The ESRD Network is working to improve the quality of care for patients receiving dialysis in a Nursing Home (NH) or Skilled Nursing Facility (SNF). Patients that receive dialysis in a NH or SNF can receive dialysis in a den or at the bedside depending on the dialysis program and individual state regulations. The patients do not have to be transported to and from an outside dialysis facility.
Centers for Medicare & Medicaid Services (CMS) has set goals to decrease hemodialysis catheter and peritonitis infection rates, and to decrease blood transfusion rates for dialysis facilities that provide dialysis in NHs. To support CMS’ goals, the Network recommends dialysis facilities use A Change Package to Improve Dialysis Care in Nursing Homes, which includes actionable change ideas, collected from high performing dialysis facilities. The change ideas are intended as a menu of interventions from which leaders can choose to implement within their facilities.
The following resources and tools can also be used to improve dialysis care provided in NHs.
- Educate Your Dialysis Patients About Anemia: Use this NKF resource to educate patients about why dialysis patients have anemia, the signs and symptoms of anemia, anemia therapy, how patients are checked for anemia, potential risks and benefits of blood transfusions and actions patients can take to improve outcomes and avoid the need for blood transfusions.
- Treating Anemia: This fact sheet answers questions for people with chronic kidney disease (CKD) or on dialysis who are receiving Erythropoiesis Stimulating Agents (ESAs) to treat their anemia. This fact sheet provides questions to help patients talk with their doctor or anemia management nurse about their treatment.
- KDIGO Clinical Guideline for Anemia 2012: This Clinical Practice Guideline document is based upon systematic literature searches last conducted in October 2010, supplemented with additional evidence through March 2012. It is designed to provide information and assist decision making. It is not intended to define a standard of care, and should not be construed as one, nor should it be interpreted as prescribing an exclusive course of management.
- Hemodialysis Catheters—How to Keep Yours Working Well: National Kidney Foundation resource to educate patients about what a hemodialysis catheter is and how to care for it.
- Be a Safe Patient—Dialysis Safety: Resource from the CDC that teaches patients how to help prevent infections.
- Cover Your Cough Handout: One-page flyer from the CDC with visuals that show how to stop the spread of germs, that can make people sick, by covering your mouth.
- 6 Tips to Prevent Dialysis Infections: One-page flyer from the CDC with tips on how to prevent dialysis infections for patients with catheters, fistula, and grafts.
- Catheter Reduction Toolkit: The Forum of ESRD Networks’ Medical Advisory Committee developed this toolkit that includes quality improvement approaches that dialysis facilities can use to ensure care coordination for patients.
- ESRD NCC Clean Hands Count Campaign: The ESRD NCC National Patient and Family Engagement Learning and Action Network (NPFE-LAN) members adapted the CDC's Clean Hand's Count campaign to make the materials applicable to ESRD and dialysis care.
- Decreasing LTC Infections for Patients Receiving Hemodialysis in the NH: This resource offers tips to help reduce the rate of LTC infections if your facility or organization provides hemodialysis to patients residing in a nursing home.
- HSAG Website for Patients and Families: Look under the infection prevention tab for a number of great resources on infection prevention.
- Learning and Action Network (LAN) Webinar Series: LAN webinars are intended to support dialysis providers and ESRD Networks with improving care for persons on dialysis who reside in nursing homes. This call includes actionable change ideas and perspectives from professionals in the ESRD Network service areas.
- Expert Team Calls: Expert Teams bring groups of providers and specialists at centers of excellence together in regular real-time collaborative sessions. The sessions are designed around case-based learning and mentorship and help local healthcare professionals and clinicians gain the expertise required to provide needed services.
- Educational Resources: Additional resources that support improving dialysis care in Nursing Homes.
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