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Sensing Savvy

What to Know about the CDC's Safer Dialysis Initiative

Posted by Deborah Brouwer-Maier RN, CNN on Dec 5, 2016 7:00:00 AM

Behind cardiovascular disease, bloodstream infections are the second highest killer of hemodialysis patients. The death rates from infection could be halved if dialysis facilities implemented the CDC’s Core Interventions for Dialysis Bloodstream Infection Prevention, the health agency notes.

To make dialysis professionals more aware of these interventions, the Centers for Disease Control and Prevention has launched a “Making Dialysis Safer for Patients” initiative.

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Topics: Clinical Trends, Hemodialysis

Pediatric Vascular Access Surveillance Examined at Boston Children's Hospital

Posted by Deborah Brouwer-Maier RN, CNN on Nov 23, 2016 6:30:00 AM

Pediatric nephrologists at Boston's prestigious Children's Hospital recognized that an arteriovenous (AV) access is the preferred vascular access for dialysis delivery in children and adolescents requiring chronic hemodialysis (HD). They also understood that, because of the small size of the accesses, maintenance of an access after it is created becomes all the more important and difficult.

Ultrasound dilution (UD) monitoring of AV access flow is widely used in adult HD units for early stenosis detection, but its experience in pediatrics is limited. Therefore, the Boston group they undertook a study to examine its usefulness in children and adolescents.

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Topics: Clinical Trends, Hemodialysis

The Cardiovascular Effects of Arteriovenous Fistulas: A Cause for Concern?

Posted by Deborah Brouwer-Maier RN, CNN on Nov 16, 2016 6:30:00 AM

Jennifer MacRae and her colleagues from the University of Calgary, Calgary, Alberta, Canada, reviewed the hemodynamic and cardiovascular consequences of arteriovenous fistulas. Their findings were published in a 2006 paper in Seminars in Dialysis.

MacRae identified three periods when the presence of an AV fistula influences a patient's hemodynamics.

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Topics: Clinical Trends, Hemodialysis

The Maytag and Nose-Cone Artificial Kidneys

Posted by Susan Eymann, MS on Nov 7, 2016 7:00:00 AM

During the early days of dialysis, in the 1960s, only a few patients could be treated, and even then at great cost. This was unacceptable to W.J. Kolff, the inventor of the first artificial kidney.

As head of the Department of Artificial Organs at the Cleveland Clinic, Kolff wanted to make dialysis so reasonable that anyone could afford it. In his biography, Inventor for Life, The Story of W.J. Kolff, Father of Artificial Organs, Herman Broers relates how Kolff went in search of a way to allow kidney patients to dialyze at home to relieve the pressure of limited beds in dialysis centers. In 1966, Kolff and his team arrived at a solution.

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Topics: Clinical Trends, Hemodialysis

Beating Surgeon Burnout: Advice From Your Peers

Posted by Thomas Gole, DO, FAAFP on Oct 10, 2016 6:30:00 AM

“Doctors and other health workers pay dearly for the relentless stress of patient care, a plight compounded by mounting bureaucracy and accelerating change in the healthcare industry,” Dr. Mark Greenawald concluded after tragically losing one of his ob-gyn patients during childbirth, and being unable to successfully process the grief from the experience.

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Topics: Clinical Trends, CABG Surgery

How Do You Rate the Affordable Care Act (ACA)? These Docs Gave it an F

Posted by Thomas Gole, DO, FAAFP on Sep 26, 2016 7:00:00 AM

Since its inception six years ago, the Affordable Care Act (ACA) has received lots of feedback. Regardless of political opinions, physicians have voiced their thoughts on the law, praising it for improving access to healthcare but saying it has negatively affected their practices.

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Topics: Hospital Administration, Clinical Trends

How Surgeon Specialization Impacts Patient Outcomes

Posted by Roger DeLong, CP, PE, MBA on Sep 19, 2016 7:00:00 AM

The phrase “practice makes perfect” has never been more true than in surgery. Research shows that better outcomes are associated with an increased procedure volume. While practicing and completing procedures can affect patient outcomes, the British Medical Journal (BMJ) has found that specializing in a specific procedure may be just as important as the number of times you perform it.

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Topics: Clinical Trends, Cardiothoracic

How a Mother’s Grief Sparked Medical Safety Improvements

Posted by Susan Eymann, MS on Sep 5, 2016 7:00:00 AM

In January 2001, 18-month-old Josie King was rushed to the Johns Hopkins Children’s Center with second-degree burns. She had inadvertently stepped into scalding bath water. The child’s mother, Sorrel King, stayed at her child’s bedside as doctors and nurses valiantly administered to the child. A couple of weeks later Josie seemed well enough to be sent home. A celebration was planned, but then everything went downhill. The toddler became acutely sick. Her mother suspected dehydration, but nobody seemed to listen. When they did, it was too late. Josie was battling two infections—one was from a central venous line that led to sepsis. It ultimately took her life.

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Topics: Hospital Administration, Clinical Trends

How the Affordable Care Act Affects Dialysis Patients

Posted by Susan Eymann, MS on Aug 29, 2016 7:00:00 AM

The Patient Protection and Affordable Care Act (ACA or “Obamacare”), signed into law March 23, 2010, requires everyone—including children—to have health insurance or pay a penalty. The law aims to have health insurance cover the services people need so that they won’t suffer financial ruin if an unexpected medical event occurs.

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Topics: Clinical Trends, Hemodialysis

Fresenius and DaVita Capture 84% of U.S. Hemodialysis Market

Posted by Susan Eymann, MS on Aug 24, 2016 6:30:00 AM

In its 2016 July issue Nephrology News and Issues published its annual survey of dialysis providers. Fresenius Medical Care and DaVita control the hemodialysis market with 84%, which translates to 366,000 patients out of a total of 433,000 patients.The two companies employ more than 135,000 employees. DaVita further solidified its position as one of the top players in the market with its 2015 acquisition of Renal Ventures Management, which added 2,387 patients to its roster. U.S. Renal Care, the third largest company, bought DSI Renal. Other mid-sized companies with national coverage are Dialysis Clinic Inc., American Renal Associates Inc. and Satellite Heathcare Inc. The top 10 are:

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Topics: Clinical Trends, Hemodialysis