5-Diamond Patient Safety Program

To implement a K-DOQI recommended Stenosis Surveillance program in the dialysis unit that allows for a consistent and continuous evaluation process for AVF and AVG access.

• Complete the in-service training module Stenosis Surveillance.
• Staff complete the Vascular Access Stenosis Surveillance Pre- and Post-Tests.
• Review your facility's Policies and Procedures for stenosis surveillance and identify opportunities for improvement.
• Trend Stenosis Surveillance methods using the Stenosis Tracking Tool.

• Distribute Protect Your Lifeline brochure to patients and their family, to facilitate patient-centered discussion of stenosis surveillance importance.
• Complete the Protect Your Lifeline Word Challenge.
• Complete the Stenosis Monitoring and Surveillance Word Search (Stenosis Monitoring and Surveillance Word Search ANSWERS).
• Identify accountability and methodology for trending stenosis surveillance using the Monitoring Venous Stenosis Worksheet.
• Assign a Vascular Access Manager and assemble a Vascular Access team.

• In-service training Vascular Access and the Conditions for Coverage-What you Must Do. (with speaker notes)
• K-DOQI Stenosis Surveillance Guidelines and Recommendations.
• PDSA Worksheet.
• Vascular Access Monitoring and the Conditions for Coverage - Requirements.
• Stenosis Surveillance Change Concepts.
• Understanding Your Hemodialysis Access Options - AAKP brochure available in English and Spanish.

• 100% of staff in-serviced on stenosis surveillance.
• 100% of staff complete the Vascular Access Stenosis Surveillance Pre- and Post-Tests.
• Submit a de-identified Stenosis Tracking Tool for trending of stenosis surveillance.

After you have completed this module, and have documented the required measures, please submit the following documents via mail or fax.

5-Diamond Patient Safety Program
1360 Energy Park Drive, Suite 200
Saint Paul, MN 55108
651-644-9853 Fax

1. Completed project reporting form.
2. In-service attendance log.
3. Vascular Access Stenosis Surveillance Pre- and Post-Tests.
4. De-Identified Stenosis Tracking Tool for trending of stenosis surveillance.

For more assistance contact us at 5diamondsafety@nw11.esrd.net or at 651-644-9877.