Additional Clinical Issues
Patient Education Tool: 'Patient's Guide to Hand Hygiene' Flyer - 12/20/2011
Kimberly-Clark, as part of its healthcare-associated infections website, provides a free, downloadable flyer for patients on hand hygiene.
Download the Kimberly-Clark Patient's Guide to Hand Hygiene flyer (pdf) for use in your facility
Patient-Centered Medication Safety Poster - 9/28/2011
A new patient-centered poster addressing medication safety has been developed by the FDA and AHRQ. Click here to view.
The CDC has released updated guidelines for prevention of catheter-related infections - 4/7/2011
Replacing a 2002 edition, the new guidelines are titled "Guidelines for the Prevention of Intravascular Catheter-Related Infections" and were published April 1, 2011. You can view the guidelines by clicking here.
March 2011 Vital Signs Fact Sheet from the CDC - 3/23/2011
About 37,000 bloodstream infections happen each year to kidney dialysis patients with central lines. For more information on how to reduce central line infections, click here to view the March 2011 Vital Signs Fact Sheet from the CDC.
CDC Resource Page for Health-Care Associated Infections in Dialysis - 3/14/2011
Swine Flu Information Posted
The “widget”at the top of this page is designed to give you a quick way to access up to date information about the swine flu epidemic. Click on the appropriate links above to learn more.
If your organization has a website and you would like to include this same tool for your readers, click here to find information that your webmaster can use.
Para más información en español sobre la gripe porcina, diríjase a http://www.cdc.gov/swineflu/espanol/
MRSA Skin Infections Initiative
The U.S. Centers for Disease Control and Prevention (CDC) recently issued new MRSA materials for patients and healthcare providers. Materials include brochures, fact sheets, posters, Web graphics and a treatment algorithm related to MRSA skin and soft tissue infections. Click here to view materials.
Home Dialysis Assessment Tool
The Medical Education Institute, Inc. in Madison Wisconsin has developed a tool known as MATCH-D to help nephrologists and dialysis staff identify and assess candidates for home dialysis therapies (PD and HHD). Three categories describe patients that are excellent candidates, those who may need to have a barrier addressed first, and those who may require an alternate modality choice. Click here to access the MATCH-D tool.
Unit Self-Assessment Manual for Renal Rehabilitation
Assessment is the logical first step for any dialysis unit interested in starting or improving renal rehabilitation programming. This 38 page manual is the complete guide to the use and interpretation of the Life Options Unit Self-Assessment Tool for Renal Rehabilitation (USAT). The manual covers a range of important topics, including the rationale for unit self-assessment, a description of the USAT criteria, and explanation of scoring, suggested action steps based on scores and tips for the use of USAT. Click here to view the Unit Self-Assessment Manual.
Tools and Resources for Assessing Functional Status of ESRD Patients
The following link by the Northwest Renal Network provides some resources and tools that can aid renal social workers in the assessment of the functional status of ESRD patients.
http://www.nwrenalnetwork.org/SW/AssessFunStat.htm
Immunization Resources
The Centers for Disease Control and Prevention has a wealth of information on vaccines—including vaccines for special patient populations, vaccines for healthcare workers, vaccine information statements and much, much more. Click here to visit the CDC Vaccine and Immunization web page.
Billed as the nation's premier source of childhood, adolescent, and adult immunization information and hepatitis B educational materials, theImmunization Action Coalition isa 501(c)3 nonprofit organization working to increase immunization rates and prevent disease. The IAC creates and distributes educational materials for health professionals and the public that enhance the delivery of safe and effective immunization services. The Coalition also facilitates communication about the safety, efficacy, and use of vaccines within the broad immunization community of patients, parents, health care organizations, and government health agencies. Click here to access the full range of IAC resources. (Link opens in a new browser.)
ESRD Network 6, the Southeastern Kidney Council, Inc., has established STIC, the Safe and Timely Immunization Coalition, and has additional immunization resources available on their website.
CDC Urges Free Influenza Vaccinations for Health Care Personnel
The CDC has released formal guidance from two advisory committees strongly urging facilities to provide free influenza vaccinations to health care workers as a strategy for reducing patient morbidity and worker absenteeism. The recommendations are targeted at health care administrators and other professionals responsible for influenza infection control programs at their institutions. The two advisory committees responsible for the recommendations are the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP).
CDC Vaccination Guidelines
In June 2006, CDC released new guidelines for vaccinating kidney dialysis patients and patients with chronic kidney disease. Click here to view the guidelines.
Bone Disease - 3-13-09
In October 2004, the K/DOQI Bone Metabolism and Disease guidelines were published in the American Journal of Kidney Disease. The guidelines address 16 different facets of this complicated disease state and cover areas such as calcium and phosphorus metabolism, secondary hyperparathyroidism, vitamin D analogue administration, and metabolic acidosis. A link to the guidelines can be found here. http://www.kidney.org/professionals/kdoqi/guidelines_bone/index.htm
Mineral metabolism is also included in the newest CMS Clinical Performance Measures, released 4-1-08 http://www.cms.hhs.gov/CPMProject/Downloads/ESRDPhaseIIICPM04012008Final.pdf
Many, many resources on bone disease prevention and management can be found at this Renal Web link http://www.renalweb.com/topics/out_bonedisease/bonedisease.htm
Information on medications used for treating renal-related bone disease can be found at
- http://www.renagel.com/
- http://www.sensipar.com/
- http://www.zemplar.com/
- http://www.drugs.com/cons/phoslo.html Information target to consumer
Infection Control
Always a paramount clinical concern, space does not permit links to all applicable infection control articles or websites! The following links are included to provide the most comprehensive and expert advice available.
- CDC Dialysis-Associated Infections-Prevention and Control
- CDC At-A-Glance Guidelines (MMWR page 28-29)
- International Society for Peritoneal Dialysis (ISPD) 2005 Update
- ISPD Guidelines for treatment of peritonitis in pediatric patients
- Fact Sheet--Infection Control for PD patients
CDC reports dialysis patients face 100-fold increased risk for MRSA infections
Staphylococcus aureus is a leading cause of bloodstream and other invasive infections in the United States. S. aureus has become increasingly resistant to first-line antimicrobial agents in health-care settings. Dialysis patients are especially vulnerable to infections, frequently those caused by antimicrobial-resistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA). To assess the incidence of invasive MRSA infection among dialysis patients in the United States during 2005, surveillance data were analyzed from the Active Bacterial Core surveillance (ABCs) system. This report summarizes the results of that analysis, which estimated that, in 2005, the incidence of invasive MRSA infection among dialysis patients was 45.2 cases per 1,000 population. Persons receiving dialysis are at high risk for infection with invasive MRSA compared with the general population, in which rates of invasive MRSA have ranged from 0.2 to 0.4 infections per 1,000 population. The findings in this report underscore the need for continued surveillance and infection-control strategies aimed at reducing infection rates and preventing additional antimicrobial resistance among persons receiving dialysis. Read full report. (Link opens in a new browser.)
Compliance Issues
- "Techniques to improve compliance" (PDF file opens in a new browser)
- 4 Steps to Better Patient Compliance (link opens in a new browser)
CAHPS In-Center Hemodialysis Survey Now Available
In November 2006, the CAHPS Consortium, in cooperation with the Centers for Medicare & Medicaid Services (CMS), released the CAHPS In-Center Hemodialysis Survey for public use. This standardized questionnaire was designed to help dialysis facilities and ESRD Networks assess and improve the experiences of their patients with in-center hemodialysis.
The instrument is available in a Kit that can be downloaded from the CAHPS Web site: https://www.cahps.ahrq.gov/cahpskit/ICH/ICHChooseQX.asp. (Link opens in a new browser.)
