QIA Guidelines

The Network will:

  • Assist facilities to implement and monitor all of the CDC recommended interventions for dialysis BSI prevention
  • Educate facilities on the CDC Core Interventions, assist the facilities to implement the CDC Core Interventions and monitor their progress toward implementing the CDC Core Interventions and reduction of BSIs
  • Incorporate action steps developed from each ESRD NCC BSI LAN into the QIA plan to assist facilities in implementing CDC recommended interventions
  • Encourage facilities to discuss the use of the CDC Core Interventions and infection rates at QAPI meetings
  • Assist facilities to complete a root cause analysis if there was successful implementation of all the CDC Core Interventions and the BSI rate did not decrease by at least 10% during the QIA.
  • Use CDC technical assistance and tools in enrolling facilities in NHSN
  • Promote communication and discussion between dialysis facilities, hospitals, and other healthcare entities
  • Encourage facilities to participate in CDC HAI Training activities by encouraging all clinical staff to complete the CDC Infection Prevention in Dialysis Settings Continuing Education course at http://www.cdc.gov/dialysis/clinician/CE/infection-prevent-outpatient-hemo.html as well as view the CDC video “Preventing Bloodstream Infections in Outpatient Hemodialysis Patients: Best Practices for Dialysis Staff” at http://www.cdc.gov/dialysis/prevention-tools/training-video.html
  • Involve Patient SMEs, family members, or caregivers in discussions regarding infection control practices and ways to encourage patients to bring issues and suggestions to the attention of facility staff members

 

Reduce Bloodstream Infection (BSI) Rates Activities

Facility Selection/Inclusion Criteria:
The Network shall select a Cohort of 20% of facilities in the Network service area using the National Healthcare Safety Network (NHSN) Excess Infection Report.

Bloodstream Infection (BSI) Goal:
Demonstrate a 20% or greater relative reduction in the semi-annual pooled mean in the cohort of 20% of facilities with the highest infection rates in the Network service area at re-measurement compared to 2019.

Graduation Requirements:
A facility may be removed and replaced for 2020 in the QIA if it is no longer in the cohort of facilities with the highest 20% of excess infections in the Network-service area determined by use of the Excess Infection Report or maintains a BSI rates of zero for at least six (6) months of the QIA.

Partnerships/Collaborations:

  • ESRD National Coordinating Center (ESRD NCC)
    • National BSI QIA Learning and Action Network (ESRD NCC BSI LAN) webpage
    •  National Patient Subject Matter Experts Affinity Group webpage
  • The Centers for Disease Control and Prevention (CDC)
  • New York State Department of Health
    The One & Only Campaign Safe Injection Practices Coalition webpage

QIA Reporting to Network

  • February 2020 QIA bi-Monthly Feedback Worksheet PDF; Online Reporting Form (Due February 15, 2020)
  • ALL QIA Facility Contact Form and RCA Barriers   Online Form (Due January 15, 2020)
  • RCA/PDSA Worksheet  PDF (Barriers to be reported on QIA Facility Contact Form)

Activities

Participate in the ESRD NCC BSI LAN:  The Network and facilities in the Network-service area are invited to attend and participate in the bi-monthly ESRD NCC BSI LAN.  The LAN has two primary purposes. The first is to improve information communication across care settings, with emphasis on communication between hospitals and dialysis centers caring for the same ESRD patients. The second is to increase awareness of and implementation of promising practices to reduce bloodstream infections

CMS Recommended Learning Activity:
Prevention of intravascular infections, blood-borne pathogen transmission (e.g., hepatitis B), and influenza and pneumococcal disease are priorities identified in the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination
(https://health.gov/hcq/prevent-hai.asp)

Reduce Long Term Catheter (LTC) Use Activities

Selection Criteria:
Using the Achievable Benchmark of Care (ABCTM) Model, the Network shall identify facilities in the Network service area with Long-Term Catheter (catheter in use > 90 days) rates.

Long-Term Catheter (LTC) Goals:
The Network shall decrease LTC rates in the Network-service area by at least 0.25% by evaluation based on data available in 2019.

CMS Recommended Learning Activity:
Prevention of intravascular infections, blood-borne pathogen transmission (e.g., hepatitis B), and influenza and pneumococcal disease are priorities identified in the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination (http://www.hhs.gov/ash/initiatives/hai/esrd.html).

Tools and Resources

CDC Resources:
Four ways to get ahead of Sepsis flyer PDF
What Got You Sick? Viruses or Bacteria? flyer PDF
Six Tips to Prevent Dialysis Infection Guide PDF

Network Resource(s):
Catheter Countdown Laminated Poster  PDF
Sepsis Q&A and Puzzle (for patients): PDF

Agency for Healthcare Research and Quality
Patient Engagement in Infection Prevention: Link
Fostering a Culture of Safety: Link

Network Webinars

2020 QIA Overview Webinar: This recording provides an overview of Network QIAs, timelines, resources and activities.
RecordingSlides

June 12, 2019
2019 HAI BSI/LTC Best Practice Webinar
Slides

April 11, 2019
2019 HAI BSI Educational Training Webinar
Slides

 

For more information:

Jeanine Pilgrim, MPH, PMP, CPHQ, CHES, CPXP
Network Program Director
(516) 209-5365
jeanine.pilgrim@ipro.us

Elena Balovlenkov, RN, BSN, MS
Quality Improvement Director
 516-209-5416
 elena.balovlenkov@ipro.us