National Social Work Month and National Nutrition Month. Social workers and dietitians play vital roles in the patient care team, and we want to take this opportunity to recognize and appreciate all the hard work they do to ensure patients receive the best possible outcomes. Similarly, we would also like to acknowledge Administrative Professionals Week, which takes place from April 21-27. We work closely with administrative assistants and are genuinely grateful for their help in keeping everything running smoothly. Lastly, May is National Nurses Month, and we would like to express our gratitude to all the nephrology nurses who have chosen this profession. Your work is seen and appreciated more than you know!
Candida Auris
Last August, we distributed a resource on Candida auris to Tennessee facility managers on behalf of the Tennessee Department of Health. Similarly, the Texas Department of State Health Services (DSHS) provided a resource for Network 14 facilities that was distributed via email to all Network 14 facility managers. Candida auris, a highly drug-resistant fungus, poses a serious threat as it can cause severe infections and easily spread among patients in health care facilities, including dialysis facilities. Here are a few important recommendations regarding C. auris:
There were two important occasions in March that we should not let pass without notice: National Social Work Month and National Nutrition Month. Social workers and dietitians play vital roles in the patient care team, and we want to take this opportunity to recognize and appreciate all the hard work they do to ensure patients receive the best possible outcomes. Similarly, we would also like to acknowledge Administrative Professionals Week, which takes place from April 21-27. We work closely with administrative assistants and are genuinely grateful for their help in keeping everything running smoothly. Lastly, May is National Nurses Month, and we would like to express our gratitude to all the nephrology nurses who have chosen this profession. Your work is seen and appreciated more than you know!
Candida Auris
Last August, we distributed a resource on Candida auris to Tennessee facility managers on behalf of the Tennessee Department of Health. Similarly, the Texas Department of State Health Services (DSHS) provided a resource for Network 14 facilities that was distributed via email to all Network 14 facility managers. Candida auris, a highly drug-resistant fungus, poses a serious threat as it can cause severe infections and easily spread among patients in health care facilities, including dialysis facilities. Here are a few important recommendations regarding C. auris:
- Reinforce the importance of using alcohol-based hand sanitizer. This is the preferred method of cleaning hands unless hands are visibly soiled.
- Place dialysis patients with C. auris on transmission-based precautions and in an isolation room or area. If possible, provide space between other patients.
- Wear a gown and gloves when caring for patients with C. auris or touching items at their station. Discard the gown and gloves before leaving the patient station.
- Clean the patient’s environment using a disinfectant from EPA’s List P or List K.
- Inform and educate appropriate personnel about C. auris control measures.
- Clearly communicate C. auris status to any receiving health care provider.
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Behavioral Health: Palliative Care
Can patients who are on dialysis receive palliative or hospice care? Patients who are on dialysis often have many health-related problems, which makes it difficult for the patient or family to manage alone. Palliative care focuses on improving the quality of life for patients with serious illnesses. This type of care can be provided alongside curative treatment such as dialysis. Palliative care helps the patient manage pain and other physical symptoms and address psychosocial, social, and spiritual needs. Palliative care often provides additional support and care for patients and families.
Hospice care, like palliative care, can provide patients and families with additional support services and pain management. Typically, hospice care can only be provided for patients who have chosen to no longer pursue curative treatments. Depending on the individual patient’s circumstances and primary diagnosis, dialysis patients can continue to receive dialysis and receive hospice care simultaneously.
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: Attitude Is Everything
Independence and an active role in health care and decision-making processes can be very rewarding to home dialysis patients. However, home dialysis can also consume patients and rule their lives, leading to burnout and potential home loss.
As members of the home dialysis team, try to keep in mind that “dialysis patients” are actually “people on dialysis”—people with a disease that requires treatment. Encourage patients to view home dialysis as the treatment that keeps them alive so they can be whoever they want to be.
This shift in attitude can provide meaningful change to continue to motivate patients, especially home dialysis patients or future home patients. "How to Stay Motivated to Do Home Hemo," penned by a home dialysis patient for Home Dialysis Central, discusses the importance of a positive attitude with home dialysis.
As members of the home dialysis team, try to keep in mind that “dialysis patients” are actually “people on dialysis”—people with a disease that requires treatment. Encourage patients to view home dialysis as the treatment that keeps them alive so they can be whoever they want to be.
This shift in attitude can provide meaningful change to continue to motivate patients, especially home dialysis patients or future home patients. "How to Stay Motivated to Do Home Hemo," penned by a home dialysis patient for Home Dialysis Central, discusses the importance of a positive attitude with home dialysis.
Home Dialysis Contacts:
Network 8: katherine.buntin@allianthealth.org
Network 14: grace.robbins@allianthealth.org
Network 8: katherine.buntin@allianthealth.org
Network 14: grace.robbins@allianthealth.org
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Hospital Admissions, Readmissions and ER Visits
After reviewing the ICD-10 code claims for ESRD Inpatient Admissions, Readmissions and ER Visits, it has been found that the top diagnoses remain the same: hemorrhage due to vascular prosthetic devices, hyperkalemia, and fluid overload. To avoid access problems, it is recommended to have a designated vascular access manager and educate staff and patients on vascular access assessment, maintenance, and common complications.
Facilities reported that missed or shortened treatments are the primary drivers behind hyperkalemia and fluid overload. Our Patient Advisory Committee suggests using games and activities to engage patients and encourage attendance. Successful facilities also recommend this approach. Simple compliance challenges between shifts, days of the week, or sister facilities may motivate some patients. If you need ideas, please reach out! Additionally, the resources below can help address various issues to help dialysis patients stay well and prevent unplanned hospitalizations.
Hospitalization Contacts:
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Transplant
A new feature added to EQRS is the Dialysis Facility Transplant Waitlist. This feature provides a dashboard that displays EQRS and United Network for Organ Sharing (UNOS) information for all patients in a facility who are waitlisted with one or more transplant centers. The dashboard also includes contact information for those transplant centers, patients listed as “Temporarily Inactive,” and the reasons for their inactivity or removal. EQRS users can download and print the dashboard information by clicking the download CSV button.
This information can be used with your internal tracking tool to:
- Keep track of a patient’s waitlist status.
- Communicate with transplant centers where patients are listed.
- Assist patients in maintaining their active transplant status to successfully receive a kidney transplant.
Transplant Contact: arlandra.taylor@allianthealth.org
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Vaccinations: Back to Basics
Flu and Pneumonia
Influenza: Flu season is from August 1 through April 30 for our contract. Compare your internal flu rates to those recorded in EQRS, making edits as needed. If facility data is batch uploaded to EQRS, ensure that any vaccines recorded on paper have been properly entered into the patient electronic record so it can batch uploaded correctly.
Influenza: Flu season is from August 1 through April 30 for our contract. Compare your internal flu rates to those recorded in EQRS, making edits as needed. If facility data is batch uploaded to EQRS, ensure that any vaccines recorded on paper have been properly entered into the patient electronic record so it can batch uploaded correctly.
Pneumococcal: The PCV20 vaccine is the “easy button.” One shot and DONE! If you don’t have PCV20, administer one PCV13, followed by a PPSV23 eight weeks later, with ONE booster dose of PPSV23 five years after the initial vaccination.
For each of these vaccines, if patients decline vaccinations due to religious or philosophical reasons, document those reasons in the medical record or directly into EQRS if your system does not include this field.
Patient-specific flu and pneumococcal data, including reasons for declination, can be accessed from the EQRS vaccination dashboards that are located here:
For each of these vaccines, if patients decline vaccinations due to religious or philosophical reasons, document those reasons in the medical record or directly into EQRS if your system does not include this field.
Patient-specific flu and pneumococcal data, including reasons for declination, can be accessed from the EQRS vaccination dashboards that are located here:
COVID-19
CMS continues to monitor both staff and patients' COVID vaccinations. Please record those correctly in the patient record so the batch upload to NHSN is correct. If you enter data directly into NHSN, enter these vaccinations each month.
*IMPORTANT: The CDC issued new guidance for dialysis facilities on COVID-19 vaccinations on March 31. In short, individuals (patients and staff) are only up to date after receiving two doses of the updated 2023-2024 COVID-19 vaccine or one dose of the updated 2023-2024 COVID-19 vaccine in the past four months.
CMS continues to monitor both staff and patients' COVID vaccinations. Please record those correctly in the patient record so the batch upload to NHSN is correct. If you enter data directly into NHSN, enter these vaccinations each month.
*IMPORTANT: The CDC issued new guidance for dialysis facilities on COVID-19 vaccinations on March 31. In short, individuals (patients and staff) are only up to date after receiving two doses of the updated 2023-2024 COVID-19 vaccine or one dose of the updated 2023-2024 COVID-19 vaccine in the past four months.
- There is no change to the up-to-date definition for individuals younger than 65. Therefore, individuals younger than 65 are up to date when they have received one dose of the updated 2023-2024 COVID-19 vaccine (any time since it was approved in September 2023).
- Continue to count health care personnel under the age of 65 as up to date if they have received one dose of the updated 2023-2024 COVID-19 vaccine.
- The up-to-date definition change for individuals 65 years and older will occur at the start of Quarter 2 of 2024 (the week of April 1-7, 2024).
Vaccination Contacts:
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Patient and Family Engagement (PFE): Annual Patient Advisory Committee Recruitment
Networks 8 and 14 seek patients from all modalities to join the ESRD Network Patient Advisory Committee (PAC). Caregivers/family members are welcome to apply as well. These individuals will be the voice for patients in Network 8 (Alabama, Mississippi, Tennessee) and Network 14 (Texas). There are opportunities to work with other organizations and CMS as well. Please provide the recruitment flyer and application linked below to any patient who would be willing to help their fellow ESRD patient.
PAC members should:
PAC members should:
- Be involved with their facility and fellow patients
- Be willing to represent patients of all treatment modalities
- Have at least one year as an ESRD patient
- Have some computer knowledge, especially email
- Be willing to provide feedback on Network patient education materials
- Provide feedback on Network Quality Improvement Activities (QIA)
- Identify the needs of renal patients and their caregivers
Resources:
Network 8:
Network 14:
DO NOT email PAC application forms. Network fax numbers are in the Recruitment Flyer's lower right-hand corner.
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
Congratulations to those who completed their annual 2744 report! We are in the home stretch and working furiously to complete all reviews by the end of March. If you haven’t completed your 2744, check your email and follow up as requested.
If you were unable to attend the March 14 EQRS Town Hall featuring information on ESRD data reporting deadlines, ESRD Quality Reporting System (EQRS) updates, including the Form CMS-2728 updates, the Facility Influenza Vaccination Dashboard, the new medication reconciliation reporting field, the CMS-2744 Annual Facility Survey, and frequently asked questions, the presentation and recording can be accessed here.
If you were unable to attend the March 14 EQRS Town Hall featuring information on ESRD data reporting deadlines, ESRD Quality Reporting System (EQRS) updates, including the Form CMS-2728 updates, the Facility Influenza Vaccination Dashboard, the new medication reconciliation reporting field, the CMS-2744 Annual Facility Survey, and frequently asked questions, the presentation and recording can be accessed here.
Finally, April EQRS New User Training is scheduled for April 16 at 2 p.m. ET.
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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