Get Outpatient Dialysis Event

Filling out the Outpatient Dialysis Event form is a crucial step in ensuring accurate surveillance and reporting for outpatient hemodialysis facilities. This guide will provide clear, step-by-step instructions to help users complete the form with confidence.

Follow the steps to complete the Outpatient Dialysis Event form effectively.

1. Press the ‘Get Form’ button to acquire the Outpatient Dialysis Event form and open it in the editor.
2. Begin by entering facility information. This includes the facility name, CMS ID number, and contact information. Make sure to provide accurate details to maintain compliance with reporting requirements.
3. Complete the patient census section. Record the number of dialysis outpatients on the first two working days of the month. Remember to stratify data by vascular access types.
4. Document Dialysis Events. For each event, designate whether it involves IV antimicrobial starts, positive blood cultures, or symptoms of infection like pus, redness, or increased swelling at the vascular access site.
5. If applicable, detail any problems or outcomes associated with the dialysis event, such as hospitalizations or adverse reactions.
6. Review all entries for accuracy. Ensure that all required fields are completed and that information aligns with the guidelines provided in the Dialysis Event Protocol.
7. After final review, save changes. You can then download, print, or share the completed form as needed for submission or record-keeping.

Take the next step in improving dialysis care by completing the Outpatient Dialysis Event form online.