**Please allow for 30 days to receive your ordered materials.**

Question Title

* 1. Mailing Information

Question Title

* 2. Vascular Access Printed Materials

  Quantity
Vascular Access: A Guide for Patients Pamphlet English
Vascular Access: A Guide for Patients Pamphlet Spanish
Still Using a Catheter For Your Dialysis Access? Poster
Hemodialysis Vascular Access Flyer English Only
Preparing for the Vascular Access Portion of Your Medicare Survey Pamphlet
Does This Look Normal? Patient Guide To Infection Flyer
Vascular Access for Hemodialysis Traffic Lights-Fistula/Graft/Catheter ENGLISH Poster
Vascular Access for Hemodialysis Traffic Lights-Fistula/Graft/Catheter SPANISH Poster

Question Title

* 3. Vascular Access DVDs Now Available

  Quantity
Atlas of Dialysis Vascular Access DVD
Fistula First National Vascular Access Improvement Initiative Creating AV Fistula  5 DVD Set
Dialysis Patients Speak: A Conversation About AV Fistulas DVD

Question Title

* 4. TRANSPLANT

  Quantity
New York State Renal Transplant Center Referral Guide
Turning Negatives Into Positives Flyer ENGLISH
Turning Negatives Into Positives Flyer SPANISH
"A Transplant Regardless of Age" Poster
Your Life, Your Choice; Stories from Kidney Transplant Patients and Donors Booklet
Get The  Facts: Kidney Transplantation Tri Fold Brochure ENGLISH
Get The Facts: Kidney Transplantation Tri Fold Brochure SPANISH
How do you find out if a kidney transplant is right for you? Poster
PAC Chairs Speak - Sept 2012 Issue "Our Transplant Story: Living Donation"
PAC Speaks - Summer 2014 Issue "A Transplant at 77"  2 Page Flyer
PAC Speaks - August 2013 Issue "Surviving CKD"  2 Page Flyer
PAC Chairs Speak - September 2012 Issue "Our Transplant Story: Living Donation" 2 Page Flyer
PAC Chairs Speak - August 2012 Issue: "Dialysis: A Way To Life" 2 Page Flyer

Question Title

* 5. INFECTION PREVENTION

  Quantity
Clean hands can prevent infections. Ask your healthcare.....Speak Up For Clean Hands Poster
Patients and Visitors Clean Hands Count Flyer
Patients and Visitors Ask for Safe Care Ask For Clean Hands Poster
Put Together The Pieces To Prevent Infections Poster
PAC Chairs Speak - December 2011 Issue: "Washing Your Hands"  2 Page Flyer
CDC Approach to BSI Prevention in Dialysis Facilities Flyer

Question Title

* 6. ESRD QIP

  Quantity
Understanding the ESRD QIP and Facility Score Card Poster
ESRD Quality Incentive Program, the Dialysis Performance Score Certificate, and YOU
Understanding ESRD QIP & Dialysis Facility Score Card  Pamphlet
How is my facility doing? Did You Know?  Poster

Question Title

* 7. Patient Advisory Committee (PAC)

  Quantity
Network Patient Facility: ESRD Improving Care Poster
Network Patient Facility: Be Active In Your Care  Poster
Network Patient Facility: YOU can make a difference  Poster
"Volunteer to be a PAC Representative"  Pamphlet
"Volunteer to be a PAC Representative" Poster
"Volunteer to be a PAC Representative" Flyer
You Can Make A Difference. Be The Change. Get Involved  Poster

Question Title

* 8. PATIENT EXPERIENCE CARE

  Quantity
Act Now To Improve Patient Experience of care Postcard Size Handout
Your ESRD Network: Improving Care for ALL ESRD PATIENTS  Poster
Improve Your Health. Be Active In Your Healthcare  Poster
Why Do I Feel Cold During Dialysis?  Poster English
Why Do I Feel Cold During Dialysis?  Poster Spanish

Question Title

* 9. Grievances

  Quantity
QIA Interactive Poster - Patient
QIA Interactive Poster - Provider
Forum Grievance Toolkit ENGLISH
Forum Grievance Toolkit SPANISH
ACT 2 RESOLVE. Steps to Successful Communication Poster
ACT 2 RESOLVE. You have the power to improve patient experiences in your facility Poster

Question Title

* 10. Home Therapies

  Quantity
Know Your Options. Crossword Puzzle: Peritoneal Dialysis
Peritoneal Dialysis (PD) Start the conversation. Poster
Do you know all of your treatment options? Tri-Fold Flyer
PAC Speaks; Home Dialysis Issue: "Dialysis at Home: On My Terms" 2 Page Flyer

Question Title

* 11. PATIENT SUPPORT

  Quantity
Could you have too much calcium Poster
Enhance Your Dialysis Experience Poster
PAC Chairs Speak - January 2012 Issue: "Talking to your Doctor about Anemia Management"

Question Title

* 12. VACCINATIONS

  Quantity
Protect Yourself. Get the Vaccines You Need!  Brochure

Question Title

* 13. PEER MENTORING

  Quantity
Peer Mentorship Facility Poster

Question Title

* 14. Please contact the Network if the quantity that you require exceeds the amount allowed in the order form by written request to info@nw2.esrd.net

 
 100% of survey complete.

T