A Periodic Newsletter from The Mid-Atlantic Renal Coalition | www.esrdnet5.org
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February 5, 2016 
MARC e-lerts 
The Mid-Atlantic Renal Coalition (MARC) distributes MARC e-lerts to share important information affecting the Network 5 renal community.  We hope you find this edition's reminders, educational opportunities, tools, and resources helpful.  
NOTE: To ensure delivery to your inbox, please add marc@nw5.esrd.net to your address book. 

Message from the Director
In this issue, we report on two serious health concerns for dialysis patients: cardiac arrests of undetermined cause and the importance of infection control in light of a recent uptick in the incidence of Hepatitis C Virus. Please read this information carefully and share it with those in your facility. Attention and adherence to patient safety standards not only improve the quality of care we provide to patients; they saves lives.

In this issue, you'll also find information on this month's Virtual Council Meeting and opportunities to receive training on the CMS-2744, which is due to the Network on April 1. The HAI LAN hosts its first learning session on bloodstream infections this month. Please share these and other learning opportunities with your colleagues and patients.

We hope you enjoy this issue!

Nancy Armistead
Executive Director, MARC

CardiacArrestCDC Issues Health Alert: Undetermined Cause of Cardiac Arrest During Dialysis
The Connecticut Department of Public Health (CT DPH) has received reports of six patients who experienced sudden cardiovascular collapse leading to cardiac arrest during routine outpatient hemodialysis. Three of the six expired. Four cases occurred in one clinic on December 18 and 19, 2015, and on January 12, 2016. There have been two other cases, one on December 18, 2015, in a separate clinic, and one on December 30, 2015, in a third clinic. These events occurred 30 to 135 minutes after the initiation of the hemodialysis treatment and not immediately following administration of a medication. The three cases who expired had findings suggestive of an anaphylactic reaction (airway edema noted clinically and/or during autopsy and elevated serum tryptase level). 

While such events occur among hemodialysis patients during their treatment, this number of events clustered in time appears to be unusual. Therefore, CT DPH and the Centers for Disease Control and Prevention (CDC) are collaborating on an investigation. Possible etiologies under consideration include contamination of medications or medical devices.

The CDC is requesting notification about similar cases that may have occurred in other dialysis centers from November 2015 to present. They are specifically requesting notification of the following:
  1. A patient who had cardiovascular collapse and/or cardiac arrest during hemodialysis with signs/symptoms of anaphylaxis;
  2. A patient who had severe anaphylactic reaction during hemodialysis without cardiac arrest; or
  3. Two or more patients in the same facility who had cardiac arrest without anaphylaxis that occurred during hemodialysis within 24 hours of each other, from November 2015 to present.
Please forward information to haioutbreak@cdc.gov.

VirtualCouncilMeeting24Join Us for the 2016 Virtual Council Meeting
The Network will host its annual Virtual Council Meeting webinar on February 25.  Please join us for this FREE continuing education (CE) credit opportunity.  It is strongly recommended that each facility have at least one representative on this call, as MARC staff will describe Network 5's 2016 focus, which emphasizes patient- and family-centered care and provider collaboration with the Network, and also provide an opportunity for open Q & A.   Register your facility.

Patient Safety 
Join the 5-Diamond Patient Safety Program for 2016
More than 1,300 facilities participated in the 2015 5-Diamond Patient Safety Program year, engaging 33,000 dialysis facility personnel to focus on and further patient safety education for over 150,000 patients. As of February 1, more than 450 dialysis facilities nationally have already signed on to participate in the 2016 5-Diamond Patient Safety Program year. Join the 8,100 dialysis facility personnel who have already signed up to make patient safety a focus again for 2016.
  • Participation is FREE
  • Recognition is FREE
  • The National Nephrology Certification Commission (NNCC) recognizes completed modules toward CCHT recertification requirements
  • The program is endorsed by the American Nephrology Nurses' Association (ANNA), Renal Physicians Association (RPA), National Renal Administrators Association (NRAA), American Association of Kidney Patients (AAKP), Dialysis Clinics Inc. (DCI), and Fresenius Medical Care (FMC)
Learn more or register to join the program.

CMS2744OCT Offers Training on CMS-2744
Here is the timeline for the CMS-2744 Annual Facility Survey:
  • February 15: Deadline for generating the 2744
  • April 1: Deadline for submitting the balanced 2744 with any comments to the Network
The Outreach, Communications, and Training Team (OCT) will provide CMS-2744 training on Thursday, March 3. During this webinar session, attendees will gain an understanding of the purpose of the CMS-2744 form and how it impacts facilities, how to complete the CMS-2744, and how to utilize CMS-2744 reports to resolve errors. Attendees can register via the CROWNWeb training calendar.

Infection Prevention
HepCCDC Issues Health Advisory: Hepatitis C Virus Transmission in Patients Undergoing Hemodialysis
The Centers for Disease Control and Prevention (CDC) has received an increased number of reports of newly acquired hepatitis C virus (HCV) infection among patients undergoing hemodialysis. Infection control lapses in dialysis care could expose patients to HCV. Any case of new HCV infection in a patient undergoing hemodialysis should prompt immediate action. CDC is urging dialysis providers and facilities to:
  1. Assess current infection control practices and environmental cleaning and disinfection practices within the facility to ensure adherence to infection control standards;
  2. Address any gaps identified by the assessments;
  3. Screen patients for HCV, following CDC guidelines, to detect infections, determine treatment potential, and halt secondary transmission; and
  4. Promptly report all acute HCV infections to the state or local health department.
More information can be found on the CDC website.

NHSN Outpatient Dialysis Center Practices Survey is Released
The 2016 Outpatient Dialysis Center Practices Survey (required for Dialysis Event reporting) became available in NHSN on February 1. Many questions in the 2016 survey pertain to the first week of February; therefore, NHSN users are encouraged to begin the survey on or after February 1. The survey cannot be submitted to NHSN (i.e., "saved as complete") until after the first week of February. Please contact the NHSN helpdesk (nhsn@cdc.gov) for questions, and enter "Dialysis" in the subject line.

HAILANYou're Invited to Join the First HAI LAN Learning Session of 2016
Catheter-related bloodstream infections (CRBSIs) equate to 10-20% of all healthcare-associated infections (HAIs). CRBSIs are the most common cause of nosocomial bacteremia and possess a mortality rate of 25%, resulting in an increased length of hospital stay and high treatment costs. Patients dialyzed through catheters are two to three times more likely to be hospitalized for infection and die of sepsis than patients who dialyze with an AVF or AVG. Given these statistics, patients dialyzing via catheters have a higher risk of acquiring a BSI from their vascular access.

We invite you to join our first HAI learning session of 2016 to hear Tamara Kear, PhD, RN, CNN, present on the incidence of infections in the nephrology patient population and what nephrology nurses can do to prevent and mitigate infections. You will also hear from Heather Weirich, BSN, RN, CNN, on how being an active member of the CDC's BSI Collaborative and implementing the CDC Core Interventions decreased her dialysis facilities' bloodstream infection rates. Look for updates on the learning session to be posted on the HAI LAN webpage.

OPTN/UNOS Requests Public Comment on Policy and Bylaw Proposals
The Organ Procurement and Transplantation Network (OPTN)/ United Network for Organ Sharing (UNOS) has offered nine proposals, developed by its committees, for public comment. When the public comment period ends on March 25, each sponsoring committee will review the feedback it received and consider modifications to the original proposals. The OPTN/UNOS Board of Directors may then review and vote on these proposals at its meeting on June 6 and 7. Please provide your comments on these proposals. You may also continue to send general feedback to publiccomment@unos.org. Please submit all comments no later than March 25. For general questions about the proposals, please contact your Regional Administrator at (804) 782-4800.

OPTN/UNOS welcome your feedback on these proposals and other aspects of the public comment process as it continues to improve the way that it communicates with the community.
Thank you in advance for your careful review and feedback on these proposals.

Patient Services
NKF Seeks Nominations for Kidney Living Editorial Board Members
Kidney Living is a quarterly magazine specifically designed for all dialysis patients, their families, and care partners.  New patients and professionals are being sought to serve on the editorial board.  Members will help suggest topics, develop and solicit content, and edit material. Editorial board members will need to be available for quarterly conference calls and also maintain regular communication via email.  The term of service is for a minimum of 1 year and can be renewed by the National Kidney Foundation (NKF) on a yearly basis.   Applications and nominations will be reviewed by NKF staff, and appointments will be made by March 2016. Direct questions to Kelli Collins at kelli.collins@kidney.org.   

Patient Resources
AAKP Offers FREE HealthLine Conference Calls
The American Association of Kidney Patients (AAKP) presents monthly FREE HealthLine conference calls for patients. Encourage your patients to join the upcoming call:

February 24: "The Importance of Exercise for All Stages of Kidney Disease"

Find more information about these calls, and how to register. For recordings of previous HealthLine calls, visit the AAKP website

Patient Resources: Recovering Emotionally from Disaster
Disasters are stressful and emotionally upsetting for everyone affected, especially children, the elderly, and those with chronic illnesses or access issues. Check out the American Psychological Association's mental health resources for recovering emotionally from disasters.
  • Recovering Emotionally from Disaster (English)
  • Recovering Emotionally from Disaster (Spanish)

ESRD NCC Offers Catheter Freedom Tools
The ESRD National Coordinating Center (NCC) has announced new Fistula-First-Catheter-Last tools for access planning and monitoring. The Vascular Access Planning Guide for Renal Professionals is a comprehensive guide with all the steps in planning for and placing an arteriovenous (AV) fistula or an AV graft. It is a companion resource to Lifeline for a Lifetime: Planning for Your Vascular Access, the access planning guide for use in educating patients. The "Ready Set Go" tools were designed to aid renal professionals in understanding the stages of fistula maturation and graft healing and to help you educate patients, including companion patient resources. Learn more

NANT Annual Symposium is Scheduled for March 21-24
The National Association of Nephrology Technicians (NANT) Annual Symposium provides up to four days of dialysis technician-focused education. Technicians who participate in all four days can earn 25 contact hours. View complete information  

47th ANNA National Symposium Will Be Held in May
ANNA will be hosting its 47th National Symposium May 1 - 4 at the Marriott Louisville and Kentucky International Convention Center in Louisville, KY. The symposium provides opportunities for nephrology nurses to expand their knowledge, enhance clinical skills, and widen professional networks. For more information, visit www.annasymposium.org

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