Question Title

* 2. Complete the below information.

Question Title

* 3. Please list the Primary and Secondary Contacts for this project. (If UNKNOWN, list the Facility Administrator for the Project Lead and Regional Corporate Representative as the Backup)

Question Title

* 4. Has corporate management notified this facility of bloodstream infection (BSI) performance issues in this facility?

Question Title

* 5. Were any actions taken after corporate management notified this facility of bloodstream infection (BSI) performance issues?

Question Title

* 6. Do you know where to find current bloodstream infection data on your facility in your internal system?

Question Title

* 7. Do you know where to find current bloodstream infection data on your facility on the National Healthcare Safety Network (NHSN) site?

Question Title

* 8. Does your facility actively use ALL of the CDC's Core Interventions to prevent bloodstream infections?

Question Title

* 9. How many CDC Core Interventions for Dialysis Bloodstream Infection Prevention are there?

Question Title

* 10. Has the facility ever used the CDC's Conversation Starter to Prevent Infections in Dialysis Patients?

Question Title

* 11. How many current NHSN users are at your facility? (They have access to NHSN and can enter data for your facility.)

Question Title

* 12. Is anyone at your facility a member of the Making Dialysis Safer for Patients Coalition (nephrologist, medical director, nurse, technician, patient, or caregiver)?

Question Title

* 13. Which Dialysis Prevention Process Measures does your facility actively complete each month? (select all that apply)

Question Title

* 14. Are these Prevention Process Measures entered into NHSN each month?

Question Title

* 15. Do you know what a Healthcare-Associated Infections Learning and Action Network (HAI LAN) is?

Question Title

* 16. Do you know what a Health Information Exchange (HIE) is?

Question Title

* 17. Does your facility participate in a Health Information Exchange (HIE) or another information transfer system to receive information relevant to positive blood cultures during transitions of care?

Question Title

* 18. Do you have a Facility Patient Representative (FPR), Patient Subject Matter Expert (SME) or an actively engaged patient?

Question Title

* 19. If not, do you think there is a patient who may be interested in becoming a Facility Patient Representative (FPR) or Patient Subject Matter Expert (SME) for your facility?

Question Title

* 20. Do you think that your facility serves patients from a vulnerable population? If so, please select all that apply.

Question Title

* 21. Do you think that your facility serves patients with health disparities? If so, please select all that apply.

Question Title

* 22. Does your facility hold monthly patient engagement or educational activities for all patients?

Question Title

* 23. When is your facility's monthly QAPI meeting held?

Enter the date closest to typical meeting date.

Question Title

* 24. Why do you think this facility has a high BSI rate?

Question Title

* 25. Have you notified your regional corporate representative that your facility has been selected to participate in the 2018 BSI QIA?

Question Title

* 26. Do you feel that you have or will have the resources and support necessary for your facility to successfully participate in the 2018 BSI QIA?

Question Title

* 27. If you answered NO to Q26, what do you need (from the Network or from your organization) in order to be successful and able to participate fully in the 2018 BSI QIA?

Question Title

* 28. What do you hope to gain by participating in this Quality Improvement Activity?

T