Hi Folks
Still no word from my center on any of this… I will see them on the 27th and will have a talk with them… And since my center is so far away I not going to make an any more runs there than needed. I 'm doing my part , the center needs to take some part in keeping the people who use that center up to speed.
Bob Obrien
You’re right, I work at a center and cannot be identified. Aside from that I think that patients have the right to know exactly what is happening in their care. CMS (Medicare) gave NxStage the mandate and all NxStage units were notified by 9-24-07. I was told by NxSatge that we needed to get the policies in place ASAP. Within 2 weeks we had a luncheon for the patients and explained the changes. (We added the new available sacks to the same meeting).In fact another independant unit near us had their patient’s inserviced the same week the memo came out.
The memo is very specific. Patients that use community water can supply the unit with a copy of their safe water drinking report. Patient on private well water need to complete an water test yearly to ensure the quality of their water. (However, I personally will not start anyone on private well water on the pureflow after reading the EPA’s discussion on how quickly well water can change, but we are very rural here.) Secondly when the pureflow says “Last Batch” a bacterial count needs to be drawn. If you get 3 weeks out of a pack you test ever 3 weeks, if you get 12 weeks (yea right) you test that often. We have found that the urine cups that people use for urine tests work very well. (And almost everyone has used on of those cups). Our labs go out the same as all the other home patient labs.
The last change was with how patients check for chloramines.
Additionally CMS has released new guidelines for dialysis. It is still in draft form, but is available at http://www.cms.hhs.gov/GuidanceforLawsAndRegulations/05_Dialysis.asp (sorry you’ll have to cut and paste it). Almost at the bottom of the page is a draft of the interpertative guidelines. Download it. Home dialysis starts on section 533, but it all applies to dialysis patients. CMS has gotten very specific to home dialysis patients.
I consider the company I work for to be very progressive. NxStage may think I’m at total pain in the ass, but my patients come first. (Almost every rep at NxStage knows me by first name).
Hope this answers some of your questions.
Our center is also on top of this.
As I have stated before, we were testing from day one on the pureflow. So when the directives came out we were already doing tests.
Also we are on community (city)water and that water does change. When my hubby was having a problem with aluminum; we check the city water again. It had more clorine in it than it did the year before.
But it was well within the guidelines.
Bravo to you for sticking up for your patients.
Our center does as well.
Pat
DaVita just adopted their testing policies in Michigan.
My water and batch is scheduled to be tested next Monday. I will then be responsible for monthly testing even though we are on a municipal water system.
Erich
aka the riverdude
theriverdude@sbcglobal.net
The last change was with how patients check for chloramines.
Additionally CMS has released new guidelines for dialysis. It is still in draft form, but is available at http://www.cms.hhs.gov/GuidanceforLawsAndRegulations/05_Dialysis.asp (sorry you’ll have to cut and paste it). Almost at the bottom of the page is a draft of the interpertative guidelines. Download it. Home dialysis starts on section 533, but it all applies to dialysis patients. CMS has gotten very specific to home dialysis patients.
I consider the company I work for to be very progressive. NxStage may think I’m at total pain in the ass, but my patients come first. (Almost every rep at NxStage knows me by first name).
Hope this answers some of your questions.[/QUOTE]