Infection Control and Prevention in Outpatient Hemodialysis Facilities Examination
This issue of NephSAP is a special issue that addresses infection control and prevention in out- patient hemodialysis facilities. It represents collaborative work between the American Society of Nephrology (ASN) and the Centers for Disease Control and Prevention (CDC), through sponsoring Nephrologists Transforming Dialysis Safety (NTDS).
To delineate the epidemiology and impact of infections on patients treated with maintenance hemodialysis and the development of a national safety strategy.
To describe a systems approach for implementation of the national safety strategy to prevent and decrease infections in patients treated at outpatient hemodialysis facilities.
To discuss implementation of universal infection prevention strategies that apply to outpatient hemodialysis facilities.
To elucidate infection prevention strategies speciﬁcally adapted for outpatient hemodialysis facilities.
To examine other infection-related issues, including emerging problems, disaster preparedness, and available resources that support infection prevention and control implementation in outpatient hemodialysis facilities.
The ASN is responsible for identifying and resolving all conﬂicts of interest prior to presenting any educational activity to learners to ensure that ASN CME activities promote quality and safety, are effective in improving medical practice, are based on valid content, and are independent of the control from commercial interests and free of bias. All faculty are instructed to provide balanced, scientiﬁcally rigorous and evidence-based presentations. In accordance with the disclosure policies of the Accreditation Council for Continuing Medical Education (ACCME), individuals who are in a position to control the content of an educational activity are required to disclose relationships with a commercial interest if (a) the relation is ﬁnancial and occurred within the past 12 months; and (b) the individual had the opportunity to affect the content of continuing medical education with regard to that commercial interest. For this purpose, ASN consider the relationships of the person involved in the CME activity to include ﬁnancial relationships of a spouse or partner. Peer reviewers are asked to abstain from reviewing topics if they have a conﬂict of interest. Disclosure information is made available to learners prior to the start of any ASN educational activity.
EDITORIAL BOARD for this Issue:
Gerald A. Hladik, MD, FASN—Current Employer: University of North Carolina at Chapel Hill; Honoraria: Renal Research Institute; Scientiﬁc Advisor/Membership: ASN Co-Director, NephSAP, Board Member, Renal Research Institute
Alan S. Kliger, MD—Current Employer: Yale New Haven Health System; Consultancy: American Society of Nephrology; National Institutes of Diabetes, Digestive Diseases and the Kidney; Honoraria: Several universities, and medical schools, professional organizations - for lectures, seminars, webinars; Scientiﬁc Advisor/Membership: Qualidigm (Quality Improvement Organization); Other Interests/Relationships: American Society of Nephrology, Renal Physicians Association
Eduardo K. Lacson, Jr., MD, MPH, FASN—Current Employer: Tufts University School of Medicine, Dialysis Clinic, Incorporated (Non-Proﬁt Dialysis Provider); Honoraria: American Society of Nephrology, Nephrologists Transforming Dialysis Safety (NTDS)
Ruediger W. Lehrich, MD—Current Employer: Duke University Medical Center
Brad H. Rovin, MD, FASN—Current Employer: Ohio State University Wexner Medical Center; Consultancy: Genentech, Mallinckrodt, Chemocentryx, Alexion, Aurinia, Roche, Calliditas, BMS, Ra Pharmaceuticals, Retrophin, Rigel, EMD-Serono/Merck, Novartisk Biogen, RILITE Foundation, Human Genome Sciences (GSK), Biomarin, Morphosys, Chugai Pharmaceuticals, Astra Zeneca, Janssen, MedImmune, Omeros; Research Funding: NIH, Rigel, Hoffman-La Roche, AstraZeneca, Human Genome Sciences (GSK), Chemocentryx, RILITE Foundation, EMD Serono (Merck), NIH/NIDDK; Honoraria: Genentech, Mallinckrodt, Chemocentryx, Alexion, Aurinia, Roche, Calliditas, BMS, Ra Pharmaceuticals, Retrophin, Rigel, EMD-Serono/Merck, Novartisk Biogen, RILITE Foundation, Human Genome Sciences (GSK), Biomarin, Morphosys, Chugai Pharmaceuticals, Astra Zeneca, Janssen, MedImmune, Omeros; Scientiﬁc Advisor/Membership: Kidney International, Kidney International Reports, Nephrology Dialysis and Transplantation, Lupus Foundation of America, UpToDate, CureGN, KDIGO, Biocon; Other Interests/Relationships: ASN educational courses, National Kidney Foundations, International Society of Nephrology, Lupus Foundation of America
Jerry Yee, MD, FASN—Current Employer: Henry Ford Hospital; Consultancy: La Jolla Pharmaceuticals, Elsevier Inc., Vasc-Alert LLC, EBSCO, Merck, Reata; Ownership Interests: Vasc-Alert; Honoraria: National Kidney Foundation, Drexel University, UNC Chapel Hill, Ascension Health; Patents/Inventions: Vasc-Alert; Scientiﬁc Advisor/Membership: NKF: Editor-in-Chief, Advances in Chronic Kidney Disease journal; Editorial Board: American Journal of Nephrology, American Journal of Kidney Diseases, Heart Failure Journal, Clinical Journal of Nephrology, American Journal of Hypertension; ASN Co-Director NephSAP, EBSCO DynaMed: Section Editor; Section Editor Elsevier Ferri’s Clinical Advisor 2018 Textbook
Daniel L. Landry, DO, FASN—Current Employer: University of Massachusetts Medical School-Baystate, Kidney Care & Transplant Services of New England
Gisela A. Deuter, BSN, MSA—Nothing to disclose
There is no commercial support for this issue.
The Editorial Board of NephSAP and KSAP extends its sincere appreciation to the following reviewers. Their efforts and insights help improve the quality of these postgraduate education offerings.
NephSAP/KSAP Review Panel
Mustafa Ahmad, MD, FASN, King Fahad Medical City, Riyadh, Saudi Arabia
Nasimul Ahsan, MD, FASN, University of Florida and Oscar G. Johnson Veteran Affairs Medical Center, Iron Mountain, MI
Dario Roccatello, MD, San Giovanni Hospital and University of Torino, Torino, Italy
Helbert Rondon-Berrios, MD, FASN, University of Pittsburgh School of Medicine, Pittsburgh, PA
Ehab R. Saad, MD, FASN, Medical College of Wisconsin, Milwaukee, WI
Mark C. Saddler, MBChB, Mercy Regional Medical Center, Durango, CO
Neil Sanghani, MD, Vanderbilt University, Nashville, TN
Mohammad N. Saqib, MD, Lehigh Valley Hospital, Allentown, PA
Hitesh H. Shah, MD, Hofstra Northwell School of Medicine, Great Neck, NY
Michiko Shimada, MD, PhD, Hirosaki University, Hirosaki, Japan
Shayan Shirazian, MD, Winthrop-University Hospital State University of New York at Stony Brook, Mineola, NY
Arif Showkat, MD, FASN, University of Tennessee, Memphis, TN
Stephen M. Sozio, MD, Johns Hopkins University School of Medicine, Baltimore, MD
Ignatius Yun-Sang Tang, MD, FASN, University of Illinois at Chicago, Chicago, IL
Ahmad R. Tarakji, MD, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
Hung-Bin Tsai, MD, National Taiwan University, Taipei, Taiwan
Katherine Twombley, MD, Medical University of South Carolina, Charleston, SC
Kausik Umanath, MD, Henry Ford Hospital, Detroit, MI
Puchimada M. Uthappa, MBBS, FASN, Columbia Asia Hospital, Mysore, Karnataka, India
Anthony M. Valeri, MD, Columbia University Medical Center, New York, NY
Allen W. Vander, MD, FASN, Kidney Center of South Louisiana, Thibodaux, LA
Jon R. Von Visger, MD, PhD, The Ohio State University, Columbus, OH
Nand K. Wadhwa, MD, Stony Brook University, Stony Brook, NY
Connie Wang, MD, Hennepin County Medical Center, Minneapolis, MN
Maura A. Watson, DO, Walter Reed National Military Medical Center, Bethesda, MD
Dawn Wolfgram, MD, Medical College of Wisconsin, Milwaukee, WI
Sri Yarlagadda, MBBS, University of Kansas Medical Center, Kansas City, KS
Brian Young, MD, Santa Clara Valley Medical Center, San Jose, CA
Mario Javier Zarama, MD, Kidney Specialists of Minnesota, Saint Paul, MN
Program Mission and Objectives
The Nephrology Self-Assessment Program (NephSAP) provides a learning vehicle for clinical nephrologists to renew and refresh their clinical knowledge, diagnostic, and therapeutic skills. This enduring material provides nephrologists challenging, clinically oriented questions based on case vignettes, a detailed syllabus that reviews recent publications, and an editorial on an important and evolving topic. This combination of materials enables clinicians to rigorously assess their strengths and weaknesses in the broad domain of nephrology. Accreditation Statement The American Society of Nephrology (ASN) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
AMA Credit Designation Statement
The ASN designates this enduring material for a maximum of 10 AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Original Release Date: July 2019 CME
Credit Termination Date: June 30, 2021
Examination Available Online: On or before Monday, July 15, 2019
Estimated Time for Completion: 10 hours
Answers with Explanations
Provided with a passing score after the ﬁrst and/or after the second attempt
July 2021: posted on the ASN website when the issue is archived.
Nephrology certiﬁcation and recertiﬁcation candidates
Method of Participation
Read the syllabus that is supplemented by original articles in the reference lists.
Complete the online self-assessment examination.
Each participant is allowed two attempts to pass the examination (.75% correct) for CME credit.
Upon completion, review your score and incorrect answers and print your certiﬁcate.
Answers and explanations are provided with a passing score or after the second attempt.
Enter your (ABIM) Candidate Number and Date of Birth prior to completing the examination.
Take the self-assessment examination within the timeframe speciﬁed in this issue of NephSAP.
Upon completion, click Claim Your MOC points, the MOC points submitted will match your CME credits claimed, check the Attestation Statement box and submit.
ABIM will notify you when MOC points have been added to your record.
Maintenance of Certiﬁcation Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 10 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certiﬁcation (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
MOC points will be applied to only those ABIM candidates who have enrolled in the MOC program. It is your responsibility to complete the ABIM MOC enrollment process.
System Requirements Compatible Browser and Software
The ASN nephSAP website (nephSAP.org) has been formatted for cross-browser functionality, and should display correctly in all currently supported web browsers. Individual nephSAP articles are also available in Portable Document Format (PDF), which requires Adobe Reader or comparable PDF viewing software.
The ASN nephSAP website is designed for responsive display. This means the content display will respond to the device you use and to your devices screen resolution.
Medium or Combination of Media Used
The media used include online content display in HTML 5 and/or static PDF, in addition to online evaluation and examination.
If you have difﬁculty viewing any of the pages, please refer to the nephSAP tutorials page for possible solutions. If you continue having problems, contact ASN at firstname.lastname@example.org.