By Isabelle Novak
In order to prevent dialysis patients from disease and infection, the End-Stage Renal Disease Prospective Payment System (ESRD) is making hemodialysis event reports mandatory under the Quality Incentive Program (QIP).
This healthcare surveillance system falls under the Centers for Disease Control and Prevention (CDC). According to CDC’s website, cdc.gov, CDC works to “reduce the burden of reporting, harmonization of healthcare performance measures across national organizations.” CDC encourages all private sector vendors to voluntarily utilize the QIP system for more efficient dialysis care.
“(The purpose of QIP is to) collect data from a sample of healthcare facilities in the United States to permit valid estimation of the magnitude of adverse events among patients and healthcare personnel,” CDC’s website said.
Infections are commonplace in dialysis clinics. This is due to the elevated risk of bacteria spread caused by heavy use of catheters and tubes entering punctured skin.
Bacteria travels quickly through these sensitive openings and spreads through the bloodstream. According to the American Association of Kidney Patient’s (AAKP) website, aakp.org, hemodialysis vascular access infections are the most noted in patients. Not only are these common, but also the main reason for hospitalization and serious illness among dialysis patients.
The procedural aspect of dialysis is not the only contributor to these rapidly-spreading infections. Hemodialysis patients generally have abnormally-weak immune systems. White blood cells, crucial for fighting off infection, typically do not function properly among these patients, AAKP’s website said.
The bacteria known as Staphylococcus is especially prevalent in dialysis clinics. AAKP’s website explained that although a healthy count of the bacteria is found in every body, a weakened immune systems see Staphylococcus as a threat. This bacteria can multiply to an unusually large amount, gaining access to the bloodstream. Once Staphylococcus reaches this point in the infection, it commonly inhabits bones, joints and the heart. Results can be fatal to physically weak patients, AAKP’s website said.
Dialysis patients suffering from kidney disease are especially vulnerable to fungal and viral infections. Lymphocytes are important for the body to fight these infections. However, they tend to be dysfunctional in those with kidney disease, causing serious illnesses to contract. AAKP’s website explained that influenza, shingles and hepatitis are all potential threats to dialysis patients. Not only is the risk of getting these viruses increased, but the severity tends to heighten as well.
Although the risk of infection remains, early-on detection and careful monitoring of patient symptoms can prevent complicated and dangerous cases from occurring. This is why the QIP encourages all dialysis clinics to thoroughly observe and record abnormalities before infections spread. By implementing the QIP, clinics serve patients more efficiently through extra observation while saving money on avoidable procedures down the road.
All outpatient centers for hemodialysis patients are required at least six months of Dialysis Event (DE) surveillance for each individual undergoing treatment. According to CDC’s website, this specific type of patient-surveillance includes monthly reports of recorded census information for the first two work days of the month. These reports provide an overview of patient history to ensure all potential infection cases are accounted for and treated.