Network 4 on the Web
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Facility Resources

As a professional caring for individuals with chronic kidney disease, you are aware of the multitude of resources available to you on the Web. We hope we have provided enough materials on our site that you find these helpful.

We are always looking for ways to improve our webpages, so should you have any suggestions or comments, please call us.

Immunization Resources Moved!

We moved our immunization information (flu, pneumonia and hepatitis b) to a new page on our website. Visit our IMMUNIZE homepage

Clinical Performance Goals Document

NOW AVAILABLE -- 2011-2012 Clinical Performance Goals Document (format: PDF, size: 1.1 mb)
This document may be used to develop appropriate Quality Assessment and Performance Improvement (QAPI) programs within your unit.
Let us know what you think about our Clinical Performance Goals Document -- Evaluate online

Bedbugs Logo LeftBedbugs Logo Right

The Renal Network is aware of recent issues related to Bed Bugs. Below are some resources that may help you with this topic.

Adherence Toolkit

The Renal Network developed an Adherence Toolkit as a response to address adherence issues. The toolkit is divided into three sections and contains tools for staff, patient handouts, and articles that address the topic of adherence.

Exercise and Dialysis Resources

Exercise has been shown to improve some aspects of health-related quality of life in individuals with kidney disease. Our Exercise Resources Page give you tools promote motivation, helping patients get started, and how to set up an exercise program.

Vocational Rehabilitation Toolkit

The Renal Network strives to facilitate the achievement of optimal wellness for renal disease patients. "Optimal wellness" not only includes safe and quality care, but must also include efforts to improve patient independence, quality of life, and rehabilitation. The CMS Conditions for Coverage for ESRD Facilities require facilities to assist patients with an individualized vocational rehabiliation (VR) plan. In support of this endeavor, and to aid you in your quality improvement efforts, The Renal Network has developed a Vocational Rehabilitation Toolkit.

Patient Stories -- Fistula Journeys
The Renal Network is pleased to provide the following articles. These stories were written by patients, for patients. Feel free to print and display them in your patient areas, or pass them around to people you feel would benefit or enjoy reading about "Fistula Journeys".
Life Options Offers Free Mini-Movie About Fistulas

For Immediate Release: June 28, 2011
Madison, Wisconsin

A 3-minute multimedia movie called "Let's Talk About...Fistulas" is now available for free download from the Life Options website in English (www.lifeoptions.org/letstalk/mov1eng/) and Spanish, and via the Fistula First Breakthrough Initiative website www.fistulafirst.org/HealthcareProfessionals/FFBIChangeConcepts/ChangeConcept10.aspx)

About the movie

"We created this short, high-impact message to help dialysis patients understand why replacing a hemodialysis catheter with a fistula is so important," explained MEI Executive Director Dori Schatell. The movie quickly and graphically addresses:

  • Problems with catheters, including an animation of "germs" entering the bloodstream
  • Benfits of fistulas for having a good life
  • Fear of surgery, dialysis needles, and the appearance of a fistula—reasons patients may refuse to switch from a hemodialysis catheter

Dialysis professionals can use the movie to start a conversation with patients about converting from a catheter to an arteriovenous fistula (AVF).  The movie can be quickly downloaded or sent via email, and is available for mobile devices via YouTube™ (www.youtube.com/watch?v=VmOG2TzO7dk).  A DVD will soon be available for a small fee; submit a request via the website (www.lifeoptions.org/letstalk/).  Funding for the project was provided by the Fistula First Breakthrough Initiative, Amgen, and Genzyme.

Increasing fistula use

Researchers estimate that as many as 68,653 lives could be saved in the U.S. solely by reducing dialysis catheter use to less than 7%.  The decision to allow creation and use of an AVF is in patients' hands.  Gaining patient cooperation to convert from a catheter to a fistula is literally a matter of life and death.

About Life Options

Life Options is a program of the non-profit Medical Education Institute, Inc.  Founded in 1993, Life Options is dedicated to helping people with chronic kidney disease (CKD) live long and live well.  All Life Options materials are non-commercial and have been reviewed for accuracy by a multidisciplinary panel of experts.  For more information about the non-profit Medical Education Institute and its programs, including Life Options, visit www.meiresearch.org.

ESRD Quality Incentive Program

CMS developed the ESRD Quality Incentive Program (QIP) to be the nation's first pay-for-performance quality incentive program as mandated by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) section 153 (c). This first-of-its-kind program provides the ESRD community with the opportunity to enhance the overall quality of care than ESRD patients receive as they battle this devastating disease.

ESRD Network 4 is pleased to share the following documents to help you understand the ESRD Quality Incentive Program.

  • ESRD QIP Talking Points (format: PDF, size: 286 kb) -- a Questions and Answers formatted document that addresses most QIP issues.
  • ESRD QIP Medicare Fact Sheet (format: PDF, size: 80 kb) -- a Medicare Fact Sheet with topics: overview, background, linking payment to quality, payment parameters, QIP measures, performance scoring, program monitoring and evaluation.
  • ESRD QIP Medicare News Release (format: PDF, size: 60 kb)

Care Transitions

The "Dialysis Transfer Summary" document was used in the Pilot Project to improve communication between dialysis facilities and acute-care patient settings. This form is available in both an editable Word version (size: 40 kb) and a "print and use" PDF version (size: 55 kb).

Involuntary Patient Discharge

Involuntary Discharges by Attending Physicians

The Medical Review Board (MRB) recently discussed patients who are involuntarily discharged by their physicians. The MRB acknowledges that physicians can discharge patients without the consent of The Renal Network or the staff at the unit. However, the attending physician is required to follow the unit’s involuntary discharge (IVD) process which should include the Network's IVD process (format: PDF, size: 407 kb) that is outlined in the Conditions for Coverage (494.180).

The medical director is required to be involved in all discharges and the MRB recommends that medical directors reinforce V760 and V763 of the State Guidance for the Conditions for Coverage (format: PDF, size: 82 kb). In addition, medical directors need to educate their attending physicians on the policies regarding involuntary discharges and to make them aware of the resources available from the staff that also can assist them with challenging situations to avoid discharging patients whenever possible.

For a complete Check-List of all responsibilies, refer to the Network's IVD Process (format: PDF, size: 407 kb).

PATIENT BULLETIN BOARD PACKET (updated July 2011)

  1. Network 4 Poster (format: PDF, size: 138 kb) -- best if printed on 11x17" paper -- provides a summary of the Network, our grievance procedure and contact information
  2. Patient Rights and Responsibilities Brochure (format: PDF, size: 262 kb) -- prints on 8.5x11" paper
  3. CMS Dialysis Facility Compare Brochure (format: PDF, size: 1.9 mb) -- best if printed on legal (8.5x14") paper
  4. Network 4 Website Flyer (format: PDF, size: 163 kb) -- prints on 8.5x11" paper
  5. Getting Back to Work Brochure (format: PDF, size: 574 kb) -- prints on 8.5x11" paper
  6. Patient Safety Brochure (format: PDF, size: 161 kb) -- prints on 8.5x11" paper
  7. 5 Reasons to Consider an A-V Fistula Pamphlet -- electronic resource not available
  8. Services for Patients Brochure (format: PDF, size: 635 kb) -- best if printed on legal (8.5x14") paper
  9. Transplant Education Document (format: PDF, size: 528 kb) -- prints on 8.5x11" paper
  10. ABCs of Fistula Placement Brochure -- inside (format: PDF, size: 8.7) -- outside (format: PDF, size: 8.5 mb)
  11. How Do I Look Brochure -- inside (format: PDF, size: 2.9) -- outside (format: PDF, size: 2.8 mb)

National ELAB Report

The National ELAB Report provides information and trends analysis from our Lab Data Collection project.

For background information and additional analysis, you may visit http://www.esrdnet11.org/Elab -- The Renal Network of the Upper Midwest (a.k.a. ESRD Network 11) manages the national electronical ESRD lab data collection project.

This document may be used to develop appropriate Quality Assessment and Performance Improvement (QAPI) programs within your unit.

ESRD Conditions for Coverage Page

Click the link above to go to our page dedicated to the revised ESRD Conditions for Coverage, which were published in the Federal Register on April 15, 2008. Included on this page are resources such as a crosswalk from the old conditions to the new, the state's Interpretive Guidance document, measures assessment tool, comprehensive multidisciplinary patient assessment example, and frequently asked questions on the revised conditions

Decreasing Dialysis Patient-Provider Conflict (DPC)

Click the link above to go to our Decreasing Dialysis Patient-Provider Conflict (DPC) page. There you will find the DPC Brochure and DPC Provider Manual.

Assessing Functional Status of ESRD Patients

This page is dedicated to resources and tools that can be used to assess the functional status of ESRD patients.

Looking for Disaster or Emergency Preparedness information?

Then turn to our Disaster Preparedness and Response page for materials and information.

Looking for Dialysis Units?

Then turn to our Patient Resources Page for several dialysis unit search engines. Links to these search engines are provided in the left side menu under the heading "Dialysis Unit Search Engines".

Looking for Patient Education Opportunities?

Then turn to our Patient Resources Page for information on home modalities, tranplantation, the Offices of Vocational Rehabilitation and more (including our "Services for Patients" pamphlet).

Network Document: ESRD Network 4's Guidelines for Care of ESRD Patients Document (format: PDF, size: 616 kb) -- DRAFT version available effective April 2010

This document is an excellent resource that provides some general guidelines that could be followed by dialysis and transplant facilities. The information in this guide does not contain "rules" that should be considered enforceable, unlike Medicare's Conditions for Coverage. They are recommendations made by the professional communities within Network 4.

Network 4 Brochure: Transplant Education Document (format: PDF, size: 357 kb) - Publication Number: PBB-000-062010

Contains: "Preparing for a Kidney Transplant / Frequently Asked Questions, Transplant Centers in ESRD Network 4, and Kidney Donation / Frequently Asked Quesitons"

This brochure should be included on the Patient Bulletin Board at each Dialysis Facility and it REPLACES the following two documents:
1. Key Information About Kidney Transplant Brochure (Publication Number: PBB-002-032009)
2. Preparing for a Kidney Transplant / Frequently Asked Questions (Publication Number: PBB-003-062008)
Please discard Publication Numbers PBB-002-032009 and PBB-003-062008

In Service Education: Dialysis Patient Care Staff Education Modules - From the Mid Atlantic Renal Coalition (MARC)

Network 5 Dialysis Care Program LogoThe Mid Atlantic Renal Coalition (MARC), also known as ESRD Network 5, created five great training modules for dialysis patient care staff centered on "Communication Skills for Providing Quality Care."

The five modules are:

Life Options Resources: Life Options Products Catalog

Free resource materials are available from Life Options and range from a Unit Self-Assessment Tool to booklets on the 5 E's of rehabilitation: Encouragement, Education, Exercise, Employment, and Evaluation.

Now on DVD! Exercise Guide for People on Dialysis

May 29, 2009 -- Madison, Wisconsin -- Announcement for Immediate Release
The Life Options program announces the re-release of the popular "Feeling Better with Exercise" video in a new DVD format. Back by popular demand, this 30-minute guide includes easy-to-follow demonstrations -- by people on dialysis -- of stretching exercises (to build flexibility) and strength exercises (to build muscles). Many of the exercises can be done while seated, making them suitable for those who cannot stand for a long time or are in wheelchairs. Testimonials and instruction about the importance of exercise for maintaining good quality of life round out the program.

Originally filmed in 1995, "Feeling Better with Exercise" was part of a comprehensive exercise program for people on dialysis, developed by Life Options. Noted exercise physiologist Patricia Painter, PhD, developed the exercises and reviewed all the content of this program. It has been one of the most popular offerings in the history of Life Options, with more than 10,000 copies distributed since the original release.

The DVD can be ordered online at http://www.lifeoptions.org for $10.00, which includes shipping and handling to all U.S. locations.

The Life Options program, founded in 1993 with a grant from Amgen, is dedicated to helping people live long and well with chronic kidney disease. In addition to the exercise DVD, Life Options offers many other educational materials, including a free online learning program called Kidney School (http://www.kidneyschool.org). Life Options is administered by the nonprofit Medical Education Institute, Inc. of Madison, Wisconsin. For more information about Life Options, please visit the Life Options website at http://www.lifeoptions.org.

Medicare Conditions for Coverage: End-Stage Renal Disease Facilities

This link to the Medicare Conditions for Coverage of End-Stage Renal Disease Facilities also provides the "State Operations Manual: Guidance to Surveyors".

CDC Resources -- Hepatitis B Vaccination Recommendations for the Hemodialysis Facility

NKF KDOQI

Homepage to the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative

Journal of Renal Nutrition

The official journal of the Council on Renal Nutrition of the National Kidney Foundation and the International Society of Renal Nutrition & Metabolism

UNOS

Homepage to the United Network for Organ Sharing

USRDS

Homepage to the United States Renal Data System, located at the University of Michigan

National CPM Information and Report

This site, from CMS, provides the measures, data collection descriptions and ESRD CPM Annual Reports

ASN

Homepage to the American Society of Nephrology

NRAA

Homepage to the National Renal Administrators Association

ANNA

Homepage to the American Nephrology Nurses' Association

RPA

Homepage to the Renal Physicians Association

RENALNET

RENALNET is a kidney information clearinghouse that has a lot of useful information, including chat rooms for the renal community (look for those under "RENALNET Features" then "Conference Rooms")

NIDDK/NIH

Homepage to the National Institute of Diabetes, Digestive, and Kidney Diseases at the National Institute of Health

Nephron

Homepage to Nephron, a nephrology information resource center

National Healthcare Safety Network (NHSN) and Your Dialysis Unit
-- HOW TO GET STARTED --

Join us for a four-part webinar series focusing on NHSN. Register for each session below:

  1. Friday, January 6, 2012
    -- 2:00 PM to 3:00 PM EST --
    Agenda: Why you should enroll and how to navigate the first two stages of NHSN enrollment
  2. Friday, January 13, 2012
    -- 2:00 PM to 3:00 PM EST --
    Agenda: Finalizing the enrollment of your dialysis facility
  3. Friday, January 20, 2012
    -- 2:00 PM to 3:00 PM EST --
    Agenda: Discussion on Dialysis Events -- what are they and how to report them
  4. Friday, January 27, 2012
    -- 2:00 PM to 3:00 PM EST --
    Agenda: Joining the ESRD Network Group and utilizing reports for Quality Improvement

Turning Vascular Access Best Practices Into Exemplary Outcomes

Presentations by Beverly Bulliner, BS, MJ and Brani Ross, RN. Each webinar will last 60 minutes, sponsored by The Renal Network, Inc. (ESRD Networks 4, 9 and 10). After registering, you will recieve a confirmation email containing information on how to join to webinar. 1.2 CEs have been applied for through NANT for nurses and patient care technicians. To get your NANT CE Certificate, you will need to complete an online evaluation. The link to the evalution will be provided after the presentation.

Click to visit our 3Ps for Vascular Access Success page

Click to visit our 5 Diamond Patient Safety page

Keep your sick kids home from school. Visit www.cdc.gov/h1n1 for more information.

http://www.kidneyeol.org - Click to visit the Kidney EOL Coalition Website

Network 4 Links

Additional Resources

Accessibility and Usability Resources

This page passed the "Cynthia Says" Section 508 compliance tester February 23, 2011.

Privacy Policy

The privacy of visitors to our website is important to ESRD Network 4, Inc. Therefore the following is our Internet Privacy Policy:

We will not obtain personal identification information about you when you visit our site, unless you choose to provide such information. While our Network will make every attempt to protect the personal information you may share with us, electronic mail is not secure against interception. If your communication is sensitive, or includes identifiers such as your Social Security number or medical history you may want to consider sending by another means; such as via US postal services. The personal information you send may be shared with appropriate others with your consent only. Otherwise it will be held in strictest confidence for your protection. Your personal information will be used only for such purposes as described by you and only at the point of request or collection.

This policy may be revised as needed, updates will be posted here.