Indicating Infectious Areas

Complications from infections are the second leading cause of hospitalization in the ESRD population.1 Facilities continue to strive to prevent access-related infections, and CROWNWeb will aid in these efforts by providing units with a means to monitor trends and assess changes in access-related infection rates over time.

The system will allow facilities to record infection-related data, such as information regarding the site, whether antibiotics are being administered, the patient’s blood culture results, and whether hospitalization is necessary. (See Figure 2 for CROWNWeb’s “Infections” fields.)


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Reflecting Hospitalization Admissions

The most recent data suggest that dialysis patients are hospitalized twice yearly on average.2 There is a long list of reasons for why dialysis patients may need to be hospitalized, and CROWNWeb will allow facilities to indicate if this occurs at any time during their course of treatment. Some of CROWNWeb’s “Hospitalization” data elements include:

  • Admission date
  • Type of visit
  • Admission diagnosis

Fluid Weight Management Data

Optimal fluid management is recognized as a crucial determinant of survival in patients on renal replacement therapy.3 Using CROWNWeb, facilities will be able to provide details regarding a patient’s blood pressure, post-dialysis target weight,  left ventricular hypertrophy, and breathing pattern.

By grouping these factors with the facility’s clinical performance data, CMS, the ESRD Networks, and dialysis facilities will have an opportunity to better analyze additional components that can improve patient care and patient outcomes.

More Information

For more information on CROWNWeb, visit the Project CROWNWeb website at www.projectcrownweb.org, or go to www.qualitynet.org and click the ESRD tab.

The work on which this publication is based was performed under Contract Number HHSM-500-2011-00157G, titled “CROWNWeb Outreach, Communication, and Training,” funded by the Centers for Medicare & Medicaid Services, Department of Health and Human Services.

The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government.

The author assumes full responsibility for the accuracy and completeness of the ideas presented. The author welcomes comments on the ideas presented; please send comments to [email protected].
Publication Number: FL-OCT-2011OTCT22-10-12470

References

  1. Collins AJ, Foley RN, Gilbertson DT, Chen SC. The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis. Clin J Am Soc Nephrol 2009;4 ( Suppl): 1:S5-S11. Available at: http://cjasn.asnjournals.org/content/4/Supplement_1/S5.full. Accessed October 5, 2011.
  2. Brophy DF, Daniel G, Gitlin M, Mayne TJ. Characterizing hospitalizations of end-stage renal disease patients on dialysis and inpatient utilization of erythropoiesis-stimulating agent therapy. Annals of Pharma 2009;44:43-49. Available at: http://www.medscape.com/viewarticle/714814. Accessed October 6, 2011.
  3. Collins AJ, Mujais S. Advancing fluid management in peritoneal dialysis. Kidney Int 2002;62 (Suppl): 81:S1-S2. Available at: http://www.nature.com/ki/journal/v62/n81s/full/4493365a.html. Accessed October 6, 2011.