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Last Updated 06/18/17

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In December 1999, the U.S. Federal Government's Institute of Medicine issued a report entitled, "To Err is Human: Building a Safer Health System". This report cited between 44,000 and 98,000 deaths every year due to medical errors. While these numbers are disputed by some, they would make medical errors the 8th leading cause of death, ahead of breast cancer or AIDS.

Dialysis patient safety is a complex issue that involves highly specialized dialysis technology, staff training and turnover, cost pressures, reporting of problems, oversight and regulations, water purification, dialyzer reuse, medication errors, patient compliance, patient education, primary care, prevention, vascular access, infection, location and layout of dialysis units, and the increased age and comorbidities of the ESRD population.

Patient safety and injury prevention are most effective when it involves everyone in the healthcare delivery scheme. Towards that end, RenalWEB has accumulated this list of resources that addresses safety issues from many perspective and at several different levels of complexity.

RenalWEB has a separate resource page for Infection Control.

Warning: Changes should never be made in a patient's treatment or care based solely on the information found here.  All patients have unique healthcare concerns and considerations and these must all be taken into account before any changes can be safely made.  All medical and therapeutic decisions must come from a qualified health care provider.  Read RenalWEB's Legal Disclaimer before proceeding.


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Study Finds One in Five Hospitalized Adults Suffer Side Effects From Prescribed Antibiotics - Press release from Johns Hopkins Medicine. New Online abstract from JAMA Internal Medicine. - June 14, 2017

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Rude Providers Jeopardize Patient Safety. So Stop It. - Article from HealthLeaders Media. - June 14, 2017

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FDA Product Recall Notices Kits from Arrow International - June 6, 2017

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Legionnaires' Hiding in Hospital, Nursing Home Plumbing Systems: CDC - Article from HealthDay. News brief from AHANews. Toolkit from the CDC. - June 6, 2017

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New CMS Survey and Certification Guidelines — Notices from the Northwest Renal Network - June 6, 2017

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Failure to Warn: Hundreds Died While Taking an Arthritis Drug, but Nobody Alerted Patients - Article from STAT. - June 5, 2017

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FDA Approves Temporary Import of Sodium Bicarbonate Injection Due to Shortage - News brief from AHANews. - June 1, 2017

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June is National Safety Month - Resources from the National Safety Council. - June 2017

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Amgen Sues to Reverse FDA Denial of Pediatric Exclusivity for Sensipar - Article from Genetic Engineering & Biotechnology News. - May 31, 2017

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Articles from Hospitals & Health Networks - May 31, 2017

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FDA Recall Notice: MesaLabs Conductivity Standard Solution, 14 mS/cm, 32 ounces (950 ml) - Mesa Laboratories is recalling Conductivity/TDS Calibrator Solution due to failure to meet product specifications. These solutions are used remotely from the hemodialysis machine or water purification equipment, and do not come into contact with the patient. - May 30, 2017

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Handshake-Free Zone: Keep Those Hands — And Germs — To Yourself In The Hospital - Article from Kaiser Health News. - May 30, 2017

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Handwashing: Cool Water As Effective As Hot for Removing Germs - Press release from Rutgers University. - May 30, 2017

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Institute Issues Guidance for Protecting Medical Device Systems from Ransomware - News brief from AHANews. - May 26, 2017

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FDA Advisory Committee Recommends Approval of Pfizer's Proposed Biosimilar to Epogen®/Procrit® Across All Indications - Press release. - May 25, 2017

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Are Dialysis Centers Unsafe, Profit-Hungry Facilities That Need Stricter Regulation? - Article from The San Diego Union-Tribune. - May 24, 2017

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At Major Teaching Hospitals, Lower Death Rates - Article from HealthDay. - May 23, 2017

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A Vital Drug (Sodium Bicarbonate) Runs Low, Though Its Base Ingredient Is in Many Kitchens - Article from The New York Times. - May 21, 2017

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Don Berwick's 7 Roadblocks to Improving Patient Safety - Article from Hospitals & Health Networks. - May 19, 2017

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To Curb Medical Errors, Physicians Must Be Better Trained to Admit Mistakes - Press release from the University of Pennsylvania School of Medicine. - May 19, 2017

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Nephrologists Transforming Dialysis Safety (NTDS) Web Site - ASN-based web site.  - May 17, 2017

Editor's note: Could the for-profit business model be unsafe for patients?

DaVita has fired a long-time employee in California for speaking out in favor of a proposed dialysis staffing law. Nurses posted dozens of comments overwhelmingly in favor of the law in response to this Medscape Nephrology article. However, this staffing law is opposed by both the Renal Physicians Association and the National Renal Administrators Association.

This Huffington Post article begins: "A California Bill Could Totally Disrupt The Dialysis Industry — And by "total disruption," we mean making sure workers have time to clean the machines between patients."

Are nephrologists' financial self-interests the source of the biggest safety problems in U.S. dialysis care?

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Safe Patient Handling from the American Nurses Association (ANA)
5-Diamond Patient Safety Program - 15 module program from the Mid-Atlantic Renal Coalition (Network 5) and the 2014-2015 5-Diamond Data Book
AAMI Standards and Recommended Practices: Dialysis 2014 edition- This comprehensive dialysis collection includes EVERY CURRENT AAMI HEMODIALYSIS standard and guidance document; Updated to include the 2012 edition of 60601-2-16, the 2013 collection includes all 10 AAMI dialysis standards. Other recently updates have included TIR43 (revises RD52) and five other standards were published in 2011, including 11663 and 23500 (revise RD52), 13958 (revises RD61), 26722 (revises RD62) and 13959. (Price Mbr/List $270/$440)
Dialysis Event Protocol (pdf) and Tables of Instructions (pdf). - updated June 2011 from the National Healthcare Safety Network (NHSN)
Electrical Safety Manual - 2015 Edition: A Comprehensive Guide to Electrical Safety Standards for Healthcare Facilities - Association for Advancement of Medical Instrumentation (AAMI) web site. Cost is $117 forAAMI members / $195 nonmembers.
FDA Drug Safety Information for Patients and Health Care Professionals - from the U.S. Food and Drug Administration
Healthy People 2010 Final Review and chapter 4 on Chronic Kidney Disease (12-page pdf). - from the U.S. Department of Health and Human Services (HHS)
Hemodialysis Administration: Strategies to Ensure Safe Patient Care - From the Sept. 2010 report from the PA Patient Safety Authority. - September 2010

IAC Publications: Needle Tips - from the Immunization Action Coalition

Improving Patient Safety in Long-Term Care Facilities - Resources from the Agency for Healthcare Research and Quality. 

Joint Commission International Center for Patient Safety web site
Keeping Kidney Patients Safe web site

National Healthcare Safety Network (NHSN) Dialysis Event Protocol - 6-page pdf from the Centers for Disease Control and Prevention web site. NHSN Dialysis Event website. -
Also see:
Patient Safety Monthly Reporting Plan (2-page pdf)
Patient Safety Component -- Outpatient Dialysis Center Practices Survey (6-page pdf)

National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004 - (pdf) from the National Center for Infectious Diseases
National Patient Safety Agency web site (UK organization)
Nephrology Nursing Scope and Standards of Practice © 2011 (7th Edition)  - from the American Nephrology Nurses Association web site
One Needle, One Syringe, Only One Time - A new educational video for healthcare providers on safe injection practices from the One & Only Campaign
Patient safety Network (PSNet) web site
Preventing Bloodstream Infection During Hemodialysis - Video from the CDC Dialysis Bloodstream Infection Prevention Collaborative is sponsored by the Centers for Disease Control and Prevention (CDC) and conducted in partnership with the Delmarva Foundation and others.
Preventing Falls Among Older Adults article from the Centers for Disease Control and Prevention web site
Protecting the Rights, Safety, and Welfare of Study Subjects (pdf) from the FDA's Regulatory Information

Renal Patient Safety Resources - List from the Renal Physicians Association web site. - July 2010

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Safe Staffing Saves Lives web site from the American Nurses Association (ANA)
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Dialysis Safety - from the Centers for Disease Control and Prevention (CDC) web site
First in a series of publications from the Institute of Medicine's Quality of Health Care in America project. To Err Is Human: Building a Safer Health System - on line book by Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, Editors; Committee on Quality of Health Care in America, Institute of Medicine; Copyright © 2000.
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Safe Patient Handling and Movement - from the U.S. Dept. of Veterans Affairs web site
Patient Safety: Safe Practices 2010 from the National Quality Forum (NQF) web site

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project. Crossing the Quality Chasm: A New Health System for the 21st Century.

Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program - from the Centers for Disease Control and Prevention web site
Internal Bleeding: the Truth Behind America's Terrifying Epidemic of Medical Mistakes by Robert M. Wachter, MD and Kaveh G. Shojania, MD (Rugged Land Books, 2004)
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PubMed Search Tool of the National Library Of Medicine's MEDLINE Database. These links allows you to search through over 11 million indexed articles. Due to copyright laws, only the abstracts (summaries) of the articles are usually listed. Some articles appear in full text on the publishers' web sites that are linked to PubMed. This page provides an Overview of PubMed. All these search results links are continually updated by the Library of Congress.
biocompatibility and dialysis
pyrogen and dialysis
equipment malfunction and dialysis
hemolysis and hemodialysis
chloramines and hemodialysis
disequilibrium syndrome and dialysis
dialysis dementia or dialysis encephalopathy
air embolism and dialysis
medical error and dialysis
patient safety and dialysis
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General Dialysis Nursing Issues and Questions (No dedicated RenalWEB forum)
Dialysis Technical Forum  
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AIDS (auto immune deficiency syndrome) and dialysis - PubMed search
VRE (vancomycin-resistant enterococci) and dialysis - PubMed search
MRSA (methicillin-resistant Staphylococcus aureus) and dialysis - PubMed search
Guidelines & Recommendations for Immunizations - infection control practices from the Centers for Disease Control and Prevention (CDC)
hepatitis AND dialysis - PubMed search - Continually Updated!
hepatitis B - PubMed search - Continually Updated!
hepatitis C - PubMed search - Continually Updated!
hepatitis AND vaccine - PubMed search - Continually Updated!
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Listing of National Patient Safety Foundation Events & Forums
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E-mail to RenalWEB on the Hepatitis Topic
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