End Stage Renal Disease (ESRD) Network 13 - Serving Arkansas, Louisiana and Oklahoma Renal Communities

ESRD Network 13


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Facility Resource Materials

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The Facility Resource Materials (FRM) provides updated materials set forth by the Network 13 Medical Review Board (MRB) and helpful information regarding the care of ESRD patients. The information is printer friendly so please feel free to copy materials as needed.

The current Network standards and recommendations are provided for reference, as well as information on disaster preparedness, infection control, patient services and other information including the updated Clearinghouse Library resource list. Use the Table of Contents to direct focus to the information needed. Place your pointer over the sections in the bar on the left for a quick view of the Table of Contents for each section, or print a copy of the expanded Table of Contents.

All applicable Quality Improvement (QI) correspondence will continue to be forwarded to the dialysis and transplant facilities. The Network QI responsibilities will continue to include:

Submittal of any required QI items to the Network;
Maintenance and knowledgeable about what QI materials are mailed to nurse managers;
The responsibility for dissemination of this information to the appropriate people in your facility.

With 280+ facilities in the Network, it is known that everyone approaches Network QI responsibilities in a variety of ways. It is our hope that the information on this site can be utilized by the facilities in improvement of ESRD patient care outcomes.

Revisions and modifications occur annually. We distribute replacement copies for inclusion in the manual each Spring/Summer. Requests for information can be done at any time by contacting the Network.

Click Here to Get a Copy of the Table of Contents

All Sections

1. Network 13 Information
(July 2009)

2. Network 13 Directives

4. CQI Resources

5. QI Activities, 2009

6. Data Abstraction Activities

7. Infection Control

8. Patient Services

9. Disaster Planning

10. Medicare Part D

11. Kidney Transplant

12. Network Patient Representative (NPR) Program

13. Clearinghouse Library for Professionals and Patients: 2009

Copy of Table of Content (pdf)

1. Network 13 Information (July 2009)

A. Network 13 Glossary of Terms

B. Listing of Board of Directors (BOD), Medical Review Board (MRB) and Network Committees (Quality Improvement, Grievance, Patient Advocacy)

C. ESRD Network 13 Office Staff

D. ESRD Network 13 Web site
http://www.network13.org

E. Network Notice of Facility Status – Guidance

Back to Table of Contents

2. Network 13 Directives

A. NETWORK STANDARDS: These standards are established by the Network with the expectation that all ESRD facilities will comply accordingly towards the provision of quality care within the renal health care community.
1. Placement of Patients in Self-/Home- Care Setting

2. Transplantation

3. Vocational Rehabilitation

4. Adequacy of Hemodialysis

5. Adequacy of Hemodialysis: Performance of Delivery of Care Audits

6. Anemia Management in Chronic Renal Failure

7. Vascular Access

a. Catheters

b. Arteriovenous Fistula (AVF’s)

c. Monitoring for Access Dysfunction

8. Nutrition in Chronic Renal Failure

9. Mineral Metabolism in Chronic Renal Failure

10. Peritoneal Dialysis (PD) Adequacy

11. Disaster Preparedness

12. Nephrologist as Dialysis Facility Medical Director

13. Facility Status Notification

14. Involuntary Discharge

B. NETWORK RECOMMENDATIONS: While not at a ‘standards’ level, the following recommendations are to be strongly considered for implementation as applicable within your renal organization.

1. Continuing Education Credits in Renal Health Care

2. Management of Hyperkalemia

3. Advance Directives

4. CMS Criteria to Determine Eligibility For the ESRD Program

5. 2008 CAHPS Survey

6. Patient Education Awareness

7. Assessment of Health-Related Quality of Life

C. NETWORK GRIEVANCE POLICY: All ESRD facilities are required to inform their patients of the Network’s grievance policy and their right to complain and/or file a grievance.

1. Grievance Poster (18” X 24” Poster available per request)

D. NETWORK 13 HIV POLICIES: All ESRD patients have the right to privacy, as well as equal treatment as directed by the Office of Civil Rights.

1. Human Immunodeficiency Virus (HIV – AIDS)

2. Understanding the Rights of HIV+ / AIDS Patients

E. NETWORK 13 PROCEDURE: ALTERNATE SANCTION RECOMMENDATION: All ESRD facilities are directed to participate towards the achievement of Network goals and objectives (e.g., Quality Improvement, Data Registry, Complaints/Grievances, etc.). Alternate sanction recommendations are directed and/or implemented at the direction of the CMS Region VI Office, Dallas, TX

F. CONCEALED WEAPONS: Sample Policy: The Network provides a sample concealed weapons policy for use in the renal communities as necessitated by state law or corporate directive.

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3. ESRD-Related Resources for Professionals and Patients

A.   UNIFORM ESRD TRANSIENT FORMS

1.    Hemodialysis

2.    Peritoneal Dialysis

B.   ESRD MEDICAL RECORDS – A NATIONAL MODEL

C. Clinical Laboratory Improvement Amendments (CLIA) / Regulations http://www.cms.hhs.gov/clia/

D. KNOW YOUR OPTIONS – Medical Device and Laboratory Product Problem Reporting Program

1.    Guidance for Industry - Medical Device Tracking; Guidance for Industry and FDA Staff http://www.fda.gov/cdrh/comp/guidance/169.html

2.    Guidance for Reporting Dialysis Reactions: FDA Adverse Event Reporting

a.    To Report Online
https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm

b.   Voluntary Reporting Form
http://www.fda.gov/downloads/Safety/MedWatch/HowToReport/DownloadForms/ucm082725.pdf

c.    Mandatory Reporting Form
http://www.fda.gov/downloads/Safety/MedWatch/HowToReport/DownloadForms/ucm082728.pdf

E.   WEB SITES OF INTEREST, As of June, 2009)

a.    General Resources (Associations/Organizations)

b.    Acute Myocardial Infarction Web sites

c.    Diabetes Web sites

d.    Heart Failure Web sites

e.    Reduce Disparities Web sites—also see SDPS Intranet links

f.     Quality Improvement with Medicare+Choice Plans Web sites

g.    End Stage Renal Disease (ESRD) Web sites

F.   MEDICAL EDUCATION INSTITUTE (http://www.meiresearch.org/): A non-profit educational institute specific to chronic kidney disease, offers many educational resources for patients and professionals.

1.    Kidney School (www.kidneyschool.org)

2.    Life Options (www.lifeoptions.org)

3.    Home Dialysis Central (www.homedialysis.org)

G. DIALYSIS FACILITY COMPARE (DFC): This CMS-managed Web site provides important information and resources for patients and family members who want to learn more about chronic kidney disease and dialysis. (http://www.cms.hhs.gov/DialysisFacilityCompare/)

H. COMMUNITY OUTREACH / WEBEX SESSIONS: These Web links provide listings of current and/or ongoing community outreach opportunities.
1.   Network 13 Workshops & Events Web Page http://www.network13.org/workshop.asp
2.   IFMC Direct WebEx Hosting Web site https://ifmcevents.webex.com

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4. Continuous Quality Improvement (CQI) Resources

A. Network 13 Performance Guidance: This resource is to provide guidance in ascertaining appropriate delivery of dialysis care to patients on chronic dialysis therapy in the areas of…

· Adequacy of Dialysis

· Anemia Management

· Nutrition Management

· Mineral Metabolism

· Vascular Access Management

· Immunizations

· Infection Control

B. CQI

1. Measures of Morbidity and Mortality

C. Accelerating Quality Improvement

D. QI TOOLS - These tools are intended to provide QI tracking and monitoring resources for use in any

Facility-Specific QI application. Tools can be modified upon request to assist your Interdisciplinary

Dialysis Team in the provision of quality care.

1. Sample Quality Improvement Plans

a. Quality Improvement Project

b. QI Sample – sample “Action Plans”

c. CQI Trend Tool – (Aggregate collection tool with review and prioritization)

d. Facility Quality Indicators

e. Sample Fishbone Templates (Word™ and Excel™)

f. Cause and Effect Diagram

2. Adequacy of Dialysis

a. Hemodialysis

1. Prescription and Delivery Audit Tool and Instructions

2. Adequacy of Hemodialysis Tools – (Prescription delivery tool quantifies root cause)

3. Dry Weight Algorithm

4. Dry Weight Monitoring Tool

5. Pre- and Post-Dialysis Blood Sampling Validation Forms

6. Frequent Hemodialysis Adequacy of Hemodialysis – (conversion formula)

7. Illustrative Conversions: G-Codes/URR to stdKt/V

8. Hemodialysis Adequacy and Kinetic Modeling Channel: Hypertension, Dialysis and Clinical Nephrology (HDCN) http://hdcn.com/ch/adeq/

9. The Nephron Information Center http://nephron.com/

b. Peritoneal Dialysis

1. PD Adequacy Flow Sheet

2. Infection Control for Peritoneal Dialysis (PD) Patients: CDC Fact Sheet

3. Anemia Management

a. Anemia Management Worksheet (with medication adjustment)

b. Anemia Management Barrier Worksheet – (quantifies root cause)

4. Dialysis-Specific Infection Control Issues

a. Hemodialysis Infection Control Log – (quantitative report)

b. Peritoneal Infection Control Log – (quantitative report)

c. Peritonitis – Exit Site Infections – (sample guidelines)

d. Hand Hygiene Fact Sheet

e. Hand Hygiene Poster

5. Nutrition Management

a. Malnutrition in ESRD Patients – (Algorithm)

b. Management of Hypoalbuminemia In Adult Dialysis Patients Algorithm

c. Patient Facility Percent Albumin – (Trending tool creates graphs)

d. Subjective Global Assessment Rating Form – (Patient assessment form)

6. Vascular Access Tools

a. AVF (see Fistula First Toolkit)
http://www.network13.org/ff_tools.asp

b. AVF Functionality Tool – (Trends AVF utilization barriers with quantitative report)

c. Catheter Reduction Worksheet – (Trends Catheter barriers with quantitative report)

7. Self-/Home- Care Training Materials

a. Hemodialysis Home Training Checklist – (Patient competency checklist)

8. Water Treatment

a. Water Quality Chart

9. Hemolysis

10. Patient Plan of Care

11. Diabetic Foot Screening

a. Diabetic Foot Examination Risk Categories

b. Basic Foot Assessment Check List – (With foot diagram & Referral Action Plan)

c. Prevention of Serious Complications from Diabetes (NIH) – (Patient education sheet)

d. Preventing Foot Ulcers and Amputation – (Professional education sheet)

12. Automated External Defibrillator (AED)

a. SAMPLE Procedure: AED

b. SAMPLE Policy (supplied from Medtronic)

c. Emergency Cardiovascular Care (ECC) Class Connector
http://www.americanheart.org/presenter.jhtml?identifier=3012360

E. Institute for Healthcare Improvement (IHI)

1. An Introduction to the Model for Improvement
http://www.ihi.org/IHI/Programs/AudioAndWebPrograms/OnDemandPresentationMFI.htm

2. Building Skills in Data Collection and Understanding Variation
http://www.ihi.org/IHI/Programs/AudioAndWebPrograms/OnDemandPresentationVariation.htm

3. Using Run and Control Charts to Understand Variation
http://www.ihi.org/IHI/Programs/AudioAndWebPrograms/OnDemandPresentationMeasurement.htm

F. ESRD SURVEY AND CERTIFICATION MATERIALS

1. Measures Assessment Tool (version 1.4)

2. Outline of the Basic ESRD Survey Process

3. End Stage Renal Disease Facilities V-Tags & Identifiers

4. Personnel Requirements

5. Correlation Grid for Patient Assessment & Plan of Care

6. Principles of Documentation Overview

7. Infection Control (version 1.2)

8. Dialysis Lab Tests at a Glance

9. Chemical Contaminant Levels in Water Used to Prepare Dialysate (version 1.0)

Back to Table of Contents

5. QI Activities, 2009

A. Network 13 Annual Reports http://www.network13.org/data_report.asp#ar

2008, 2007, 2006, 2005 (PDF format)

B. National CMS Clinical Performance Measures (CPM) Activities
CMS CPM Link: http://www.cms.hhs.gov/CPMProject/02_MeasuresandDataCollection.asp

C. National ESRD Clinical Performance Measures Project

D. NETWORK 13 QUality improvement activities

1. 2009 – 2010 CPM QI Work Plan (QIWP

Back to Table of Contents

6. Data Abstraction Activities

A. CROWNWeb – (Consolidated Renal Operations in a Web-Enabled Environment)

1. Overview

2. Article – CROWNWEB – A Phased in Approach – description of the program

3. Training Modules (Power Point Presentations) LINK TO INTERACTIVE ONLINE TRAINING

a. Facility Module - Facility Personnel

b. Facility Module - Intro and Facility Info

c. Facility Module - Managing Role and Scope

d. Patient Admit Module - Admit and Discharge

e. Patient Admit Module - Completing a CMS-2728 Form

f. Patient Admit Module - Viewing and Editing Patient Attributes

g. Patient Treatment Module - Entering Clinical Values

h. Patient Treatment Module - Viewing and Verifying PART

i. Patient Treatment Module - Completing a CMS-2746 Form

B. QUALITYNET IDENTITY PROVISIONING SYSTEM (QIPS)

1. Copy of QIPS Registration Form https://www.qualitynet.org/crown/registration_form.pdf

2. Role Selection for CROWNWeb Users

3. Hard Copy Instructions:

a. Instruction for completing QIPS registration form for Facility Security Administrator (FSA)
(must be mailed to Network office for entry into QIPS system)

b. Instructions for completing QIPS registration form for User-Editor and User-Viewer
(must be entered into QIPS system by FSA and mailed directly to CMS designee)

4. Instructions for QIPS Editor/Viewer registration forms entry into QIPS system by FSA

C. QUALITYNET and SECURITY

1. QualityNet Registration Form – Secure method for electronic transfer of PHI (not CROWNWeb)

2. HIPAA Acknowledgement Form

D. PATIENT FORMS

1. CMS-2728 (Medical Evidence Report) Overview

a. Form with Instructions
http://www.cms.hhs.gov/cmsforms/downloads/CMS2728.pdf

b. CMS–2728 Form Mandatory Fields

c. Most Common Errors

d. CMS-2728 Forms Completion Training Tool

2. CMS-2746 (Death Notification) Overview

a. Form with Instructions
http://www.cms.hhs.gov/cmsforms/downloads/CMS2746.pdf

b. Most Common Errors found on CMS-2746 form

c. CMS-2746 Forms Completion Training Tool

E. NON-ELECTRONIC FACILITY REPORTING

1. Monthly Activity Reports

a. Network Patient Activity Report (NPAR) and Instructions
http://www.network13.org/Forms_Instructions/PAR.xls and
http://www.network13.org/Forms_Instructions/PAR_Instructions1.pdf

b. Patient Event Definitions and Business Rules for Facilities
http://www.network13.org/Forms_Instructions/EventDefinitionsandBusinessforFacilities.pdf

c. Helpful Hints for Completing NPAR

d. Transplant Activity Report and Instructions
http://www.network13.org/Forms_Instructions/TARFORM.pdf

e. Disaster Patient Activity Report

Back to Table of Contents

7. Infection Control

A. Recommendations for Preventing Transmission of Infections Among
Chronic Hemodialysis Patients

B. Preventative Measures for Health-Care Settings

1. Universal Precautions

2. Hand Hygiene Fact Sheet
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm

3. CDC Web site in Spanish
http://www.cdc.gov/spanish/

4. Dialysis Surveillance Report: National Healthcare Safety Network (NHSN)—
Data Summary for 2006

5. Pandemic Planning Update VI
http://www.pandemicflu.gov/plan/pdf/panflureport6.pdf

6. Complying with OSHA’s Bloodborne Pathogens Standard
http://www.osha.gov/SLTC/bloodbornepathogens/index.html

C. Hepatitis Control Measures for Dialysis Centers

1. CDC's Division of Viral Hepatitis recently redesigned its Web site, accessed at

http://www.cdc.gov/hepatitis

2. New Global Guidelines for Kidney Disease and Hepatitis C

3. Hepatitis A, B, and C: Learn the Differences
http://www.cdc.gov/hepatitis/Resources/Professionals/PDFs/ABCTable.pdf

4. Guidelines for Viral Hepatitis Surveillance and Case Management
http://www.cdc.gov/hepatitis/PDFs/2005Guidlines-Surv-CaseMngmt.pdf

5. Hepatitis B Frequently Asked Questions

http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm

6. Hepatitis B Patient Education materials

http://www.cdc.gov/hepatitis/B/PatientEduB.htm

7. Hepatitis B “What You Need To Know” (English)
http://www.immunize.org/vis/hepb01.pdf

8. Hepatitis B “What You Need To Know” (Spanish)
http://www.immunize.org/vis/sphepb01.pdf

9. Hepatitis C Frequently Asked Questions

http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm

10. Hepatitis C: “What Vaccinations are Needed?”
www.immunize.org/catg.d/p4042.pdf

11. Hepatitis C patient Education Materials

http://www.cdc.gov/hepatitis/C/PatientEduC.htm

12. Hepatitis C Test
http://www.labtestsonline.org/understanding/analytes/hepatitis_c/test.html

13. Hepatitis C Info in Spanish
http://www.hcvadvocate.org/espanol.asp#sencillos

14. Testing and Public Health Management of Persons with Chronic Hepatitis B Virus Infection
http://www.cdc.gov/hepatitis/HBV/TestingChronic.htm

15. CDC Study: Failures to Follow Infection Practices Have Placed More than 60,000 Patients at Risk for Hepatitis B and C
http://www.cdc.gov/media/pressrel/2009/r09106.htm

16. NIH Consensus Development Conference: Management of Hepatitis B
http://consensus.nih.gov/2008/2008HepatitisBCDC120main.htm

17. Hepatitis / HIV Resources Newsletter
http://www.hivandhepatitis.com/

D. Human Immunodeficiency Virus (HIV-AIDS)

1. Recommendations for Prevention of HIV Transmission in Health-Care Settings
http://wonder.cdc.gov/wonder/prevguid/p0000318/P0000318.asp

2. Sterilization or Disinfection of Patient Equipment HIV Related
http://www.cdc.gov/ncidod/dhqp/bp_sterilization_patient_care.html

3. Advancing HIV Prevention: Fact Sheet
http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/factsheets/pdf/Progress_2005.pdf

4. HIV Fact Sheets http://www.cdc.gov/hiv/resources/factsheets/index.htm

E. Prevention of Intravascular Catheter-Related Infections

1. Guidelines for the Prevention of Intravascular Catheter-Related Infections
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5110a1.htm

2. Examples of Clinical Definitions for Catheter-Related Infections
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5110a2.htm

F. Antimicrobial Resistance in the Healthcare Settings / Drug-Resistant Pathogens

1. Prevent Antimicrobial Resistance in Healthcare Setting Fact Sheet
http://www.cdc.gov/drugresistance/healthcare/dialysis/12steps_dialysis.pdf

2. Multi-Resistant Organisms in Non-Hospital Healthcare-Settings FAQ:

MRSA-VRE-ESBLS-PRSP
http://www.cdc.gov/ncidod/dhqp/ar_multidrugFAQ.html

3. Amino glycoside Resistance in Enterobacteriaceae and Pseudomonas aeruginosa
http://www.cdc.gov/ncidod/dhqp/ar_lab_amino.html

4. Vancomycin-resistant Enterococci (VRE) and the Clinical Laboratory
http://www.cdc.gov/ncidod/dhqp/ar_lab_vre.html

5. Recommendations for Preventing the Spread of Vancomycin Resistance -
US Department of Health & Human Services - September 1995
http://www.cdc.gov/mmwr/PDF/RR/RR4412.pdf

6. Methicillin-resistant Staphylococcus aureus – MRSA
http://www.cdc.gov/ncidod/dhqp/ar_mrsa.html

G. Tuberculosis

1. Tuberculosis CDC Homepage http://www.cdc.gov/tb/default.htm

2. Tuberculosis Q and A - Large File -
http://www.cdc.gov/tb/publications/faqs/pdfs/qa.pdf

3. Tuberculosis Glossary of Terms

4. Tuberculosis Fact Sheets
http://www.cdc.gov/tb/publications/factsheets/default.htm

5. Update: OSHA Enforcement Policy for Occupational Exposure to Tuberculosis
http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table
=INTERPRETATIONS&p_id=21919

6. Tuberculosis Surveillance Information/Management
http://www.cdc.gov/tb/programs/tims/default.htm

H. Immunizations

1. Adult Immunization Recommendations (Schedule USA 2009 version)
http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm

2. 2008 Childhood & Adolescent Immunization Schedules
http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm

3. Adult Vaccination Screening Forms (English and Spanish)

4. Online Vaccine Quiz
http://www2.cdc.gov/nip/adultImmSched/

5. Summary of Recommendations Immunizations
http://www.cdc.gov/vaccines/

6. Updated Infection Control Measures for Prevention and Control of Influenza in Long-Term care Facilities
http://www.cdc.gov/flu/professionals/infectioncontrol/pdf/longtermcare.pdf

7. Interim Antiviral Guidance for 2008-09
http://www.cdc.gov/flu/professionals/antivirals/

8. Updated Influenza Information
http://www.cdc.gov/flu/

9. Inactivated Influenza Vaccine 2007-2008 information in English
http://www.immunize.org/vis/2flu.pdf

10. Inactivated Influenza Vaccine 2007-2008 information in Spanish
http://www.immunize.org/vis/spflu06.pdf

11. Prevent Influenza Now Web site
http://www.preventinfluenza.org/

12. Influenza Vaccine Availability Tracking System (IVATS)

http://www.ama-assn.org/ama/pub/physician-resources/public-health/vaccination-resources/adult-vaccination/national-influenza-vaccine/influenza-vaccine-availability.shtml

13. Vaccine Information Statements http://www.immunize.org/vis/

14. Immunization Action Coalition
http://www.immunize.org/

15. Adult Shingles Immunization Information
http://www.immunize.org/catg.d/p3092.pdf

16. Prevention of Herpes Zoster
http://www.cdc.gov/mmwr/PDF/rr/rr57e0515.pdf

17. eDispense™ Information
http://www.dispensequick.com/edispense.html

18. Immunization Action Coalition: State Info
http://www.immunize.org/states/

19. Immunization Action Coalition: Coordinator Info
http://www.immunize.org/coordinators/

20. Immunization Action Coalition: Laws Info
http://www.immunize.org/laws/

21. Immunization Action Coalition: Indian Health Services (HIS) Info
http://www.immunize.org/coordinators/ihs.asp

22. CDC Statement on Oseltamivir (Tamiflu®) Resistance and Antiviral Recommendations
http://www.cdc.gov/media/pressrel/2009/s090109.htm

23. How to Administer Intramuscular (IM) Injections
http://www.immunize.org/catg.d/p2020.pdf

24. Administering Vaccines to Adults: Dose, Route, Site, Needle Size, and Preparation
http://www.immunize.org/catg.d/p3084.pdf

25. Dosing Recommendations for Anti-Virals

26. New Emergency Storage Issues

I. Other Infectious Diseases

1. INFLUENZA

i. Avian (Bird) Influenza and Avian Influenza A (H5N1) Virus Information:

a. http://www.cdc.gov/flu/avian/gen-info/pdf/avianflufacts.pdf

b. http://www.cdc.gov/flu/avian/professional/pdf/possible-exposure-avianflu.pdf

c. http://www.cdc.gov/flu/avian/professional/pdf/infectcontrol.pdf

d. http://www.cdc.gov/flu/avian/outbreaks/current.htm

e. http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm

f. http://www.cdc.gov/flu/avian/gen-info/facts.htm

g. http://www.cdc.gov/flu/avian/gen-info/qa.htm

ii. Swine Influenza (H1N1) Interim Guidance for Infection Control for Care of Patients with Confirmed or
Suspected Novel Influenza A
(H1N1) Virus Infection in a Healthcare Setting

a. http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm

iii. Dosing Recommendations for Anti-Virals used for Prophylaxis and Treatment of Influenza in ESRD Patients

2. Anthrax: What you Need to Know
http://www.bt.cdc.gov/agent/anthrax/pdf/needtoknow.pdf

3. Severe Acute Respiratory Syndrome (SARS): Preparedness and Response in Healthcare Facilities
http://www.cdc.gov/ncidod/sars/guidance/C/pdf/c.pdf

4. Responding to Detection of Aerosolized Bacillus anthracis by Autonomous Detection Systems in the Workplace
http://www.cdc.gov/mmwr/pdf/rr/rr53e430-2.pdf

J. Communicable Disease and Injury Reporting as known by state (Available via Internet)

ARKANSAS: Arkansas Disease Information

http://www.healthyarkansas.com/data/pdf/reportable_disease2004.pdf

LOUISIANA: Louisiana Disease Information

http://www.dhh.louisiana.gov/offices/miscdocs/docs-249/annual/LaIDAnnual__Diseaselist2006.pdf

OKLAHOMA: Oklahoma Disease Information

http://www.ok.gov/health/documents/Blue%20Card.pdf

Back to Table of Contents

8. Patient Services

A. Patient Education
1. Patient Education Web Links
2. Dialysis Facility Compare - http://www.medicare.gov/Dialysis/Home.asp
3. Network 13 Patient Rights & Responsibilities Poster (18” x 24” Poster available upon request)

B. Patient Centeredness

1. Patient Centered Web Links

2. Patient Centeredness In the Dialysis Unit (Power Point)

C. Difficult Situations Behavioral Management

1. Decreasing Dialysis Patient/Provider Conflict (DPC) Toolkit

2. Difficult Situations Behavioral Management Web Links

3. Behavioral Agreement (SAMPLE)

4. Guidelines for Behavioral Agreements

5. Violence Policy (SAMPLE)

6. Involuntary Discharge (Recommendation)

D. Quality of Life

1. QOL Web Links

2. Measurement of Physical Functioning In Older Adult Populations (Requires Log-in)
http://www.nia.nih.gov/NR/rdonlyres/AF0997F6-0C16-4A76-96C0-D3780F00E6D4/2300/phys_perform_meet_agend_particip_12_12_03.pdf

E. End Of Life

1. End of Life Web Links

2. Kidney End of Life Coalition -
http://www.kidneyeol.org

3. Advance Care Planning in Dialysis Facilities

4. USDHHS: Advanced Literature Review on Advance Directives

5. FAQ About End of Life Care for Renal Patients

6. End of Life Issues and Care
http://www.apa.org/pi/eol/issues.html

7. Guidelines for Terminating Treatment (University of Michigan)
http://www.med.umich.edu/psm/guidelines.html

8. Hospice Payment System: Fact Sheet Series

F. Rehabilitation

1. Rehabilitation Web Links

2. Vocational Rehabilitation Services (Arkansas, Louisiana, Oklahoma): Includes Eligibility for Services Criteria

G. Social Worker Resources

1. Social Worker Resources Web Links

2. Arkansas

a. State Medical Assistance Program

b. DMERC-Durable Medical Equipment Regional Carrier

c. Fiscal Intermediary-Medicare Part A and Medicare Part B

3. Louisiana

a. State Medical Assistance Program

b. DMERC-Durable Medical Equipment Regional Carrier

c. Fiscal Intermediary-Medicare Part A and Medicare Part B

4. Oklahoma

a. Oklahoma State Medical Assistance Program

b. DMERC-Durable Medical Equipment Regional Carrier

c. Fiscal Intermediary-Medicare Part A and Medicare Part B

5. Multi-Language Medicare Publications
http://www.cms.hhs.gov/Partnerships/downloads/multilanguage.pdf

6. New Help with Employment Services - Assessment Tool

7. New Help with Services/Resources - Assessment Tool

8. State NKF - Contact Information

H. Links to Mental Health Services (Arkansas, Louisiana, Oklahoma)

Back to Table of Contents

9. Disaster Planning

A. ESRD Network 13 Disaster Planning Resource

1. Disaster Plan Template

B. Disaster Preparedness Tools (Arkansas, Louisiana and Oklahoma)

THESE MATERIALS WERE DISTRIBUTED IN ARKANSAS, LOUISIANA AND OKLAHOMA FOR DISASTER PREPAREDNESS; HOWEVER THE MATERIALS REMAIN AVAILABLE AND CAN BE UTILIZED/MODIFIED FOR ANY DISASTER PREPAREDNESS ACTIVITY. MATERIALS CAN BE REQUESTED THROUGH THE NETWORK OFFICE OR DOWNLOADED FROM THE NETWORK 13 WEB SITE http://www.network13.org/disaster.asp

1. Disaster Information

a. Kidney Community Emergency Response (KCER) Coalition

b. Patient ID Card: Dialysis and Transplant

c. Patient and Staff Placards for Vehicles / Checkpoints

d. Needs Assessment

e. Disaster Poster for Patient Waiting Areas (Posters available upon request)

2. Evacuation Resources (During Disaster) (Located in State Specific Tools Listed Above)

a. Region

b. Dialysis Facility and Patient Counts by Parish/County

c. Emergency Contact Information by City

d. Evacuation Routes and Potential Dialysis Units

3. Post Disaster

a. Triage Information for Shelters as Needed

b. ESRD Fact Sheet for General Public

c. Public Service Announcement (Sample)

d. American Red Cross Safe and Well List Web site
https://disastersafe.redcross.org/Default.aspx

C. Disaster Supplies Kit (Please NOTE that supply kits are generic, not renal-specific)

1. Family Supply Kit http://www.fdem-mediacenter.org/PDF/Family_Disaster_Supplies.pdf

2. Disaster Services - Disaster Supplies Kit
http://www.fema.gov/areyouready/assemble_disaster_supplies_kit.shtm

3. Workplace Disaster Supply Kit

D. Disaster Preparedness for People with Disabilities
1. Emergency Meal Planning for Diabetics
http://www.kidney.org/atoz/atozPrint.cfm?id=133

2. Disaster Preparedness For People With Disabilities
http://www.fema.gov/pdf/library/pfd_all.pdf

3. Assisting People With Disabilities In A Disaster
http://www.fema.gov/plan/prepare/specialplans.shtm

E. Fact Sheets

1. Hurricanes: Key Facts About Hurricane Readiness
http://www.bt.cdc.gov/disasters/hurricanes/pdf/readiness.pdf

2. Tornadoes: Being Prepared
http://emergency.cdc.gov/disasters/tornadoes/prepared.asp

3. Winter Weather: Winter Storm Facts
http://www.bt.cdc.gov/disasters/winter/pdf/factsheet.pdf

F. Bioterrorism Readiness Plan: A Template for Healthcare Facilities

1. Bioterrorism Agents/Diseases
http://www.bt.cdc.gov/agent/agentlist.asp

2. Bioterrorism and Public Health Preparedness
http://www.cdc.gov/ncidod/EID/vol9no4/pdfs/02-0593.pdf

3. Chemical Agents: Facts About Sheltering in Place
http://www.bt.cdc.gov/planning/Shelteringfacts.pdf

4. Chemical Agents: Facts About Evacuation
http://www.bt.cdc.gov/planning/evacuationfacts.pdf

5. Chemical Agents: Facts About Personal Cleaning and Disposal of Contaminated Clothing
http://www.bt.cdc.gov/planning/personalcleaningfacts.pdf

6. General Information About Terrorism (Red Cross Power Point Presentation)

7. Guide For All-Hazard Emergency Operations Planning – Terrorism

G. Pandemic Checklist for Hemodialysis Centers

1. Medical office Influenza checklist
http://www.pandemicflu.gov/plan/pdf/medofficesclinics.pdf

2. Business Pandemic Influenza Planning Checklist “Modified for ESRD Providers”

3. Influenza General Information
http://www.pandemicflu.gov/general/

4. Pandemic Preparedness tools
http://www.pandemicpractices.org/practices/article.do;jsessionid=
50F5947D9C878EA846B0553DCE890102?page=home

5. Guidance on Allocating and Targeting Pandemic Influenza Vaccine (Large File)
http://www.pandemicflu.gov/vaccine/allocationguidance.pdf

H. Other Disaster Websites

1. CDC Emergency Preparedness and Response
http://emergency.cdc.gov/

2. Kidney Community Emergency Response (KCER) Coalition
http://www.kcercoalition.com/

3. Emergency Preparedness Tools & Disaster Solutions for Organizations & Families
http://www.disasterprepped.com/

4. FCC Public Safety and Homeland Security Bureau
http://www.fcc.gov/pshs/health-care.html

Back to Table of Contents

10. Medicare Part D

A. Medicare Part D Web Links

B. 2008 CMS Formulary Guidance

http://www.medicare.gov/Publications/Pubs/pdf/11136.pdf

C. YOUR gUIDE TO mEDICARE pRESCIPTION dRUG cOVERAGE

http://www.medicare.gov/Publications/Pubs/pdf/11109.pdf

D. Coverage Gap

E. SSA Premium Info

a. Medicare Part D Coverage Determination Request Form: enrollee

http://www.cms.hhs.gov/MedPrescriptDrugApplGriev/Downloads/
ModelCoverageDeterminationRequestForm.pdf

b. MEDICARE PART D COVERAGE DETERMINATION REQUEST FORM: PHYSICIAN

http://www.cms.hhs.gov/MedPrescriptDrugApplGriev/Downloads/
PhysicianCoverageDeterminationRequestForm.pdf

Back to Table of Contents

11. Kidney Transplants

A. Transplant Web Links

B. United Network for Organ Sharing (UNOS):
(http://www.unos.org/whatWeDo/patientServices.asp)

1. Transplant Living
(http://www.transplantliving.org/)

2. Change in Kidney Allocation Policy
http://www.unos.org/shareddownloadables/Final_Kidney_brochure5_Oct22.pdf

3. Living Kidney Donor Evaluation Guidelines
http://www.unos.org/ContentDocuments/Living_Liver_Donor_Evaluation_Guidelines2(1).pdf

4. Q & A’s about Multiple Listing & Waiting Time Transfer

a. English – (Large File)
http://www.unos.org/SharedContentDocuments/multiple_listing(2).pdf

b. Spanish – (Large File)
http://www.unos.org/SharedContentDocuments/span_multiple_listing.pdf

C. Infection Control Issues:

1. Adult Shingles Immunization Information
http://www.immunize.org/catg.d/p3092.pdf

2. Prevention of Herpes Zoster
http://www.cdc.gov/mmwr/PDF/rr/rr57e0515.pdf

D. Kidney Transplant Disaster Preparedness Resources (Also found in Section 9, above):

1. Disaster Information

a. Kidney Community Emergency Response (KCER) Coalition
http://www.kcercoalition.com/

b. TRENDS: Transplant Rates for States, Network (2004-2008)

c. Patient ID Card

d. Disaster Poster for Patient Waiting Areas

2. Evacuation Resources (During Disaster) (Located in State Specific Tools Listed in Section 9B)

a. State Specific Emergency Contacts by Parish or County

b. Emergency Contact Information by State

3. Post Disaster

a. ESRD Fact Sheet for General Public

Back to Table of Contents

12. Network Patient Representative (NPR) Program

A. New NPR Orientation Packet

1. NPR Brochure

2. NPR Role

3. HIPAA and Confidentiality

4. Facility / NPR Agreement (Must be completed to participate in program)

5. NPR Activity Suggestion List

6. NPR Index Card Information Sheet

7 Index/Business Card example

8. NPR Photo Release

9. NPR Orientation Packet Evaluation

10. Social Worker Evaluation for NPR Packet

B. Web site Resources

C. Bulletin Board Posters

Back to Table of Contents

13. Clearinghouse Library for Professionals and Patients: 2009

A. Clearinghouse Item List

B. Order Form

C. NW 13 Web site LINK http://www.network13.org

Back to Table of Contents

Updated 8/27/2009