leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Mon Mar 29, 2004 1:40 am Post subject: Patients concerned about dialysis center
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From the Daily Illini
www.dailyillini.com/news/1319<
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>Sounds like the dialysis centers I have been to also....techs not washing hands, attitude of you don't like it here go somewhere else, etc.<
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>Three times a week, Denny Bradley drives from Sadorus, Ill., to the Champaign-Urbana Dialysis Center to receive hemodialysis treatment ? totaling about 108 miles of travel and 15 hours of treatment every week.<
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>Bradley, 47, has permanent kidney failure, end-stage renal disease, and must undergo a five-hour hemodialysis treatment three times a week because patients with kidney failure must have dialysis to survive if they do not receive a kidney transplant.<
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>Hemodialysis filters the patient's blood through an external machine. The machine withdraws excess fluids and toxins before returning cleansed blood to the patient.<
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>The 149-patient center, once owned by Provena Covenant Hospital, was sold to Renal Research Institute (RRI) in 1998. Since then, Bradley and other patients said they began to experience problems in their treatment.<
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>"I'm not looking for a perfect place," said Bradley. "And I know it can't be a perfect place, but it could be a darn site better than what it is here."<
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>Despite multiple inspections by the Illinois Department of Health (IDPH), some patients say the center needs to improve.<
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>The August 2003 IDPH inspection report showed the facility failed to correctly monitor its water system. The heat disinfection unit, which disinfects the water used for dialysis, was not functioning properly.<
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>According to the report, medications for patients were unlabeled, and staff had knowledge of it. In addition, the staff was observed not washing their hands between patients' visits and could not ensure dialysis stations and equipment were properly disinfected.<
>The center was given until November 2003 to improve before IDPH revoked their certification. The center remained open and met IDPH recertification standards in November 2003, according to IDPH inspection reports.<
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>However, patients are still experiencing some of the same problems at the center because there is not an incentive for the facility to improve, said Claudia Lennhoff, executive director of CCHCC.<
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>Like most dialysis centers, patients of the Champaign-Urbana Dialysis Center must
ing in their own linens. However, they receive one blanket prior to their first dialysis treatment.<
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>The facility does not launder any linens contaminated during dialysis, said William Venus, spokesman for RRI, and patients are responsible for handling their linens.<
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>Most of the clinics within the dialysis industry found that linens do not provide additional safety for infection prevention and were too costly to provide, Venus said.<
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>Bradley said he had to take a blood soaked blanket home to launder it himself.<
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>"I was sleeping and my arm jerked and the needle come up out of my skin and it sprayed everywhere," he said.<
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>The center's infection-control policy requires contaminated laundry be bagged or contained at the location where it was used. The container must be closeable and leak proof. The center's policy states certain diseases and viruses can be transported if containment regulations are not followed.<
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>Champaign-Urbana Dialysis Center's management declined to comment on the issue and directed all policy and regulation questions to the RRI headquarters in New York City.<
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>Maureen Schlereth, spokeswoman for RRI, said she is unaware of the Champaign-Urbana center's containment practices, but said most RRI units give patients a plastic bag if there is a blood spill.<
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>Medicare, which funds dialysis treatment at the Champaign-Urbana Dialysis Center, has regulations prohibiting blood-contaminated blankets to be left in or transported around a dialysis unit unless it is properly contained.<
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>But, Bradley said he was never given a container, nor was he informed on the proper way to handle the soiled blanket ? a problem, he said, that is frequent at the facility.<
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>The United States General Accounting Office (GAO), an evaluation and investigative arm of Congress, issued a report in October 2003 examining all U.S. dialysis facilities and their compliance with Medicare quality standards.<
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>The center failed to meet Medicare standards, according to the IDPH August 2003 report, but the IDPH report shows the center met the standards in November 2003.<
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>According to the GAO report, "No effective sanctions are available to enforce compliance, short of terminating the facility from the Medicare program, which is rarely done."<
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>Rawle Austin, administrator for the center, said state policies are vague and vary depending on an inspector's interpretation.<
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>Since it opened in January 2003, Gam
o Healthcare, a smaller dialysis center in Champaign, has had no deficiencies, said Ellie Suhl, regional director of Gam
o.<
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>IDPH policies are clear, Suhl said.<
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>"I would say we haven't gotten anything that I would consider a (patient) complaint. From time to time patients have requests, or
ing things to our attention," Suhl said.<
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>A continuing problem for some patients at the Champaign-Urbana Dialysis Center is the administering of heparin, Lennhoff said. Heparin, an anti-blood clotting agent, must be administered to patients toward the beginning of their dialysis.<
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>Illinois law requires that only registered nurses and doctors administer heparin to patients, according to IDPH.<
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>Patricia Kingston, a patient of the facility, said she has been asked to administer heparin to herself while a technician sets up the treatment. Although she has asked for a nurse's help, a technician sometimes administers the drug anyway, she said.<
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>The Champaign-Urbana Dialysis Center would not comment on self-administered treatment and referred all questions of self-administration to RRI.<
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>Although Illinois law requires that only nurses and doctors administer the drugs, Maureen Schlereth, RRI spokeswoman, said patients can do self-care.<
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>Julie Bradley said her husband Denny was asked to cut down his dialysis run time so the staff would not have to stay late on Saturday night.<
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>"Unless there was a major weather or an unusual problem, we do not end treatments early," Schlereth. "It would only be detrimental over time."<
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>Amy Meyer, social worker for Champaign-Urbana center, said the facility once held patient support meetings, but because of low patient attendance, they discontinued the meetings.<
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>Bradley said he and others have
ought complaints to RRI's grievance committee but were met with unresponsiveness. He said he was told he could go somewhere else if he did not find the facilities suitable.<
>It is difficult for some patients to adjust to a dialysis lifestyle, said Meyer. Because patients cannot adjust and enjoy the same things anymore, some get angry and complain, she said.<
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>Bradley said he tried going to other dialysis centers, but there was either a waiting list or it was too far.<
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>Available times at Gam
o might conflict with a possible patient's schedule.<
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>"What we're dealing with here is a manifestation of a national problem that's going to explode," Lennhoff said. "We're seeing the devolution of health care right in this community with this example."<
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>CCHCC plans to meet with government representatives to pass legislation that would make all dialysis centers meet the same standards.<
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>The GAO report stated in 2002, 216 facilities nationwide went without inspection for nine or more years. The report also found medication errors, contaminated water used for dialysis and inadequate physician involvement for patients in dialysis centers across the country. The GAO suggests that state agencies inspect facilities more often and post the results on state agency Web sites.<
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>The U.S. Department of Health and Human Services is making progress toward these changes, said Thomas A. Scully, the department's administrator, in a letter to the GAO.<
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>"You're dealing with people who have needs," Kingston said. "We're at their mercy because we
can't help ourselves in some instances."<
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Tue Mar 30, 2004 2:18 am Post subject: Pt. care
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I
ing my own blanket so if it gets soiled it's my responsibility to take it home and launder it. I have a plastic bag in my tote for such a purpose. As to the Heparin administration, that does bother me. In both units I've been at Heparin was both drawn up and administered by the pct's. That baffles me because I was for over twenty years a nursing assistant both in nursing home and out in the field and I was not allowed by state nursing regulations to administer any medications. I would have lost my cert. if I did that! I live in NJ and here it's not allowed, but yet the pcts are allowed to do it in dialysis units. It seems like allowances are made! Lin.
