CN113539421A

CN113539421A - Hemodialysis quality control system and control method thereof

Info

Publication number: CN113539421A
Application number: CN202110754854.9A
Authority: CN
Inventors: 陈丽琴; 闵浩迪
Original assignee: Shenzhen Yuchen Medical Technology Co ltd
Current assignee: Shenzhen Yuchen Medical Technology Co ltd
Priority date: 2021-07-03
Filing date: 2021-07-03
Publication date: 2021-10-22

Abstract

The invention relates to a hemodialysis quality control system and a control method thereof, wherein the system comprises: the data collection module is used for collecting data collected by the collection mechanisms in the district; the data preprocessing module is used for analyzing and preprocessing the stored data, preprocessing qualified data and then storing the preprocessed qualified data in groups; the index quality control module is used for directly comparing each item of collected data with a preset standard index or comparing the ratio obtained after the collected data are processed with a preset standard ratio; the evaluation module is used for counting the qualification rate of each index after comparison and comprehensively analyzing the indexes; and the quality control report generation module is used for generating a quality control report according to the data of the data collection module and the calculated data obtained by the index quality control calculation module and the comprehensive analysis of the qualification rate and the index of the evaluation module. The system is combined with a control method, and various data of the acquisition mechanism are compared with set indexes, so that quality control work and all-dimensional supervision of the hemodialysis industry are met.

Description

Hemodialysis quality control system and control method thereof

Technical Field

The invention relates to the technical field of medical treatment, in particular to a hemodialysis quality control system and a control method thereof.

Background

Hemodialysis is one of the kidney replacement treatment modes of patients with acute and chronic renal failure. The method comprises the steps of draining blood in vivo to the outside of the body, enabling the blood and electrolyte solution (dialysate) with similar body concentration to be inside and outside one hollow fiber through a dialyzer consisting of a plurality of hollow fibers, and carrying out substance exchange through dispersion, ultrafiltration, adsorption and convection principles, so as to remove metabolic waste in the body and maintain the balance of electrolyte and acid and alkali; at the same time, the excess water in the body is removed, and the whole process of purified blood reinfusion is called hemodialysis.

At present, a plurality of information centers, hemodialysis rooms and independent hemodialysis centers of hospitals related to hemodialysis exist in various places, each acquisition mechanism operates independently and does not have a unified quality control index, so that information of patients cannot be communicated, and further information of the patients cannot be mastered at the first time, and therefore a set of reasonable and standard hemodialysis quality control system is urgently required to be suggested.

Disclosure of Invention

The purpose of the invention is: the invention provides a hemodialysis quality control system which combines a plurality of hemodialysis data and quality control indexes so as to meet the quality control work and all-around supervision of hemodialysis industry, and the invention also aims to provide a control method of the hemodialysis quality control system which combines a plurality of quality control indexes such as patient self, acquisition mechanism equipment, quality control process, quality control result and the like to realize evaluation and supervision of an acquisition mechanism.

The technical solution of the invention is as follows: a hemodialysis quality control system, characterized in that the system comprises:

the data collection module is used for collecting data collected by the collection mechanisms in the district;

the data preprocessing module is used for analyzing and preprocessing the data stored by the data collecting module, preprocessing qualified data and then storing the qualified data in groups;

the index quality control module is used for comparing various collected data stored in groups by the data preprocessing module with a preset standard index or comparing the collected data with a preset standard ratio after calculating the ratio of various indexes in the jurisdiction through a preset formula;

the evaluation module is used for counting the qualification rate and index comprehensive analysis of each index after the index quality control module compares;

and the quality control report generation module is used for generating a quality control report according to the data of the data collection module and the calculated data obtained by the index quality control calculation module and the comprehensive analysis of the qualification rate and the index of the evaluation module.

Preferably, the method comprises the following steps: the data collection module comprises a cache database which is used for collecting collected information and outputting the collected information to the data preprocessing module, and the data collection module collects the collected information and respectively classifies the collected information into a patient basic statistical data module, an infrastructure management index module, a quality control process management index module and a quality control result management index module according to a collected object;

The collection mechanism in the district comprises an information center, a hemodialysis room and an independent hemodialysis center of a hospital.

Preferably, the method comprises the following steps: the patient basis statistics module includes:

demographic data of A: age of hemodialysis patients, their composition, prevalence of maintenance hemodialysis patients within the jurisdiction;

b, statistical data of diseases: the prevalence rates of various chronic complications of chronic renal failure hemodialysis patients, the renal pathogen morbidity diagnosis composition ratios of the hemodialysis patients, the dialysis age composition ratios of the chronic renal failure maintenance hemodialysis patients, the mean, standard deviation and median of the dialysis ages of the chronic renal failure maintenance hemodialysis patients and the infectious disease diagnosis composition of the hemodialysis patients;

c type of payment for the hemodialysis patient.

Preferably, the method comprises the following steps: the infrastructure management index module comprises:

d, bed position index: the actual/approved open bed number ratio, the composition ratio in the bed number area, the bed utilization rate, the layout and the perfection degree of the functional area;

e, personnel index: the academic calendar, the job title, the qualification and the quantity of doctors, nurses and engineering technicians;

f, equipment index: the number and configuration of dialysis devices, and the configuration of the hemodialysis mode example.

Preferably, the method comprises the following steps: the quality control process management index module comprises:

g completion rate of patient-newly-entered marker detection: AIDS virus, hepatitis B, hepatitis C, treponema pallidum;

h, timing inspection completion rate: blood routine, blood biochemistry, serum ferritin, transferrin saturation, whole parathyroid hormone, beta 2 microglobulin, serum prealbumin, and C reactive protein;

i record completion rate: urea removal index, urea reduction rate;

the completion rate of the timed detection of the hepatitis B virus marker and the hepatitis C virus marker of the J maintenance patient;

the incidence of hepatitis K and hepatitis c;

l hemodialysis equipment control index: the qualification rate of dialysis water and the execution rate of dialysate.

Preferably, the method comprises the following steps: the quality control result management index module comprises:

m hemodialysis pipeline management: patency rate of arteriovenous internal fistula, composition ratio of long-term dialysis vascular access, incidence rate of catheter-related infection, and long-term utilization rate of arteriovenous internal fistula;

n complication management index: index control rate of each substance, blood pressure control rate during dialysis;

and (4) equipment inspection qualification rate: the disinfection qualification rate of the dialysis chamber, the qualification rate of dialysis water and the execution rate of dialysate;

p dialysis patient management: the annual hospitalization rate of the maintenance hemodialysis patient, the hospitalization cause composition ratio of the maintenance hemodialysis patient, the annual death rate of the hemodialysis patient, the death cause composition ratio of the hemodialysis patient, the withdrawal reason composition of the hemodialysis patient, and the number of patients with negative positive conversion of blood-borne infectious diseases.

Preferably, the method comprises the following steps: the data preprocessing module comprises a data analysis module, a data processing module and a standardized database;

the data analysis module is divided into an index mapping group, a data quantity group and a data specification group, and the index mapping group forms a mapping relation between the data name and the index name and then respectively inputs data into the data quantity group and the data specification group to compare quantity and specification;

the data processing module standardizes the qualified data compared in the data analysis module, and then establishes tables in groups and summarizes the tables into a standardized database;

the data preprocessing module also comprises a report generating module, and the report generating module is used for collecting and comparing unqualified data and generating a report with missing data quantity or inconsistent data specification.

Preferably, the method comprises the following steps: the index quality control module comprises a description index module, a quality control process control index calculation module and a quality control structure control index calculation module, wherein the description index module, the quality control process control index calculation module and the quality control structure control index calculation module respectively calculate the ratio of each index in the jurisdiction according to a preset formula, then compare the ratio with a preset standard ratio, and output the score of each index.

Preferably, the method comprises the following steps: the evaluation module comprises a qualification rate statistic module for calculating the qualification rate of the acquisition mechanism according to the output scores of the index quality control module and an index comprehensive analysis module for analyzing according to the scores and the qualification rate of the index quality control output module.

A control method of a hemodialysis quality control system, comprising the steps of:

the method comprises the steps of setting a cache database, and collecting various data collected by each collection mechanism in an administration area into the cache database for storage;

according to the preset fields and the near-meaning words of the preset indexes, a word dictionary is omitted through the index mapping group, fuzzy matching is conducted on the word dictionary and the names of the data collected in the cache database, and the mapping relation between the data and the indexes is formed; if the data name cannot form a corresponding relation with the index name, the report generation module forms a data error report; if the index name which cannot be corresponded still exists after the matching is finished, the report generation module forms a data missing report;

comparing the data quantity with a preset index required base number by the data preprocessing module, rejecting the data if the data quantity is less than the preset index required base number, and generating a rejection report by the report generating module;

The data preprocessing module compares the data specification with a preset index requirement specification, if the data specification does not conform to the preset index requirement specification, the data is refuted, and the report generating module generates a refuted report;

fifthly, carrying out data format cleaning on the data which are qualified through comparison, carrying out standardized entry, grouping and tabulating, and then concluding to enter a standardized database;

providing grouped data in a standardized database by an index quality control module, summarizing a patient basic statistical data module and a basic setting management index module into a description index module, and carrying out classified statistics on each data or comparing each data with a preset index to output the score of each data;

the quality control process management index module is induced into a quality control process index calculation module, each data ratio is calculated according to a preset formula to obtain each data ratio, and the data ratios are compared with the preset index ratio to output the score of each data;

the quality control result management index module is induced into a quality control result index calculation module, each data ratio is calculated according to a preset formula to obtain each data ratio, and the data ratios are compared with the preset index ratio to output the score of each data;

The stranded evaluation module evaluates the following equation:

the quality control module calculates the total score of the output data/the total score of the preset index multiplied by 100 percent according to the statistical index;

the average qualification rate of the acquisition region mechanisms is equal to the total score of data/the total score of preset indexes/the number of the region mechanisms multiplied by 100 percent calculated and output by the quality control module of the statistical indexes;

obtaining the qualification rate of each acquisition mechanism and the average qualification rate of acquisition area mechanisms, and outputting index comprehensive analysis to a quality control report generation module according to the index comparison result;

and the quality control report generation module respectively outputs a regional quality control report, a annual regional institution quality control report and an annual regional patient research report according to requirements.

Compared with the prior art, the invention has the beneficial effects that:

according to the hemodialysis industry and hemodialysis system, multiple quality control data such as patient self data, acquisition mechanism equipment data, quality control process data and quality control result data are carried out on an acquisition mechanism, and compared with standard indexes preset by the system, the hemodialysis industry and hemodialysis industry are supervised from multiple aspects, monitoring and medical risk prevention are realized from the multiple quality control data, informatization construction of hemodialysis industry and hemodialysis industry is improved, and medical safety is guaranteed.

Drawings

FIG. 1 is a schematic diagram of the components of a hemodialysis quality control system of the present invention;

Fig. 2 is a control flow block diagram of the control system of the present invention.

Detailed Description

The invention will be described in more detail below with reference to the accompanying drawings:

the first embodiment is as follows:

in a specific embodiment, the present invention first provides a first embodiment, a specific hemodialysis quality control system:

the following detailed description of the preferred embodiments of the present invention, taken in conjunction with the accompanying drawings, will make the advantages and features of the invention more readily understood by those skilled in the art, and thus will more clearly and distinctly define the scope of the invention. The directional terms used in the present invention, such as "up", "down", "front", "back", "left", "right", "top", "bottom", etc., refer to the directions of the attached drawings. Accordingly, the directional terms used are used for explanation and understanding of the present invention, and are not used for limiting the present invention.

Referring to fig. 1, a hemodialysis quality control system, the system comprising:

The data collection module comprises a cache database which is used for collecting collected information and outputting the collected information to the data preprocessing module, and the data collection module collects the collected information and respectively classifies the collected information into a patient basic statistical data module, an infrastructure management index module, a quality control process management index module and a quality control result management index module according to a collected object;

The patient basis statistics module includes:

c, payment type composition of the hemodialysis patient;

the infrastructure management index module comprises:

f, equipment index: the number and configuration of dialysis devices, and the configuration of the hemodialysis mode example;

the quality control process management index module comprises:

I record completion rate: urea removal index, urea reduction rate;

the incidence of hepatitis K and hepatitis c;

l hemodialysis equipment control index: the qualification rate of dialysis water and the execution rate of dialysate;

the quality control result management index module comprises:

n complication management index: index vacancy rate of each substance, blood pressure control rate in dialysis;

The data preprocessing module comprises a data analysis module, a data processing module and a standardized database;

The data analysis module is divided into a data quantity group, a data specification group and an index mapping group;

the data quantity group is used for comparing the quantity of the provided collected data with the preset index quantity, and if the set index quantity is required to be 100 parts and the quantity of the provided collected data is less than 100 parts, the data is rejected;

the data specification group is used for comparing the provided collected data specification with a preset index specification. If the set index specification requires 3 times of detection in one week and the provided collected data specification is once detection in one week, carrying out rejection processing on the data;

the index mapping group is used for presetting fields and near-meaning words of all preset indexes, omitting a word dictionary, and carrying out fuzzy matching on the names of all data collected in the cache database to form a mapping relation between the data and the indexes;

the data preprocessing module also comprises a report generating module which is used for collecting unqualified rejected data and generating a report with data quantity missing or data specification not meeting the requirement.

The index quality control module comprises a description index module, a quality control process control index calculation module and a quality control structure control index calculation module, wherein the description index module, the quality control process control index calculation module and the quality control structure control index calculation module respectively calculate the ratio of each index in the jurisdiction according to a preset formula, then compare the ratio with a preset standard ratio, and output the score of each index;

the evaluation module comprises a qualification rate statistic module and an index comprehensive analysis module, the evaluation module obtains the qualification rate of each acquisition mechanism according to the total score of data calculated and output by the index quality control module and the total score of preset indexes, and outputs the index comprehensive analysis to the quality control report generation module according to the index comparison result, and the quality control report generation module outputs the final quality control report to each acquisition mechanism according to the requirements.

Example two:

in the second embodiment, on the basis of the first embodiment, the quality control system performs calculation and scoring in a subsequent manner:

a control method of a hemodialysis quality control system specifically comprises the following steps:

the stranded evaluation module evaluates the following equation:

The data statistics and calculation score standard in the step sixteenth are as follows:

The data acquisition of description index module comes from patient's basic statistics data module and basic setting management index module, and the data acquisition directly compares with the index, the score standard of each index of description index module is as follows:

1. demographic data:

1.1, age of hemodialysis patient and its composition: the mean age of the patients in the institutional maintenance dialysis and the mean age of the patients in the area were used for classification, not to count the scores.

1.2, prevalence of intra-jurisdictional maintenance hemodialysis patients: the index is used for classifying the percentage of the population in the region occupied by the maintenance hemodialysis patients of each collection mechanism in the statistical region in the time period, and the score is not counted.

2. Statistical data of the disease:

2.1 prevalence of various chronic complications in chronic renal failure hemodialysis patients: the index is used for recording the composition ratio of various chronic complications of chronic renal failure hemodialysis patients in the hemodialysis patients, and the index is used for classification and is not counted into scores.

2.2, the diagnosis of the renal pathogens of the hemodialysis patients comprises the following components: the primary onset diagnosis of renal disease of patients within the jurisdiction is named and classified, and the index is only used for classification and does not count the score.

2.3, the dialysis age composition ratio of chronic renal failure maintenance hemodialysis patients: the dialysis age of the patients in the district is counted according to 4 dialysis age time periods of less than 12 months, more than 12 months and less than 36 months, 36 months and less than 60 months and more than 60 months, and in addition, the time period can be customized by each acquisition institution, and the index is only used for classification and does not count the score.

2.4 mean, standard deviation and median dialysis age of chronic renal failure maintenance hemodialysis patients: the mean, standard deviation and median were calculated for patients with continuous regular hemodialysis over 3 months in the jurisdiction, and this index was used only for statistics and no score was taken.

2.5, the infectious disease diagnosis of hemodialysis patients comprises: statistics are performed on common infectious diseases of patients within the jurisdiction, such as: hepatitis B, hepatitis C, syphilis, AIDS and tuberculosis, through statistics of a plurality of continuous time points, the index is used for an index comprehensive analysis module in an evaluation module to use, and is used for analyzing the fluctuation of the prevalence rate of certain infectious diseases in hemodialysis population in an area, analyzing whether the fluctuation is caused by the fluctuation of a certain acquisition mechanism or the result caused by a certain system reason, and not counting scores by the index.

3. The type of payment for a hemodialysis patient constitutes: the method is used for counting the payment way of the patient and can be used as reference data of a designated policy of a medical insurance department in a district, and the score is not counted by the index.

4. Bed position index:

4.1, ratio of actual/approved open bed numbers: and counting the actually used bed, if the actually used bed does not exceed the approved number of beds, integrating 1 point, and if the actually used bed exceeds the approved number of beds, integrating 0 point.

4.2, the composition ratio in the dialysis bed number area is as follows: counting the number of hemodialysis beds formally put into use in the acquisition mechanism, analyzing whether the receiving capacity of the acquisition mechanism can be matched with the population base number of the region by an index comprehensive analysis module in an evaluation module, and combining corresponding data elements during analysis: population base, incidence, and prevalence of maintenance hemodialysis, this index not counting scores.

4.3, bed utilization rate: the acquired data is a calculation formula mainly designed according to open shifts common in acquisition institutions, and each dialysis device is normally used for 12 times (2-shift dialysis) or 18 times (3-shift dialysis) per week, and the calculation formula is as follows:

the collection institution opens 2 shifts of bed usage rate which is the example of hemodialysis room (center) dialysis treatment/(the number of hemodialysis beds approved at the same time × 12 × the number of weeks) × 100%;

The usage rate of 3 shifts of bed positions opened by the collection institution is equal to the example of central dialysis treatment/(the number of hemodialysis bed positions approved at the same time multiplied by 18 multiplied by the number of weeks multiplied by 100 percent;

according to the bed utilization rate obtained by the formula, if the bed utilization rate is less than 100% and more than 80%, 1 point is accumulated, and if the bed utilization rate is more than 100% or less than 80%, 0 point is accumulated, and the index comprehensive analysis module further analyzes the reason.

4.4, layout and functional area perfection degree: the acquisition mechanism is scored according to the layout requirement, if the score reaches the total score (10 points), the score is integrated into 1 point, if the score is lower than the total score (10 points), the score is integrated into 0 point, the index comprehensive analysis module lists the regions which do not reach the standard, and the layout scoring requirement is as follows:

functional area: dialysis treatment room (setting up general treatment area and/or isolation treatment area) (0.5 min) and treatment preparation room (0.5 min); auxiliary functional area: a water treatment room (0.5 min), a clean warehouse (0.5 min), a sewage treatment room (0.5 min), a sanitary appliance room (0.5 min), a reception room/area (0.5 min), a patient changing room (0.5 min), and the like; medical staff offices (0.5 point) and living quarters (0.5 point). Dividing the cleanliness area into error-free areas (5 points): clean area (2 min each item 0.5 button up): a treatment preparation room, a water treatment room, a clean storehouse, a liquid preparation room, a reused dialyzer storage room, a medical staff office and a living area; potential infection risk area (2 points, 0.5 buttons each): dialysis treatment room, special operating room/operating room, examination room/area and patient dressing room; contaminated area (1 min each item 0.5 button up): a dialyzer multiplex room, a sewage treatment room and a sanitary appliance room.

5. Personnel indexes are as follows:

5.1, the scholars, titles, qualifications and quantities of doctors, nurses and engineering technicians: according to the requirements of national standard operating code 2020 edition of blood purification: firstly, a doctor: at least 2 medical practitioners were on duty per dialysis shift, and no more than 30 patients were administered to a stable maintenance hemodialysis patient per shift. A nurse: each nurse is responsible for no more than 5 patients with stable disease and maintenance dialysis per shift; when the full-automatic dialysis system for supplying dialysate in a centralized manner is adopted, the number of patients managed by nurses in each shift can be increased properly, but is not more than 6-8 patients. (iii) the technician: equipping at least 1 full-time engineer/technician; more than one dialysis rooms of the dialysis machine 10 should be configured to increase the number of engineers/technicians appropriately according to the workload;

if the personnel index of the acquisition mechanism does not meet the requirement, integrating 0 point, and if the personnel index meets the standard, integrating 1 point;

6. equipment indexes are as follows:

6.1, number and constitution of dialysis devices: the total number of the conventionally used hemodialysis devices and hemodiafiltration devices is consistent with the approved open bed number, the total number is 1 point, if the total number is greater than the approved open bed number, the total number is 0 point, and the index comprehensive analysis module shows that the hemodialysis treatment can be carried out without being recorded.

6.2, constitution of hemodialysis mode example: the index is used for collecting the dialysis quality of an organization and the proportion of various dialysis treatment modes, and the index does not count the score.

The collected data of the quality control process control index calculation module come from the quality control process management index module, the collected data are processed according to a set formula and then are compared with the index ratio, and the calculation mode and the score standard of the quality control process control index calculation module are as follows:

7. completion rate of detection of newly entered patient markers:

the number of newly-entered hemodialysis patients with blood-borne infectious disease markers/the number of all hemodialysis patients newly entered at the same time is multiplied by 100 percent;

after the patients need to complete the detection of four markers of HIV, hepatitis B, hepatitis C and treponema pallidum, 1 completion unit is counted, and the score standard is that the ratio of the number of patients who complete the detection of 4 standard substances to the total number of patients is multiplied by 100% by 1, for example: the number of patients who completed the 4-item standard test was 90, and the score was 0.9 for 100 total patients.

8. And (3) timing inspection completion rate:

8.1, blood routine, blood biochemistry:

the completion rate of the regular test of the maintenance hemodialysis patients is equal to the number of the maintenance hemodialysis patients completing the regular test within 3 months/the number of the contemporary maintenance hemodialysis patients x 100%,

Or: the completion rate of the regular test of the maintenance hemodialysis patient is equal to the actually recorded number of regular tests of the maintenance hemodialysis patient every 3 months/the number of routine tests of the blood of the maintenance hemodialysis patient which should be recorded at the same time multiplied by 100 percent;

a first calculation formula can be used for cross-sectional survey statistics, and a second calculation formula can be used for annual statistics.

Wherein the interval between every two tests of the number of patients with maintenance hemodialysis is less than 3 months, the interval time is more than or equal to 3 months and is defined as incomplete, the scores of the completion rates of the blood routine test and the blood biochemical timing test are respectively calculated according to the ratio of the number of the patients who have completed the timing test to the total number of the patients, multiplied by 100% multiplied by 1, for example: the number of patients who finish the routine blood test is 90, the number of patients who finish the biochemical blood test is 80, and the total number of patients is 100, so the routine blood test score is 0.9, and the biochemical blood test score is 0.9.

8.2, serum ferritin, transferrin saturation, whole parathyroid hormone, beta 2 microglobulin, serum prealbumin, C reactive protein, blood borne infectious disease markers:

the completion rate of the regular test of the maintenance hemodialysis patients is equal to the number of the maintenance hemodialysis patients completing the regular test within 6 months/the number of the synchronous maintenance hemodialysis patients multiplied by 100 percent,

Or: the periodic test completion rate of the maintenance hemodialysis patients is equal to the actually recorded number of times of completing 1 periodic test every 6 months/the total number of times of completing transferrin saturation tests recorded in all the maintenance hemodialysis at the same period is multiplied by 100%;

the first calculation formula can be used for cross section survey statistics, and the second calculation formula is used for annual statistics;

wherein patients who have been on hemodialysis for 6 months in the collection facility should have completed at least 1 timed test. The time interval of every two timing tests is more than or equal to 6 months, if the time interval is less than 12 months, the test is not finished, the scores of the completion rate of the timing tests of the serum ferritin, the saturation of transferrin, the whole parathyroid hormone, the beta 2 microglobulin, the serum prealbumin, the C reactive protein and the blood-borne infectious disease marker are respectively calculated according to the ratio of the number of patients who finish the timing tests to the total number multiplied by 100% multiplied by 1, and the score of each marker is 1.

9. Urea removal index, timed record completion rate of urea decline rate:

urea clearance index (Kt/v) and urea decline rate (URR) for maintenance hemodialysis patients the number of maintenance hemodialysis patients completing the urea clearance index (Kt/v) and urea decline rate (URR) records within 6 months/number of contemporary maintenance hemodialysis patients x 100%;

Or: urea clearance index (Kt/v) and urea decline rate (URR) timed recordings completion rate for maintenance hemodialysis patients-the number of times urea clearance index (Kt/v) and urea decline rate (URR) recordings should be completed 1 time every 6 months/total number of times urea clearance index (Kt/v) and urea decline rate (URR) recordings should be completed for all maintenance hemodialysis at the same time x 100%;

the first formula, which can be used as a cross-sectional survey of the urea clearance index (Kt/v) and urea decline rate (URR) of a maintenance hemodialysis patient at a certain point in time to complete the timed recording, is a special case of the second formula.

Wherein, each patient should record urea clearance index (Kt/v) and urea decline rate (URR) level for at least 1 time within 6 months of continuous hemodialysis, if the time interval between two records is more than or equal to 6 months, the record is considered to be not completed once, the timed record completion rate scores of urea clearance index (Kt/v) and urea decline rate (URR) are respectively calculated according to the ratio of the number of patients who finish timed test of urea clearance index (Kt/v) and urea decline rate (URR) to the total number of patients multiplied by 100% multiplied by 1, and each index full score is 1.

10. Incidence of hepatitis b and hepatitis c: used for counting the proportion of patients with maintenance hemodialysis who have hepatitis B and hepatitis C, and the index is not counted as a score.

11. Hemodialysis equipment control indexes:

11.1, qualification rate of dialysis water:

comprises a dialysis water quality monitoring execution rate, a biological pollution test (bacteria culture) execution rate and a biological pollutant (endotoxin) test annual execution rate;

wherein the water quality monitoring for dialysis includes monitoring pH of pure water at least 1 time per month, culturing terminal bacteria of reverse osmosis water pipeline at least 1 time per month, monitoring terminal endotoxin of reverse osmosis water pipeline at least 1 time per 3 months, determining chemical pollutants at least 1 time per year, performing soft water hardness and total chlorine at least 1 time per day, completing all the above-mentioned detections, recording as one detection completion and nesting in a formula:

the execution rate of the dialysis water quality monitoring is the number of times of monitoring each water quality index/the number of times of monitoring each water quality index in the same period multiplied by 100 percent;

integrating 1 point when the execution rate calculated according to the formula is equal to 100%, integrating 0 point when the execution rate is less than 100%, outputting the index comprehensive analysis module to be corrected, and outputting the index as an early warning index if the execution rate is less than 100% for three times;

the execution rate of the biofouling test (bacterial culture) was calculated by the following formula:

preparing the annual execution rate of the water bacteria for dialysis, namely the number of times of the water bacteria for dialysis cultured/12 multiplied by 100%;

Wherein the number of times of the water bacteria culture for dialysis is recorded as once a month, if the execution rate calculated according to the formula is equal to 100%, the volume is 1 point, and if the execution rate is less than 100%, the volume is 0 point;

the annual execution rate of the biological contaminant (endotoxin) test was calculated by the following formula:

the annual execution rate of the dialysis water biological pollutant (endotoxin) test is equal to the number of times of the dialysis water endotoxin test/synchronization, and the number of times of the dialysis water bacteria culture is regulated according to the SOP or 4 × 100%;

the number of endotoxin tests for dialysis was recorded once a quarter, and if the execution rate calculated according to the formula was equal to 100%, the product was divided into 1 and less than 100%, the product was divided into 0.

11.2, dialysate execution rate:

the method comprises the following steps of bacterial culture execution rate and liquid endotoxin test execution rate:

the bacterial culture execution rate was calculated by the following formula:

the execution rate of the dialysate bacterial culture of the dialysis machine is equal to the number of cases of complete dialysate bacterial culture examination actually recorded by all the running dialysis machines/the number of cases of performing the dialysate bacterial culture in the same period multiplied by 100%;

wherein the maximum allowable level of the bacteria culture in accordance with the standard dialysate is less than 100CFU/ml, and the intervention level is 50 CFU/ml; the criterion that the maximum allowable level of ultra-pure dialysate bacterial culture is less than 0.1CFU/ml is recorded as an example, and the allowable value of dialysate bacterial culture for low-throughput dialysis and the intervention level are performed according to the standard dialysate; high-throughput dialysis or hemodiafiltration is performed as ultra-pure dialysate;

Taking 1 natural year as a statistical time interval, and integrating 1 point when the bacterial culture execution rate calculated according to a formula is equal to 100% and integrating 0 point when the bacterial culture execution rate is less than 100% in the statistical time interval;

the liquid endotoxin assay performance rate was calculated by the following formula:

the dialysate endotoxin test execution rate of the dialysis machine is equal to the number of cases of completion of the dialysate endotoxin test actually recorded by the operation dialysis machine/the number of cases of performing the dialysate endotoxin test in the same period multiplied by 100 percent;

wherein the liquid endotoxin test conforms to the standard dialysate endotoxin test with the maximum allowable level less than 0ml and the intervention level 0.25 EU/ml; the standard that the maximum allowable endotoxin level of the ultrapure dialysate is less than 0.03EU/ml is recorded as an example, and the maximum allowable endotoxin value and the intervention level of the dialysate subjected to low-flux dialysis are performed according to the standard dialysate; high-throughput dialysis or hemodiafiltration is then performed on ultrapure dialysate.

Taking 1 natural year as a statistical time interval, and integrating 1 point when the liquid endotoxin test execution rate calculated according to a formula is equal to 100% and integrating 0 point when the liquid endotoxin test execution rate is less than 100% in the statistical time interval.

The collected data of the quality control result control index calculation module come from the quality control result management index module, and the collected data is compared with the index ratio after being processed according to a set formula;

12. Managing a hemodialysis pipeline:

12.1, patency rate of arteriovenous internal fistula:

the calculation is made by the following formula:

the patency rate of the arteriovenous internal fistula of the maintenance hemodialysis patient is equal to the number of days for the arteriovenous internal fistula of the maintenance hemodialysis patient to be unobstructed/the total number of days for the maintenance hemodialysis patient to use the arteriovenous internal fistula multiplied by 100%;

the method is used for counting days for maintaining patency in arteriovenous of hemodialysis patients, and the index does not count the score.

12.2, long-term dialysis vascular access composition ratio:

for counting the proportion of hemodialysis patients who adopt different long-term dialysis vascular accesses, wherein the long-term dialysis vascular access comprises: autologous arteriovenous internal fistula, graft internal fistula, central venous catheters (catheters with tunnels and dacron sleeves) and the like, and the score is not counted according to the indexes.

12.3, incidence of catheter-related infection:

for counting the frequency of catheter-related infections in hemodialysis patients treated by hemodialysis catheters for vascular access dialysis, in which the possible infections caused: local infection, phlebitis, catheter bacterial colonization, catheter-related blood circulation infection, this index is not counted as a score.

12.4, the long-term utilization rate of arteriovenous internal fistula:

the number of patients with maintenance hemodialysis with the same arteriovenous internal fistula lasting for more than 2 years is counted, and the index is not counted into a score.

13. Complication management index:

13.1, index control rate of each substance:

including index control rates for renal anemia, blood calcium, blood scales, IPTH, serum albumin, urea clearance index (Kt/V), Urea Reduction Rate (URR), weight gain, renal disease-mineral and bone abnormalities;

for the renal anemia index, the score calculation formula is as follows:

the control rate of renal anemia of hemodialysis patients is equal to the number of maintenance hemodialysis patients/the number of synchronized maintenance hemodialysis patients with hemoglobin more than or equal to 110g/L multiplied by 100 percent;

the control rate of renal anemia of a hemodialysis patient is equal to or more than 100% of the hemoglobin test times of a maintenance hemodialysis patient actually recorded in a maintenance hemodialysis patient in a case/period in which hemoglobin is actually recorded at a certain value;

for the blood calcium index, the score calculation formula is as follows:

the blood calcium control rate of hemodialysis patients is that the blood calcium level is 2.10-2.50mmol/L of the number of patients in maintenance hemodialysis/the number of patients in maintenance hemodialysis at the same period is multiplied by 100 percent;

the blood calcium control rate of the hemodialysis patient is equal to the test times of the blood calcium level of the example/contemporary maintenance hemodialysis patient, the blood calcium level of which is 2.10-2.50mmol/L, which is actually recorded according to the patient schedule, multiplied by 100 percent;

For the blood scale index, the score calculation formula is as follows:

hemodialysis patients' blood phosphorus control rate-the number of patients undergoing maintenance hemodialysis with blood phosphorus level of 1.13-1.78 mmol/L/number of patients undergoing concurrent maintenance hemodialysis x 100%;

the blood phosphorus control rate of the hemodialysis patient is equal to the number of blood phosphorus level tests which are actually recorded by the patient according to the patient schedule of the example/contemporary maintenance hemodialysis patient with the blood phosphorus level of the maintenance hemodialysis patient being 1.13-1.78mmol/L, multiplied by 100 percent;

for the IPTH index, the score calculation formula is as follows:

the control rate of IPTH (IPTH) of the hemodialysis patients is 2-9 times of the number of patients with maintenance hemodialysis with iPTH level at the upper limit of a normal value/the number of patients with synchronous maintenance hemodialysis multiplied by 100%;

the control rate of blood IPTH of a hemodialysis patient is equal to the test frequency of blood IPTH level actually recorded by a patient with synchronous maintenance hemodialysis, wherein the upper limit of the blood IPTH level of the patient with maintenance hemodialysis is 2-9 times of the upper limit of a normal value, and the test frequency is multiplied by 100%;

for the serum albumin index, the score calculation formula is as follows:

hemodialysis patient serum albumin control rate-number of maintenance hemodialysis patients with serum albumin > 35 g/L/number of contemporary maintenance hemodialysis patients x 100%;

the control rate of serum albumin of hemodialysis patients is that the test times of serum albumin level of example/synchronous maintenance hemodialysis patients with the serum albumin level of maintenance hemodialysis patients being more than 35g/L are multiplied by 100 percent according to the actual record of the patients;

For the indexes of urea clearance index (Kt/V) and Urea Reduction Rate (URR), the score calculation formula is as follows:

number of maintenance hemodialysis patients/number of contemporaneous maintenance hemodialysis patients x 100% with hemodialysis patients Kt/V and URR control rates spKt/V greater than 1.2 and URR greater than 65%;

Kt/V and URR control rate of hemodialysis patients is equal to spKt/V which is more than 1.2 and URR is more than 65 percent of example/same-period maintenance hemodialysis patients, and spKt/V and URR test times which are actually recorded by the patients are multiplied by 100 percent;

aiming at the weight gain rate index, the score calculation formula is as follows:

the control rate of weight increase during dialysis is the number of hemodialysis patients with weight increase less than 5% during dialysis/the number of hemodialysis patients in the same period x 100%;

inter-dialysis weight gain control rate-inter-dialysis weight gain less than 5% dialysis cases/cases of all hemodialysis in the same phase x 100%;

aiming at the kidney disease-mineral and bone abnormality indexes, the score calculation formula is as follows:

the control rate of CKD-MBD index of the maintenance hemodialysis patients is CKD-MBD index control to reach the standard, the number of the maintenance hemodialysis patients/the total number of the maintenance hemodialysis patients in the same period is multiplied by 100 percent;

the CKD-MBD index control rate of the maintenance hemodialysis patient is CKD-MBD index control standard reaching times/the times of KD-MBD index test of the maintenance hemodialysis patient according to the actual record of the patient is multiplied by 100 percent;

The above index calculation formulas are two groups, the first formula is the control rate of a certain time point, the second formula is the control rate accumulated in a period, the score of each index is calculated according to the ratio of the number of the patients reaching the standard to the total number of the detected patients multiplied by 100% multiplied by 1, and the full score of each index is 1 point

13.2, blood pressure control rate during dialysis: including the incidence of hypotension and the control rate of hypertension in hemodialysis, and is used for counting the proportion of people with hypotension to the total number of patients and the proportion of people with hypertension to the total number of patients in hemodialysis, and the index does not count the score.

14. Equipment inspection qualification rate: the method is the same as the method for calculating the control index score of the hemodialysis equipment in the quality control process calculation module;

15. dialysis patient management:

15.1, annual hospitalization rate of maintenance hemodialysis patients: the index comprehensive analysis module is used for counting the hospitalization times of the maintenance hemodialysis patient, the index does not count the score, and if the annual hospitalization rate is higher than the preset average hospitalization rate, specific reasons are marked and required to be analyzed in a report output by the index comprehensive analysis module.

15.2, the hospitalization reasons of the maintenance hemodialysis patient are as follows: for analysis of complications leading to hospitalization of maintenance hemodialysis patients, this index was not scored.

15.3 annual mortality rate in hemodialysis patients: for counting the deaths of hemodialysis patients in different periods, this index is not counted into scores.

15.4, the death cause ratio of hemodialysis patients: for analysis of the cause of death in patients with maintenance hemodialysis, this index was not scored.

15.5, the reason for the hemodialysis patient to withdraw from the hemodialysis treatment comprises: for analysis of the reason for the withdrawal of a maintenance hemodialysis patient from the hemodialysis treatment, this index is not included in the score.

15.6, the number of patients with negative positive conversion of blood-borne infectious diseases: as important nosocomial infection prevention and control indexes and early warning indexes, if negative positive patients turn positive in the acquisition mechanism, the total score of the indexes in the acquisition mechanism is-31, and an unqualified report is directly output in the evaluation module.

Example three:

in this embodiment, the evaluation methods of the quality control process and the quality control result system in the second embodiment are further improved:

in this embodiment, with the system as in the first embodiment, in the quality control process and the quality control result system, in order to determine the quality control process index, when the specific system calculates and processes, each index is respectively calculated and processed in the following manner:

Dialysis water quality monitoring execution rate: the test times of each quality index of hemodialysis reverse osmosis water in the hemodialysis chamber (center) account for the proportion of the test times.

The water quality monitoring of the dialysis water comprises monitoring the PH of pure water at least 1 time per month, culturing bacteria at the tail end of a reverse osmosis water conveying pipeline at least 1 time per month, monitoring endotoxin at the tail end of the reverse osmosis water conveying pipeline at least 1 time per 3 months, measuring chemical pollutants at least 1 time per year, and measuring the hardness of soft water and total chlorine at least 1 time per day. The index is used for monitoring the management condition of the hemodialysis room (center) for ensuring the quality and safety of dialysis water.

Calculating the formula: the execution rate of the dialysis water quality monitoring is the number of times of monitoring each water quality index/the number of times of monitoring each water quality index in the same period multiplied by 100 percent; wherein the formula is used for the hemodialysis chamber (center), molecular: determining the denominator of times of various water quality index tests of the dialysis water in a certain period: determining the number of times that a hemodialysis chamber (center) is used for monitoring various water quality indexes according to the regulation of SOP in a time period

In the actual statistical process, statistics is generally carried out according to a natural year. And if the number of the natural years is less than 1, counting the execution rate according to the actual natural month. If the dialysis water test result is out of the normal range, the dialysis water needs to be timely processed and re-tested, and the execution rate can be more than 100%.

If the hemodialysis room (center) is provided with 2 sets or more than 2 sets of daily-used water treatment equipment, if the water treatment equipment is used simultaneously, the execution rate is respectively calculated according to the equipment 1 and the equipment 2, and the execution rate is uploaded to a quality control system according to a smaller one. If the device is used alternatively, the execution rate is not calculated according to the device. .

All records of the inspection, if not available from the Lis system, need to be manually filled in and the inspection report pictures uploaded.

[ Inclusion in groups ]

Number of times of examination of dialysis water for the water treatment apparatus being used.

[ exclude population ]

The examination of the dialysis water for the water treatment plant which is ready for use and not in use is self-determined by the respective centers and is not included in the statistics.

[ Specification of the denominator ]

Soft water hardness and total chlorine were counted monthly and yearly, and denominator was the corresponding number of days.

The bacteria number of the water for dialysis is counted quarterly and annually, and the denominator is the number of months.

The endotoxin level of the dialysis water was counted in accordance with the year, and the denominator was the number of natural seasons.

After the water treatment equipment is installed and water is introduced, the number of times of inspection is counted from the first inspection.

[ Inclusion in groups ]

Soft water

Reverse osmosis water

[ exclude population ]

Is free of

[ data elements ]

Hardness of

Total chlorine

Bacterial colony count

Endotoxin levels

pH value

Chemical contaminants

Dialysis water quality parameter checking time

Quality parameter inspection result of dialysis water

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the port and the protocol of the water treatment equipment are opened, part of parameters can be directly read to the hemodialysis information system end and then uploaded.

If the port and protocol of the water treatment equipment are not acquired, the parameters of the dialysis water are manually filled by a hemodialysis room (center) engineer, and unfinished projects can be reminded according to the specified time to urge the completion of the projects.

If the bacterial culture result can be read from Lis, the data read by the hemodialysis system can be directly uploaded to a quality control system.

The inspection results which cannot be read from the LIS or obtained from the third-party inspection institution are manually filled in, and corresponding picture files are uploaded for checking.

Mechanisms for monitoring the quality of the dialysis water which is not completed in time, unfinished projects and overdue time are reflected on a quality control management system.

[ analytical advice ]

The pH value should be maintained in the normal range of 5-7, and the sampling part is at the reverse osmosis water outlet.

Bacteria counts of <100cfu/ml are required. The sampling part is the tail end of the reverse osmosis water conveying pipeline.

Endotoxin is required to be less than 0.25EU/ml, and the sampling part is the tail end of the reverse osmosis water conveying pipeline.

The hardness requirement is less than 17ppm, and the sampling part is at the hardness sampling port.

The total chlorine requirement is less than 0.1mg/L, and the sampling part is arranged at a reverse osmosis water outlet.

If the quality monitoring of the dialysis water is not qualified, the reason is found as soon as possible and is rechecked after being corrected in time until the quality is qualified. The result of the rechecking is not included in the calculation of the water quality monitoring execution rate any more. 2 consecutive failures require the hemodialysis room (center) and the related functional personnel, department or manufacturer to jointly search for the reason and modify it.

The modification reaches the qualified standard within a monitoring time window.

If the quality control system is not qualified for 3 times continuously, the quality control system takes the early warning as an early warning index.

Execution rate of biological contamination test (bacterial culture) for water for dialysis

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-17(NEP-D-02)

[ DEFINITIONS ]

The number of bacterial cultures per 1 month of hemodialysis water in the hemodialysis room (center) is proportional to the number of tests required per year for SOP.

[ MEANS FOR solving PROBLEMS ]

Reflecting the condition of hemodialysis room (center) to ensure the quality management of water for dialysis.

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

The medical industry standard of the people's republic of China "hemodialysis and related Water for treatment" (YY0572-2015) has incidence and incidence

[ equation ]

The annual execution rate of the culture of the bacteria for dialysis is 12X 100%

[ rules of calculation ]

Molecule (a): the number of times of water bacteria culture for dialysis was determined over the period.

Denominator: the number of bacterial cultures to be completed with dialysis water was allocated in a fixed period according to the SOP regulations, 12 times per year.

[ molecular description ]

Dialysis was performed with the actual number of water bacteria cultures.

And calculating by correlating the uploaded test results.

The monitoring time window for the dialysis water bacterial culture is agreed to be each natural month, and the last day in each natural month is considered as a month in which the test is not completed if no test result exists. .

In the case where the bacterial culture was completed according to the SOP requirement in all months of 1 year, the number of cultures exceeded the SOP regulation, and the number of months of 2 extra times was counted as 1.

If the bacterial culture is not completed in a certain 1 month, the annual execution rate is 91.6 percent, and the bacterial cultures which are more than 1 time in other months are not accumulated.

[ Inclusion in groups ]

Completion rate of biological contaminant test (bacterial culture) of dialysis water actually completed in year

[ excluded population ].

If the bacteria culture result does not reach the standard in a certain 1 month, the quality requirement of the dialysis water is met by rechecking immediately after the reason is found and the correction is done as soon as possible, and if the rechecking result is not accumulated in the samples collected in the same month

[ Specification of the denominator ]

The number of times to be checked is accumulated monthly according to the specification of SOP, and is every natural month. There should be one test just before the beginning of the visit in the dialysis room (center). And counting according to the natural month from the 2 nd month.

[ Inclusion in groups ]

The number of times of biological contaminants (bacterial cultures) for dialysis was completed all year round.

[ exclude population ]

More than one test per month, no statistics were included.

[ data elements ]

Water bacteria culture for dialysis

Dialysis water quality parameter checking time

Biological contaminant for dialysis water

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the dialysis water culture is self-checked by the medical treatment unit and can be read from the Lis of the unit, the water culture can be directly read from the system.

If the results of the water bacterial culture for dialysis were not read from the LIS, they were manually filled in cfu/ml. A picture of the original of the inspection result is uploaded.

[ analytical advice ]

The quality standard of the prepared concentrated solution and the prepared dialyzate is required to meet the current industry standard of hemodialysis and related treatment water.

Annual execution rate of biological pollutant (endotoxin) test for water for dialysis

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-18(NEP-D-02)

[ DEFINITIONS ]

Hemodialysis room (center) dialysis uses water for endotoxin tests every 3 months in proportion to the number of tests required per year for SOP.

[ MEANS FOR solving PROBLEMS ]

Reflects the management condition of the hemodialysis room (center) for ensuring the quality and safety of the dialysate.

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

Standard of the medical industry of people's republic of China (hemodialysis and water for related treatments) ("YY 0572-2015)

[ equation ]

The annual execution rate of the test for biological contaminants (endotoxin) in water for dialysis-the number of tests for endotoxin in water for dialysis/the number of times of culture of water for dialysis in accordance with the SOP regulation or 4X 100%

[ rules of calculation ]

Molecule (a): the number of endotoxin tests on the dialysate was determined over the period.

Denominator: the time period was determined according to the SOP specification for the number of dialysis water endotoxin tests.

[ molecular description ]

The determined period is calculated according to the natural month.

And taking the first result in the current season as the calculation result. If the result of the 1 st time of a certain quarter is not qualified, the quarter is not qualified.

If the endotoxin test is not completed in a certain 1 natural quarter, the annual execution rate is 75%, and the endotoxin test with the number of other quarters being more than or equal to 1 is not counted.

[ Inclusion in groups ]

The dialysis chamber (center) completes the number of times of the dialysis water biological contaminant (endotoxin) test.

[ exclude population ]

The time of specimen collection for the review results did not include statistics for the dialysis water endotoxin test when the time of specimen collection did not span the quarterly.

Review results specimen collection times across quarters can be included as statistics of execution rates for the first test in this quarter.

[ Specification of the denominator ]

The endotoxin test in the water for dialysis was performed quarterly according to the SOP regulations, and 1 quarter was used as a statistical period.

The size of the denominator is determined by the actual month of the year in the newly opened dialysis room (center), and there should be 1 test result in a period of time of more than one quarter.

The denominator of the hemodialysis room (center) for 12 months of continuous treatment is 4.

The time interval for 2 examinations was < 3 natural months.

[ Inclusion in groups ]

All monthly parts of the test results were recorded.

[ exclude population ]

If the number of quarter tests in the hemodialysis chamber (center) is more than or equal to 1, the number is calculated according to 1.

[ data elements ]

Dialysis Water biocontamination (endotoxin) assay

Dialysis Water biological contaminant (endotoxin) test time

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the dialysis water culture is self-tested by the medical unit and can be read from the Lis of the unit, the water culture is directly read from the system.

If the dialysis water culture results cannot be read from Lis, the manual filling is required, and the unit is EU/ml.

[ analytical advice ]

And when the execution rate does not reach 100%, the early warning index is used as an early warning index and is uploaded to a quality control management system.

Bacterial culture execution rate of dialysate of dialysis machine

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-19

[ DEFINITIONS ]

The proportion of the cases of complete dialysate bacterial culture inspection actually recorded by operating a dialysis machine in a hemodialysis room (center) to the cases of dialysate bacterial culture to be always performed.

[ MEANS FOR solving PROBLEMS ]

Reflecting the disinfection management of the hemodialysis room (center) to the dialysis machine.

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

[ equation ]

The execution rate of the dialysate bacterial culture of the dialysis machine is equal to the number of cases of complete dialysate bacterial culture examination actually recorded by operating the dialysis machine/the number of cases of performing dialysate bacterial culture in the same period multiplied by 100%

[ rules of calculation ]

Molecule (a): time period was determined for all cases in which the dialysate culture actually recorded by the operating dialysis machine was completed.

Denominator: time period determination all cases where dialysate bacterial cultures should be performed.

[ molecular description ]

The maximum allowable level of standard dialysate bacterial culture is less than 100CFU/ml, and the intervention level is 50 CFU/ml; the maximum allowable level of ultra-pure dialysate for bacterial culture is less than 0.1 CFU/ml.

The dialysate bacterial culture allowance and intervention level for low-throughput dialysis were performed according to standard dialysate; high-throughput dialysis or hemodiafiltration is then performed on ultrapure dialysate.

The standard dialysate bacterial culture result is qualified, but if the intervention level is reached, timely intervention and rechecking are needed, if the rechecking is not carried out within 30 days, the intervention measure is considered not to be carried out, and the statistical time period is 1 time, and no test is carried out.

In a natural year statistics, according to a natural month, the time interval between the first examination of the year and the last examination of the previous year is less than or equal to 12 months, one dialysis machine finishes at least 1 time of dialysate bacterial culture within 1 year, and if the time interval is more than 12 months, the dialysis machine is considered to be not executed for 1 time of the year.

Each dialysis machine has a unique number, and the same dialysis bed can be distinguished when the dialysis machine is updated or replaced within the year.

[ Inclusion in groups ]

Hemodialysis (center) dialysis machines that perform dialysate bacterial culture all the year round.

And (5) counting the bacterial culture execution rate of the dialysate in the year when the dialysis machine which is newly replaced and put into use is included.

The interval between the first and last examination of the year was > 12 months, defined as 1 non-execution. This examination is considered as an active examination inclusion statistic.

Active checks mean that the test is not rejected or is reviewed within 30 days after reaching the intervention level, and active test cases > 1 are also included in the statistics.

If the scrapped dialysis machine in the year has the scrapped time and the time interval of the bacterial culture examination of the dialysate in the last year is less than 12 months, all the examinations are included into the statistics even if the dialysis machine with the number in the year is scrapped.

[ exclude population ]

The dialysis machine discarded in this year is not examined as an example of an unexecuted test if the interval between the discard time and the last year of the dialysis liquid bacterial culture examination is less than 12 months.

The bacteria culture of the dialysate of a certain dialysis machine fails or reaches the intervention level, but the dialysis machine is scrapped within 30 days, and the bacteria culture of the dialysate is not carried out in the period, and the bacteria culture of the dialysate is not taken as a sample of the non-performed test.

[ Specification of the denominator ]

Taking 1 natural year as a statistical time interval, and performing statistics according to a natural month.

The annual total dialysate bacteria culture case is the case of all used dialyzers in the year, the number of newly increased dialyzers in the year, the number of discarded dialyzers in the year, all cases of active inspection and the case of disqualification of dialysate bacteria culture or the case of inspection when the intervention level is more than or equal to 30 days. Dialysis machine cases that have been rejected this year but the dialysate bacterial culture test and the last test of the last year with a time interval of < 1 year and no test performed-dialysate bacterial culture test not qualified or with an intervention level of < 30 days for review but during which the dialysis machine cases are rejected

The serial number of dialysis included in the statistics cannot be higher than the number of approved beds by the health administration.

If the dialysis machines in the dialysis beds of the annual dialysis room (center) are replaced or updated for some reason, the number of dialysis machines that should be actually checked exceeds the number of approved beds.

The actual bed discharge of the hemodialysis room (center) is reduced or the number of approved dialysis beds is increased, and statistics are carried out according to the number of the patients in the current year in the actual dialysis machines. The dialysis machine which is newly put into use must have a qualified test result before being put into use.

[ Inclusion in groups ]

The test results of hemodialysis machines used in the same year and not scrapped are included in statistics.

The dialysis machines scrapped in the year, if the test results are completed in the specified time, are included in the statistics.

[ exclude population ]

If the dialysis machine scrapped in the year is cultured for less than 1 year before the last time of last year and is not checked in the year, the statistics of the annual test cases are not included.

This test case of dialysis machines with a dialysis machine dialysate bacterial culture test that fails or reaches the intervention level, which should be reviewed within 30 days and scrapped in the interim, was not included in the statistics.

[ data elements ]

Unique number of dialysis machine

Dialysis machine tool digital dialysis machine total station number dialysate bacterial culture result dialysate quality each parameter inspection time dialysate quality each parameter inspection result dialysis equipment high flux dialysis low flux dialysis

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the dialysate culture is self-tested by the medical unit and can be read from the unit's LIS, it is read directly.

If the results of the dialysate culture cannot be read from the LIS, the manual filling is required, and the picture of the test results is uploaded locally as a corroboration.

If the result is provided by a third-party testing organization, the picture of the third-party testing result is manually filled in and uploaded on the hemodialysis management system to be used as a witness.

[ analytical advice ]

The dialysis machine of the hemodialysis room (center) newly opened in the year should complete one time of dialysate bacterial culture before use and put into treatment after negative culture. The check-out date display is required prior to administrative review.

The time window for the tests should be determined according to the SOP regulations, suggesting a more even arrangement of tests for all dialysis machines according to months and divisions. And the system uploads data to the quality control management system 12 months and 31 days before the current year.

The dialysate bacteria culture inspection is unqualified, and the dialysis machine is not required to be used for treating the patient before the result of the reinspection after the intervention is qualified; the dialysate bacterial culture reaches the intervention level, and the results are uploaded to a quality control management system as supervision data within 30 days without intervention and rechecking.

The hemodialysis filter is defined as a standard for executing ultrapure dialysate in a local business system, and if a common dialysis machine is high-pass dialysis to which a dialysis doctor orders a high-pass dialyzer, the dialysis machine is executed according to the ultrapure dialysate standard, and other dialysis machines are executed according to the standard dialysate standard.

Dialyser dialysate endotoxin test execution rate

[ quality control index set ] hemodialysis quality control index set

[ quality control index number ] IIHAD-20

[ DEFINITIONS ]

The proportion of the cases of complete dialysate endotoxin test actually recorded by operating a dialysis machine in a hemodialysis chamber (center) to the cases of dialysate endotoxin test to be always performed.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

[ equation ]

The execution rate of the dialysate endotoxin test of the dialysis machine is equal to the number of cases in which the dialysate endotoxin test actually recorded by the operation dialysis machine is completed/the number of cases in which the dialysate endotoxin test should be performed in the same period is 100 percent

[ rules of calculation ]

Molecule (a): time period all the cases of completion of endotoxin tests of the dialysate actually recorded by operating the dialysis machine were determined.

Denominator: time period determination all cases where dialysate endotoxin tests should be performed.

[ molecular description ]

The maximum allowable level of endotoxin test of standard dialysate is less than 100CFU/ml, and the intervention level is 50 CFU/ml; the maximum allowable level of ultra-pure dialysate for bacterial culture is less than 0.1 CFU/ml.

The maximum allowable level of endotoxin in standard dialysate is less than 0ml, and the intervention level is 0.25 EU/ml; the maximum allowable endotoxin test level of the ultrapure dialysate is less than 0.03 EU/ml.

The maximum allowable endotoxin values and intervention levels for low-throughput dialysis are performed against standard dialysate; high-throughput dialysis or hemodiafiltration is then performed on ultrapure dialysate.

And if the standard dialysate endotoxin test result is qualified, but the intervention level is reached, timely intervention and rechecking are carried out, if the rechecking is not carried out within 30 days, the intervention measure is considered not to be carried out, and the statistical time interval is 1, and the test is not carried out.

In a natural year statistics, according to a natural month, the time interval between the first examination of the year and the last examination of the previous year is less than or equal to 12 months, one dialysis machine completes at least 1 dialysis liquid endotoxin test within 1 year, and if the time interval is more than 12 months, the dialysis machine is considered to be not executed for 1 time of the year.

[ Inclusion in groups ]

Hemodialysis (center) dialysis machines that performed endotoxin testing of dialysate in the current year.

The new dialysis machine that was put into service was included in the endotoxin test performance statistics for that year.

And (4) taking the newly replaced dialysis machine into account the statistics of the endotoxin test execution rate of the dialysis liquid in the year.

If the interval between the scrapping time and the time interval of the fine endotoxin test of the dialysate in the previous year is less than 12 months, all the tests are included in the statistics even if the number dialysis machine is scrapped in the previous year.

[ exclude population ]

If the interval between the scrapping time and the last year of the endotoxin test of the dialysate is less than 12 months, the dialysis machine scrapped in the year is not checked in the period, and the test is not performed as a case.

The endotoxin test of the dialysate of a certain dialysis machine fails or reaches the intervention level, but the dialysis machine is scrapped within 30 days, and the endotoxin test of the dialysate is not carried out in the period, and is not taken as a case of non-performed test.

[ Specification of the denominator ]

The annual total dialysate endotoxin test case is the case that all used dialyzers in the year + newly increased dialyzers in the year + discarded dialyzers in the year + all active tests are performed + the case that the dialysate endotoxin test is unqualified or the intervention level is more than or equal to 30 days and the case that the dialysate endotoxin test is required to be checked. Dialysis machine cases with spent dialysis machine endotoxin test and last test interval of < 1 year of last year and no test performed in the current year, dialysis machine cases with rejected dialysis machine endotoxin test or intervention level < 30 days as review but spent dialysis machine cases in the current period

[ Inclusion in groups ]

[ exclude population ]

If the last qualified endotoxin test of the dialysate is less than 1 year before the dialysis machine discarded in the year, and the dialysate is not checked in the year, the statistics of the annual test cases are not included.

This test case of a dialysis machine with a dialysis machine dialysate endotoxin test failing or reaching the intervention level, which should be reviewed within 30 days and discarded in the interim, was not included in the statistics.

[ data elements ]

Dialysis machine unique number dialysis machine total number dialysis endotoxin test result dialysate quality each parameter test time dialysate quality each parameter test result dialysis equipment high flux dialysis low flux dialysis

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the dialysate endotoxin test is self-test by the medical unit and can be read from the unit's LIS, it is read directly.

If the results of the dialysate endotoxin test cannot be read from the LIS, they need to be manually filled in and pictures of the test results uploaded locally as a corroboration.

[ analytical advice ]

The dialysis machine of the hemodialysis room (center) newly opened in the year should complete one-time dialysate endotoxin test before use, and put into treatment after the result is qualified. The check-out date display is required prior to administrative review.

The endotoxin of the dialysate is not qualified, and the dialysis machine is not required to be used for treating the patient before the result of the reinspection after the intervention is qualified; and (4) when the endotoxin in the dialysate reaches the intervention level, the dialysate is not subjected to intervention and has a rechecking result within 30 days, and the dialysate is used as supervision data to be uploaded to a quality control management system.

Test completion rate of blood-borne infectious disease markers of newly-entered hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-21(NEP-D-03)

[ DEFINITIONS ]

Newly enter hemodialysis patients to complete the quantity proportion of patients tested by the blood-borne infectious disease markers.

[ MEANS FOR solving PROBLEMS ]

Reflecting the management of infection control in hemodialysis patients in hemodialysis rooms (centers) and medical facilities in the area.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The test completion rate of the blood-borne infectious disease marker of the newly-entered hemodialysis patient is equal to the number of the blood-borne infectious disease markers of the newly-entered hemodialysis patient/the number of all the newly-entered hemodialysis patients in the same period multiplied by 100 percent

The test completion rate of the blood-borne infectious disease markers of newly-entered hemodialysis patients is equal to the test quantity of the blood-borne infectious disease markers of newly-entered hemodialysis patients/the test quantity of the blood-borne infectious disease markers of all newly-entered hemodialysis patients in the same period multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): the number of newly added hemodialysis patients introduced after the blood-borne infectious disease marker test is completed in an annual hemodialysis room (center).

Denominator: the total number of all newly entered hemodialysis patients in the hemodialysis room (center) at the same time.

In the region

Molecule (a): the number of newly added hemodialysis patients who are introduced after the blood-borne infectious disease marker test is completed within the range of the annual region.

Denominator: the total number of all newly entered hemodialysis patients within the contemporaneous region.

[ molecular description ]

For specific contents of hepatitis B and hepatitis C virus marker tests, see "standard operating protocol 2020 edition for blood purification

The blood-borne infectious disease marker tests comprise four pathogenic antibody tests of hepatitis B, hepatitis C, syphilis and AIDS, and the four markers are completed simultaneously.

If a patient is on a hemodialysis session in another hemodialysis room (center) after the dialysis is terminated or suspended in one hemodialysis room, and is currently returned to the original hemodialysis unit, the blood-borne infectious disease markers must still be re-tested.

After the dialysis is terminated or suspended for a period of time defined as leaving the original dialysis room (center), it is confirmed that the patient returns to the original dialysis institution after another hemodialysis room (center) completes more than 1 dialysis treatment, and a distinction can be made on the hemodialysis management system as to whether the patient is requested to complete the treatment at another dialysis institution.

If the patient has been tested for the markers of blood-borne infectious diseases within 3 months but has not been treated for hemodialysis and transfusion in any hemodialysis unit, the test within 3 months is counted as the test of the markers of blood-borne infectious diseases newly entered into the patient, and the patient must be reviewed within a schedule of 3 months from the last test.

If newly-entered patients are found not to test blood borne infectious disease markers, the quality control system can trace back which dialysis machine positions a hemodialysis room (center) has dialyzed.

All patients were enrolled and tested for blood borne infectious disease markers.

The number of times that dialysis patients newly enter a dialysis room (center) in the regional area to check the blood-borne infectious disease markers does not need to check the blood-borne infectious disease markers through identification numbers.

[ exclude population ]

Is free of

[ Specification of the denominator ]

The statistical time interval is 1 natural year generally, less than 1 natural year, and the statistics is carried out according to the actual months of the natural years.

Maintenance hemodialysis patients should re-test blood borne infectious disease markers after returning to the original hemodialysis unit for a period of time to another dialysis center hemodialysis treatment for various reasons.

Since there is a case where one patient resumes dialysis again after one dialysis unit withdraws dialysis, the denominator is greater than or equal to the total number of newly entered patients.

[ Inclusion in groups ]

All the registered hemodialysis patients are included and the patients who quit the original dialysis unit midway and then recover the dialysis in the original dialysis unit.

Some dialysis units have emergency dialysis machines, the beds of which are usually open, meaning that dialysis is performed before there is no blood-borne infectious disease marker result and hemodialysis treatment is performed, which is counted as not performing the index.

All persons who should be tested for markers of blood-borne infectious diseases should be denominated within the region.

[ data elements ]

Maintenance hemodialysis patient

Registering hemodialysis patients

The number of newly-enrolled patients

[ basic data set ]

Quality control of hemodialysis

[ data Collection method ]

Since the blood borne infectious disease markers may need to be reviewed, if the newly entered patient has several test results before dialysis, the data read should be the test data updated by Lis the latest time from the time of newly entering and resuming dialysis.

In order to avoid the condition that the patient enters a dialysis room (center) for dialysis treatment without blood-borne infectious disease marker examination, a local system is provided with a limit that the patient can not arrange a regular dialysis bed without recording or synchronizing the blood-borne infectious disease marker examination result.

Some dialysis units have emergency dialysis machines, the beds of which are usually open, meaning that dialysis beds are performed and hemodialysis treatment is performed before there is no blood borne infectious disease marker result, and blood borne infectious disease marker tests must be performed before the patient enters a conventional dialysis area.

[ analytical advice ]

Is free of

Completion rate of routine blood timing tests for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-22

[ DEFINITIONS ]

Proportion of routine blood tests completed by maintenance hemodialysis patients every 3 months.

[ MEANS FOR solving PROBLEMS ]

Reflecting the medical quality management condition of the hemodialysis room (center).

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The completion rate of the blood routine time test of the maintenance hemodialysis patients is equal to the number of the maintenance hemodialysis patients completing the blood routine test within 3 months/the number of the contemporary maintenance hemodialysis patients multiplied by 100%

The blood routine time test completion rate of the maintenance hemodialysis patients is equal to the actual recorded number of blood routine tests of the maintenance hemodialysis patients every 3 months/the number of blood routine tests of the maintenance hemodialysis patients recorded at the same period multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of routine tests of the actual recorded blood of a maintenance hemodialysis patient in a hemodialysis room (center) over a period of time.

Denominator: the number of routine tests of the blood of all the maintenance hemodialysis patients recorded in the hemodialysis room (center) at the same period.

In the region

Molecule (a): the number of routine tests of the actual recorded blood of a maintenance hemodialysis patient in a regional hemodialysis room (center) over a period of time.

Denominator: the number of routine tests of all the maintenance hemodialysis patients blood recorded in the range of the contemporaneous region.

[ molecular description ]

In statistics of the completion rate of regular tests in patients with maintenance hemodialysis, the interval between every 2 tests is < 3 months, and 1 incomplete test is defined if the interval between 2 tests is > 3 months.

The test times recorded actually refer to the test times finished according to the rule that the time interval of every 2 tests is less than 3 months in the test times recorded according to the rule of the denominator, and are not the times of the actual tests of the patient.

[ Inclusion in groups ]

The number of completed routine tests of blood in every 3 months within the time period was counted.

[ exclude population ]

A maintenance hemodialysis patient in the present hemodialysis room (center) does not complete the test within the schedule, which does not include statistics of the rate of completion, but for some reason exits the dialysis treatment in the dialysis facility.

[ Specification of the denominator ]

1 month is defined as 31 days, 3 months as a schedule, 93 days.

And (3) calculating the completion rate of the regular test of the maintenance hemodialysis patient in a period of time, wherein a progress is calculated according to the time interval of every 3 months in the statistical period, and the time interval of every 2 tests is less than 3 months.

If multiple testing results exist in one time schedule, only 1 time is counted, the last testing result in the time schedule is recorded when the control rate is counted, and the time for recording the last testing result in the time schedule is taken as the starting time point of the next time schedule.

If the test result is not recorded in the schedule, 93 days after the previous schedule is taken as the starting point of the next schedule.

If the current year and the previous year have time continuity according to the annual statistics, the recorded first test result of the current year is within the last progress of the previous year. The first time of year schedule deadline time is not 3 months and 31 days.

The maintenance hemodialysis patients who were newly introduced after continuous dialysis for 3 months in the hemodialysis room (center) were re-entered into the statistics, but the schedule was calculated according to the time of introduction.

[ Inclusion in groups ]

Hemodialysis patients who continued dialysis for 3 months included statistics.

The maintenance hemodialysis patient discontinues dialysis for any reason < 3 months, resumes dialysis at the dialysis unit still according to the maintenance dialysis patient admission statistics, if > 3 months the patient resumes dialysis at the unit for 3 months, then the unit maintenance hemodialysis patient admission statistics are called.

[ exclude population ]

1 patient had a test of 3 months or more due to discontinuation of dialysis in that unit, and the discontinuation time was not included in the statistics.

If the dialysis treatment of the maintenance hemodialysis patient is suspended in the current dialysis room (center) for any reason for more than 3 months, the completion rate is recalculated after resuming dialysis interrupted, but if the withdrawal time does not exceed 3 months, the statistics are still continuously performed. If the outside yard has already checked in the progress, the quality control system should check the statistics in the progress after repeating according to the identity card.

[ data elements ]

Maintenance hemodialysis patient

Concentration of hemoglobin

Routine blood test

[ basic data set ]

And controlling dialysis quality. .

[ data Collection method ]

The examination of the patient's hemoglobin is read on the medical institution LIS.

And setting a checking progress on a local hemodialysis management system, and judging whether the checking progress is finished within a specified progress by hemodialysis management software or judging whether the checking progress is finished within the specified progress or not by a hemodialysis quality control system after the Lis original data is obtained.

[ analytical advice ]

Is free of

Completion rate of blood biochemical timing tests for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-23

[ DEFINITIONS ]

The proportion of blood biochemical (including liver and kidney function, electrolyte, blood fat and the like) tests to be completed by the patient with maintenance hemodialysis every 3 months.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The completion rate of blood biochemical timing test of the maintenance hemodialysis patients is equal to the number of the maintenance hemodialysis patients completing the blood biochemical test within 3 months/the number of the maintenance hemodialysis patients in the same period x 100%

The blood biochemical timing test completion rate of the maintenance hemodialysis patient is equal to the actually recorded blood biochemical test times of the maintenance hemodialysis patient/the blood biochemical test times of the maintenance hemodialysis patient recorded at the same period multiplied by 100 percent

A first formula may be used for cross-sectional survey statistics and a second formula may be used for annual statistics.

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of actual recorded maintenance hemodialysis patient blood biochemical tests every 3 months in an annual or real-time hemodialysis room (center).

Denominator: the number of biochemical tests of the blood of the maintenance hemodialysis patient should be recorded in the hemodialysis room (center) at the same period.

In the region

Molecule (a): number of actual recorded blood biochemical tests of maintenance hemodialysis patients every 3 months in a hemodialysis room (center) in an annual or real-time area.

Denominator: the number of blood biochemical tests of the maintenance hemodialysis patients should be recorded in the hemodialysis room (center) in the range of the contemporaneous region.

[ molecular description ]

The blood biochemical project comprises the steps of collecting serum to test glutamic-pyruvic transaminase, glutamic-oxalacetic transaminase, urea nitrogen, uric acid, potassium, sodium, calcium, phosphorus, glucose, triglyceride and total cholesterol.

Blood biochemistry contains more contents, and the specific examination items contained in each examination item of different medical institutions are different.

Statistics of the completion rate of the timed tests of annual maintenance hemodialysis patients, with time intervals of < 3 months for each 2 tests. If the time interval between 2 tests is more than or equal to 3 months and less than 6 months, the test is defined as 1 incomplete test

[ Inclusion in groups ]

The number of persons who completed the blood biochemical test within 3 months of the test schedule at a certain time point.

The number of 1 blood biochemical tests per 3 months was completed within a certain period of time.

[ exclude population ]

Maintenance hemodialysis patients in the present hemodialysis room (center) did not complete the test within the present schedule but for some reason exited the dialysis unit, the schedule does not incorporate statistics of the completion rate.

[ Specification of the denominator ]

1 month is defined as 31 days, 3 months as a schedule, 93 days.

And (3) calculating the timing test completion rate of the annual maintenance hemodialysis patients, counting the number of the maintenance hemodialysis patients who complete the test in 4 schedules within 1 natural year, and enabling the interval of every 2 tests to be less than 3 months.

Statistics of the year and the last year have a temporal continuity, and the recorded first test result of the year is within the last progress of the last year. The first time of year schedule deadline time is not 3 months and 31 days.

The maintenance hemodialysis patients who entered the new patients after 3 months of continuous dialysis in the hemodialysis room (center) were re-entered into the statistics, and the schedule was calculated according to the time of introduction.

If a maintenance hemodialysis patient suspends dialysis treatment in the current dialysis room (center) for any reason during the course of more than 3 months and resumes dialysis again, the completion rate is recalculated, but if 3 months are not exceeded, statistics are continuously performed.

[ Inclusion in groups ]

Hemodialysis patients who continued dialysis for 3 months included statistics.

1 maintenance hemodialysis patient interrupted dialysis for < 3 months in any event, resumed dialysis at the dialysis unit still according to the maintenance dialysis patient intake statistics, if > 3 months the patient was again dialyzed at the unit for 3 months, then the unit maintenance hemodialysis patient intake statistics is called.

[ exclude population ]

[ data elements ]

Maintenance hemodialysis patient

Biochemical blood test

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The biochemical tests of the patient's blood are read on the medical institution LIS.

[ analytical advice ]

Is free of

Timed test completion rate of transferrin saturation in maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-24

[ DEFINITIONS ]

The proportion of transferrin saturation test that a patient should complete on maintenance hemodialysis every 6 months.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Transferrin saturation timed test completion rate of maintenance hemodialysis patients ═ number of maintenance hemodialysis patients who completed transferrin saturation test within 6 months/number of contemporary maintenance hemodialysis patients × 100%

Serum transferrin saturation timed test completion rate of maintenance hemodialysis patients ═ the number of actual recordings of transferrin saturation completed 1 time every 6 months/the total number of completed transferrin saturation tests recorded for all maintenance hemodialysis sessions × 100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of transferrin saturation completed every 6 months actually recorded annually or in real time in the hemodialysis room (center).

Denominator: total number of completed transferrin saturation tests recorded for all maintenance hemodialysis sessions in the same session or real-time hemodialysis room (center).

In the region

Molecule (a): the number of transferrin saturations completed every 6 months actually recorded by the hemodialysis compartment (center) in the region of the year or month.

Denominator: the total number of transferrin saturation tests that should be performed for all maintenance hemodialysis sessions in the hemodialysis compartment (center) over the same period of time.

[ molecular description ]

Transferrin saturation test refers to the ratio of serum iron to transferrin concentration (total iron binding capacity), and some health care units do not directly distribute the calculation of transferrin saturation in Lis and need to be calculated by physicians. It is suggested that the local system has simple calculation formula to automatically or manually input and then automatically obtain the result to input into the system.

The patient should be tested for at least 1 blood transferrin saturation for 6 months of continuous hemodialysis in a certain hemodialysis room (center). The time interval is more than or equal to 6 months, and the time interval is less than 12 months, the completion is considered to be completed once.

Each patient should have a time schedule of 6-month examination, if the patient is rechecked within 6 months, the schedule time is recalculated, and the recorded completion time is based on the time of the last examination result in the schedule. The time schedule is accurate to days.

The numerator of the real-time transferrin saturation completion rate is counted as the number of patients completed within this schedule.

The patient records 1 incomplete year if the test is incomplete within the completion schedule of the patient's blood transferrin saturation test.

The maintenance hemodialysis patients who entered the new patients after continuous dialysis for 3 months in the hemodialysis room (center) were counted, but the incomplete tests within 3 months were not considered as incomplete, and the statistics of the test completion rate were counted from the beginning of the month the patients were introduced.

The completion rate of the year in the year statistics is related to the time for completion of the previous year, and if 1 test completed in the year is more than or equal to 6 months according to the progress calculation of the previous year, the year is still considered as incomplete. The 1 test completed after 6 months was considered as the next example completed, and the starting time was recalculated with the 6 th month of the previous schedule as the starting time point.

During annual statistics, if the original maintenance hemodialysis patient pauses the dialysis treatment in the current dialysis room (center) for various reasons, if the month is not more than 3 months, the statistics are continuously performed. If the time is more than or equal to 3 months, recalculating according to the newly entered patient, and calculating the progress of the next test according to the reintroduction time.

[ Inclusion in groups ]

The number of people who completed the transferrin saturation test every 6 months within the test schedule at a certain time point.

The number of transferrin saturation tests was completed 1 time every 3 months over a certain period of time.

[ exclude population ]

The results of the test were obtained in patients who did not complete the serum ferritin test in the hemodialysis room (center) but who for some reason had withdrawn the dialysis unit within 6 months.

[ Specification of the denominator ]

The system schedule is 1 month calculated according to 31 days, and the test result is 6 months as the deadline of the test. The statistics are according to the month, so that the statistics are actually not completed until the progress exceeds about 1 week without a test result. The number of tests that should be performed per patient per year cannot be less than 2, and due to the difference between the 31-day per month schedule and the natural month, the 2 nd test is by default completed 12 and 31 days before the year if only 1 test is required for this year.

The number of times of transferrin saturation regular test of hemodialysis patients in hemodialysis room (center) is completed within 12 months, namely the number of test results recorded by patients who continuously perform dialysis treatment in a dialysis room (center) for 12 months + (the number of patients who newly enter the hemodialysis treatment in the current year and are cumulatively maintained for more than or equal to 6 months < 12 months x 2-the patient who newly enters the hemodialysis treatment in the current year and is cumulatively maintained for more than or equal to 6 months < 12 months and only records 1 test result + the patient who records the hemodialysis treatment in the hemodialysis patient in the current year and has less than 6 months and also records 1 test result.

Newly entered patients include patients who are newly entered in the present year or who have been under 6 months from the last half year of the previous year after the introduction of dialysis treatment.

And judging whether the last progress check result of the previous year is recorded in the next year, if so, taking the last result of the previous year as the starting time point of the progress of the current year, and calculating the progress time cut-off point of the cross-year in the current year to be used as the check to be completed in the current year. The results should be recorded 2 or 3 times in this year.

In real-time statistics, patients who are new in < 6 months are not considered incomplete if they have not completed the test, but incorporate the statistics of the denominator if they have completed the test.

If the time between 2 tests is 6 months or more, the patient leaves the hemodialysis room (center) after the test should be completed, and the patient still included the test that was completed 1 time.

Continuous calculation is possible if the patient is withdrawn after 1 test but resumes dialysis within 3 months. And recalculating for more than 3 months.

The newly-entered patient is tested within 6 months, the test frequency is 1 time, the test frequency of the patient within 6 months and less than 12 months is 1 to 2 times, and the test is completed within a specified time period according to whether the test is completed within the second time.

[ Inclusion in groups ]

Hemodialysis patients who completed 1 transferrin saturation test for 3 months of continuous dialysis and hemodialysis patients who had been continuously dialyzed for 6 months were included.

1 maintenance hemodialysis patient discontinued dialysis for any event < 6 months and resumed dialysis at that dialysis unit still according to maintenance dialysis patient inclusion statistics.

If the patient is dialyzed for more than 6 months again in the unit for 3 months, the patient is called the maintenance hemodialysis patient inclusion statistic of the unit.

[ exclude population ]

The transferrin saturation test is not completed in the newly-inserted patients with the maintenance hemodialysis for less than 6 months, and the statistics of the completion rate of the transferrin saturation test are not temporarily included in the part of the patients.

[ data elements ]

Serum iron total iron binding force detected by transferrin saturation of maintenance hemodialysis patient

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The transferrin saturation test is the ratio of serum iron to transferrin binding force, some medical units do not issue the calculation result of transferrin saturation in the LIS, need manual calculation, can match the two tests of serum iron and transferrin binding force in the LIS, and upload the result after automatic calculation in a local hemodialysis management system.

And (4) setting the transferrin saturation degree test progress on a local hemodialysis management system, and counting according to the rule.

[ analytical advice ]

Is free of

Serum ferritin timed test completion rate for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-25

[ DEFINITIONS ]

The proportion of maintenance hemodialysis patients who should complete a serum ferritin test every 6 months.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The rate of completion of the serum ferritin timed test in the maintenance hemodialysis patients was 100% of the number of maintenance hemodialysis patients who completed the serum ferritin test within 6 months/the number of contemporary maintenance hemodialysis patients

Serum ferritin timed test completion rate for patients on prolonged hemodialysis-the actual recorded number of serum ferritin completions every 6 months/total number of completed serum ferritin tests recorded for all persistent hemodialysis sessions × 100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): the number of serum ferritin completed every 6 months in the annual or real time hemodialysis room (center).

Denominator: total number of completed serum ferritin tests recorded for all maintenance hemodialysis sessions at the same time.

In the region

Molecule (a): the number of serum ferritin completed every 6 months in the hemodialysis compartment (center) in the annual or monthly region was 1.

Denominator: total number of completed serum ferritin tests recorded for all maintenance hemodialysis sessions in the same session area.

[ molecular description ]

Patients should be tested for at least 1 serum ferritin test for 6 months of continuous hemodialysis in a hemodialysis room (center). The time interval is more than or equal to 6 months, and the time interval is less than 12 months, the completion is considered to be completed once.

The patient records 1 incomplete year if the test is incomplete within the completion schedule of the patient's serum ferritin test.

The completion rate of the year in the year statistics is related to the time of completion of the previous year, and if the 1 test completed in the year is more than or equal to 6 months according to the progress of the previous year, the test is still considered as incomplete. The 1 test completed after 6 months was considered as the next example of completion, and the starting time was recalculated with the 6 th month of the previous schedule as the starting time point.

[ Inclusion in groups ]

The number of persons who completed the serum ferritin test every 6 months within the test schedule at a certain time point.

The number of 1 serum ferritin tests per 6 months was completed within a certain time period.

[ exclude population ]

[ Specification of the denominator ]

The system schedule is 1 month calculated according to 31 days, and the test result is 6 months as the deadline of the test. The statistics are according to the month, so that the statistics are actually not completed until the progress exceeds about 1 week without a test result. The number of tests that should be performed per patient per year cannot be less than 2, since the difference between the 31-day monthly schedule and the natural month is such that if only 1 test is required for this year, the 2 nd test is by default completed 12 and 31 days before this year.

The number of times of serum ferritin regular test of hemodialysis patients in hemodialysis room (center) should be completed within the year is the number of times of test results recorded by patients who continuously perform dialysis treatment in a dialysis room (center) for 12 months + (the number of patients who newly enter the hemodialysis treatment in the year and accumulated for maintenance therapy is more than or equal to 6 months and less than 12 months x 2-the number of patients who newly enter the hemodialysis treatment in the year and accumulated for maintenance therapy is more than or equal to 6 months and less than 12 months and only record 1 test result + the hemodialysis treatment of the hemodialysis patients in the year and accumulated for 1 test result.

The newly-entered patient is tested within less than 6 months, the test is performed for 1 time, the test is performed for 1 to 2 times for patients with more than 6 months and less than 12 months, and the test is completed within a specified time period according to whether the test is performed for the second time.

[ Inclusion in groups ]

Hemodialysis patients who completed 1 serum ferritin test for 3 months of continuous dialysis and hemodialysis patients who had been continuously dialyzed for 6 months were included.

[ exclude population ]

Newly entered patients with maintenance hemodialysis do not complete the serum ferritin test for less than 6 months of continuous dialysis, and the patients in this group are temporarily not included in the statistics of the completion rate of the serum ferritin test.

[ data elements ]

Maintenance hemodialysis patient

And (5) serum ferritin test.

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Serum ferritin assay records may be obtained in the LIS.

[ analytical advice ]

Is free of

Whole-phase parathyroid hormone (iPTH) timing test completion rate of maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-26

[ DEFINITIONS ]

The proportion of patients on maintenance hemodialysis that should complete the full-scale parathyroid hormone (iPTH) test every 6 months.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The complete rate of the whole parathyroid hormone (iPTH) timing test of the maintenance hemodialysis patients is equal to the number of the maintenance hemodialysis patients completing the whole parathyroid hormone (iPTH) test within 6 months/the number of the contemporary maintenance hemodialysis patients multiplied by 100%

The complete rate of the whole parathyroid hormone (iPTH) timing test of the maintenance hemodialysis patients is equal to the actually recorded times of completing 1 whole parathyroid hormone (iPTH) test every 6 months/the total times of completing the whole parathyroid hormone (iPTH) test recorded in all the maintenance hemodialysis at the same period x 100%

The first formula can be used as a cross-sectional survey of the time point of completion of the iPTH timed test for a maintenance hemodialysis patient, which is a special case of the second formula.

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of complete parathyroid hormone (iPTH) tests within 6 months recorded by annual or real-time hemodialysis chamber (central) maintenance hemodialysis patients.

Denominator: contemporaneous or real-time contemporaneous hemodialysis chamber (center) total number of whole parathyroid hormone (iPTH) tests that all maintenance hemodialysis should be completed.

In the region

Molecule (a): number of complete parathyroid hormone (iPTH) tests within 6 months recorded for all maintenance hemodialysis patients in the annual or real-time region.

Denominator: total number of complete parathyroid hormone (iPTH) tests that all maintenance hemodialysis should complete in the same period or real-time zone.

[ molecular description ]

According to the annual statistics, 1 month is calculated according to 31 days.

Each patient should have a 6 month check-out schedule on the local hemodialysis management system, and if the check-out is done within 6 months, the schedule is recalculated to the exact day.

Patients should be tested for at least 1 full-range parathyroid hormone (iPTH) level within 6 months of continuous hemodialysis in a hemodialysis chamber (center). If the patient completes a plurality of tests within a time schedule after the data is actually recorded, only the last test data in the time schedule is included as the recorded data of the completion rate and the control rate.

The real-time full-length parathyroid hormone (iPTH) completion rate molecules are counted in number of patients completed within the last schedule.

If the patient does not complete the complete progress of the whole parathyroid hormone (iPTH) test, the patient records 1 incomplete time in the year, the time span between 2 tests is less than 6 months, and 1 incomplete time is considered when the time span is more than 6 months.

The newly entered patients were counted for inclusion after 3 months of continuous dialysis in the hemodialysis room (center), but incomplete tests were not considered incomplete within 3 months, and the statistics of the test completion rate were calculated starting on the day of patient enrollment.

The completion rate of the year in the year statistics is related to the time of completion of the previous year, and if the time of the first test completed in the year is more than or equal to 6 months according to the progress of the previous year, the test is considered as incomplete. And the recorded completion check time is used as the starting point of the next completion time to recalculate the progress.

[ Inclusion in groups ]

The number of persons who completed the full-scale parathyroid hormone (iPTH) test every 3 months within the test schedule at a certain time point.

The number of complete parathyroid hormone (iPTH) tests completed every 3 months for a certain period of time.

[ exclude population ]

Test results for patients who did not complete the iPTH test in the home hemodialysis room (center) but for some reason had exited the dialysis unit within 6 months.

[ Specification of the denominator ]

The number of times that the whole-stage parathyroid hormone (iPTH) regular test of the hemodialysis patient in the hemodialysis room (center) should be completed within the year is the number of times that the patient continuously dialyzes and treats 12 months in the dialysis room (center) and records the test result + (the number of the patients newly entering the accumulative hemodialysis treatment of the maintenance in the year is more than or equal to 6 months and less than 12 months x 2-the patient newly entering the accumulative hemodialysis treatment of the maintenance in the year is more than or equal to 6 months and less than 12 months and only records 1 test result + the patient newly entering the hemodialysis treatment of the maintenance patient in the year is less than 6 months and records 1 test result.

If the patient is withdrawn after 1 test, but the dialysis is resumed within 3 months, the calculation can be continued. And recalculating for more than 3 months.

[ Inclusion in groups ]

Patients who had undergone 1 complete parathyroid hormone (iPTH) test in continuous dialysis for 3 months or more and less than 6 months and patients who had undergone continuous dialysis for 6 months or more, regardless of whether the test was completed or not, were included in the statistics.

1 maintenance hemodialysis patient did not stop dialysis for more than 3 months due to any event, and resumed dialysis at that dialysis unit still according to the maintenance dialysis patient inclusion statistics. If the patient is dialyzed for more than 3 months again in the unit for 3 months, the patient is called the maintenance hemodialysis patient inclusion statistic of the unit.

[ exclude population ]

Newly entered patients with maintenance hemodialysis who had not completed the complete parathyroid hormone (IPTH) test for < 6 months on continuous dialysis, were not enrolled in statistics of the completion rate of the complete parathyroid hormone (IPTH) test.

[ data elements ]

Maintenance hemodialysis patient

Whole-stage Parathyroid hormone (iPTH) assay

[ basic data set ]

And controlling dialysis quality.

[ data Collection method ]

Full-length parathyroid hormone (iPTH) assay records can be obtained at Lis.

[ analytical advice ]

Is free of

Serum prealbumin timed test completion rate for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-27

[ DEFINITIONS ]

Maintenance hemodialysis patients should complete the serum prealbumin test every 6 months.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The serum prealbumin timed test completion rate of the maintenance hemodialysis patients is equal to the number of maintenance hemodialysis patients completing the serum prealbumin test within 6 months/the number of contemporary maintenance hemodialysis patients multiplied by 100%

Serum prealbumin timed test completion rate for maintenance hemodialysis patients-the number of actually recorded 1 serum prealbumin test completed every 6 months/total number of completed serum prealbumin tests recorded for all maintenance hemodialysis sessions × 100%

The first formula can be used as a cross-sectional survey of the time point of completion of the timed test for serum prealbumin in a maintenance hemodialysis patient, and is a special case of the second formula.

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of serum prealbumin tests completed within 6 months recorded by year or real-time hemodialysis laboratory (central) maintenance hemodialysis patients.

Denominator: contemporaneous or real-time contemporaneous hemodialysis chamber (center) total number of serum prealbumin tests that should be completed for all maintenance hemodialysis.

In the region

Molecule (a): number of serum prealbumin tests completed within 6 months recorded for all maintenance hemodialysis patients in the annual or real-time domain.

Denominator: total number of serum prealbumin tests that should be completed for all maintenance hemodialysis in the same period or real-time zone.

[ molecular description ]

According to the annual statistics, 1 month is calculated according to 31 days.

The patient should be tested for serum prealbumin levels at least 1 time within 6 months of continuous hemodialysis in a hemodialysis chamber (center). If the patient completes a plurality of tests within a time schedule after the data is actually recorded, only the last test data in the time schedule is included as the recorded data of the completion rate and the control rate.

The molecules of the real-time serum prealbumin completion rate are counted as the number of patients completed within the last schedule.

If the patient does not complete the test within the completion schedule of the serum prealbumin test of the patient, the patient records 1 time incomplete in the year, the time span between 2 tests is less than 6 months, and the patient is considered as incomplete for more than 6 months.

[ Inclusion in groups ]

The number of persons who completed the serum prealbumin test every 6 months within the schedule of the test at a certain time point.

The number of 1 routine tests of serum prealbumin completed every 6 months within a certain period of time.

[ exclude population ]

The results of the test were obtained in 6 months from patients who did not complete the serum prealbumin test in the hemodialysis room (center) but who for some reason had exited the dialysis unit.

[ Specification of the denominator ]

The number of times that serum prealbumin of hemodialysis room (center) maintenance hemodialysis patients should be completed within a fixed time test year is equal to the number of times that test results should be recorded by patients who continuously perform dialysis treatment in a dialysis room (center) for 12 months + (the number of patients who newly enter the current year and have accumulated maintenance hemodialysis treatment more than or equal to 6 months < 12 months x 2-the number of patients who newly enter the current year and have accumulated maintenance hemodialysis treatment more than or equal to 6 months < 12 months and only record 1 test result + the patients who have recorded hemodialysis treatment of the current year and have recorded 1 test result.

[ Inclusion in groups ]

Patients who had undergone 1 serum prealbumin test for a period of continuous dialysis of 3 months or more and less than 6 months and patients who had undergone hemodialysis for a period of 6 months or more, regardless of whether the test was completed or not, were included in the study.

1 maintenance hemodialysis patient interrupted dialysis for < 3 months in any event, and resumed dialysis at that dialysis unit still according to the maintenance dialysis patient inclusion statistics. If the patient is dialyzed for more than 3 months again in the unit for 3 months, the patient is called the maintenance hemodialysis patient inclusion statistic of the unit.

[ exclude population ]

Newly entered maintenance hemodialysis patients who have continued dialysis for < 6 months have not completed the serum prealbumin test and are temporarily not enrolled in the statistics of the rate of completion of the serum prealbumin test.

[ data elements ]

Maintenance hemodialysis patient

Serum prealbumin assay

[ basic data set ]

And controlling dialysis quality.

[ data Collection method ]

Serum prealbumin assay records may be obtained at Lis.

The serum prealbumin test progress is set on the local hemodialysis management system and counted according to the above rules.

[ analytical advice ]

Is free of

Completion rate of C-reactive protein (CRP) timed assay for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-28

[ DEFINITIONS ]

The proportion of patients on maintenance hemodialysis that should complete the CRP test every 6 months.

[ MEANS FOR solving PROBLEMS ]

Reflecting the management of the patient's micro-inflammatory state in the hemodialysis compartment (center).

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The rate of completion of C-reactive protein (CRP) timed test in maintenance hemodialysis patients ═ 100% of the number of maintenance hemodialysis patients who completed C-reactive protein (CRP) test within 6 months/the number of contemporary maintenance hemodialysis patients

The rate of completion of C-reactive protein (CRP) timed tests in maintenance hemodialysis patients-the actual number of completed serum C-reactive protein (CRP) tests recorded every 6 months/the total number of completed C-reactive protein (CRP) tests recorded for all maintenance hemodialysis sessions at the same time-100%

The first formula can be used as a cross-sectional survey of the time point of completion of the C-reactive protein (CRP) timed test of a maintenance hemodialysis patient, and is a special case of the second formula)

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of C-reactive protein (CRP) tests completed within 6 months recorded by year or real-time hemodialysis room (central) maintenance hemodialysis patients.

Denominator: contemporaneous or real-time contemporaneous hemodialysis room (center) total number of C-reactive protein (CRP) tests that all maintenance hemodialysis should be completed.

In the region

Molecule (a): number of completed C-reactive protein (CRP) tests within 6 months recorded for all maintenance hemodialysis patients in the annual or real time domain.

Denominator: total number of C-reactive protein (CRP) tests that should be completed for all maintenance hemodialysis in the same period or real-time zone.

[ molecular description ]

According to the annual statistics, 1 month is calculated according to 31 days.

Patients should be tested for at least 1C-reactive protein (CRP) level within 6 months of continuous hemodialysis in a hemodialysis room (center). If the patient completes a plurality of tests within a time schedule after the data is actually recorded, only the last test data in the time schedule is included as the recorded data of the completion rate and the control rate.

The real-time C-reactive protein (CRP) completion rate molecules are counted as the number of patients completed within the last schedule.

If the patient does not complete the test within the completion schedule of the C-reactive protein (CRP) test of the patient, the patient records 1 incomplete time in the year, the time span between 2 tests is less than 6 months, and the patient is considered as incomplete for more than 6 months.

[ Inclusion in groups ]

The number of persons who completed the CRP test every 6 months within the test schedule at a certain time point.

The number of 1 CRP tests per 6 months completed within a certain period of time.

[ exclude population ]

Test results for patients who did not complete the CRP test in the hemodialysis room (center) but who for some reason had exited the dialysis unit within 6 months.

[ Specification of the denominator ]

Hemodialysis room (center) maintenance hemodialysis patient C-reactive protein (CRP) is completed within a fixed time year, namely the number of times of test results which are recorded by patients who are continuously dialyzed in a dialysis room (center) for 12 months + (the number of patients who newly enter the annual accumulative maintenance hemodialysis treatment is more than or equal to 6 months and less than 12 months multiplied by 2-the patient who newly enter the annual accumulative maintenance hemodialysis treatment is more than or equal to 6 months and less than 12 months, only 1 test result is recorded, and the patient who enters the annual maintenance hemodialysis patient hemodialysis treatment is less than 6 months and 1 test result is recorded.

[ Inclusion in groups ]

Patients who had undergone 1C-reactive protein (CRP) test for 3 months or more and less than 6 months of continuous dialysis and patients who had undergone 6 months of continuous dialysis were included in the statistics.

[ exclude population ]

Newly entered patients with maintenance hemodialysis who had not completed the C-reactive protein (CRP) test for as long as < 6 months of continuous dialysis had not included statistics on the rate of completion of the C-reactive protein (CRP) test.

[ data elements ]

Maintenance hemodialysis patient

C-reactive protein (CRP) assay

[ basic data set ]

And controlling dialysis quality.

[ data Collection method ]

C-reactive protein (CRP) assay records may be obtained at Lis.

[ analytical advice ]

Is free of

Beta 2 microglobulin timing test completion rate for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-29

[ DEFINITIONS ]

The proportion of β 2 microglobulin should be completed by maintenance hemodialysis patients every 6 months.

[ MEANS FOR solving PROBLEMS ]

Reflecting the monitoring condition of chronic complications of the hemodialysis center.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The completion rate of the beta 2 microglobulin timed test of the maintenance hemodialysis patients is equal to the number of maintenance hemodialysis patients completing the beta 2 microglobulin test within 6 months/the number of contemporary maintenance hemodialysis patients multiplied by 100%

The beta 2 microglobulin timing test completion rate of the maintenance hemodialysis patients is the actual recorded number of beta 2 microglobulin completions every 6 months/total number of completed beta 2 microglobulin tests recorded for all maintenance hemodialysis sessions × 100%

The first formula can be used as a cross-sectional survey of the time point of completion of the beta 2 microglobulin timing test in a maintenance hemodialysis patient, which is a special case of the second formula.

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of beta 2 microglobulin tests completed within 6 months recorded by year or real time hemodialysis room (central) maintenance hemodialysis patients.

Denominator: contemporaneous or real-time contemporaneous hemodialysis chamber (center) is the total number of beta 2 microglobulin tests that should be completed by all maintenance hemodialysis.

In the region

Molecule (a): number of beta 2 microglobulin tests completed within 6 months recorded for all maintenance hemodialysis patients in the annual or real-time domain.

Denominator: total number of beta 2 microglobulin tests that should be completed for all maintenance hemodialysis in the same period or real time zone.

[ molecular description ]

According to the annual statistics, 1 month is calculated according to 31 days.

Patients should be tested for β 2 microglobulin levels at least 1 time within 6 months of continuous hemodialysis in a certain hemodialysis room (center). If the patient completes a plurality of tests within a time schedule after the data is actually recorded, only the last test data in the time schedule is included as the recorded data of the completion rate and the control rate.

The molecules of the real-time beta 2 microglobulin completion rate are counted as the number of patients completed within the last schedule.

If the examination is not completed, the patient records 1 time in the year if the examination is not completed within the completion progress of the beta 2 microglobulin examination of the patient, the time span between 2 examinations is less than 6 months, and the patient is considered as not completed for 1 month or more than 6 months.

[ Inclusion in groups ]

The number of persons who completed the β 2 microglobulin assay every 6 months within the assay schedule at a certain time point.

The number of beta 2 microglobulin tests completed every 6 months within a certain time period.

[ exclude population ]

Test results for patients who did not complete the β 2 microglobulin test in the hemodialysis compartment (center) within 6 months but who for some reason had withdrawn the dialysis unit.

[ Specification of the denominator ]

Hemodialysis room (center) maintenance hemodialysis patient beta 2 microglobulin regular test is completed within year which is the number of test results recorded by patients continuously dialyzing and treating for 12 months in a dialysis room (center) + (the number of patients newly entering the current year accumulated maintenance hemodialysis treatment is more than or equal to 6 months < 12 months x 2-the patient newly entering the current year accumulated maintenance hemodialysis treatment is more than or equal to 6 months < 12 months and only 1 test result is recorded within the current year accumulated maintenance hemodialysis treatment is more than or equal to 6 months < 12 months + the patient of the current year hemodialysis patient hemodialysis treatment is less than 6 months and records 1 test result.

[ Inclusion in groups ]

Patients who have undergone 1 beta 2 microglobulin test in continuous dialysis for more than 3 months and less than 6 months and patients who have undergone continuous dialysis for more than 6 months, regardless of whether the test is completed or not, are included in statistics.

[ exclude population ]

Newly entered patients with maintenance hemodialysis who have continued dialysis for < 6 months have not completed the β 2 microglobulin test and are temporarily not enrolled in the statistics of the rate of completion of the β 2 microglobulin test.

[ data elements ]

Maintenance hemodialysis patient

Beta 2 microglobulin assay

[ basic data set ]

And controlling dialysis quality.

[ data Collection method ]

The beta 2 microglobulin assay record may be obtained at Lis.

[ analytical advice ]

Is free of

Urea clearance index (Kt/V) and urea decline rate (URR) timed record completion rates for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-30

[ DEFINITIONS ]

Proportion of Kt/V and URR timed recordings completed by maintenance hemodialysis patients every 6 months

[ MEANS FOR solving PROBLEMS ]

Reflecting the adequacy and quality management of the dialysis treatment of the hemodialysis center.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Urea clearance index (Kt/v) and urea decline rate (URR) for maintenance hemodialysis patients the number of maintenance hemodialysis patients completing the urea clearance index (Kt/v) and urea decline rate (URR) records within 6 months/number of contemporary maintenance hemodialysis patients x 100%, (Kt/v) and urea decline rate (URR) records

Urea clearance index (Kt/v) and urea decline rate (URR) timed recordings completion rates for maintenance hemodialysis patients-the number of urea clearance index (Kt/v) and urea decline rate (URR) recordings completed 1 time every 6 months/the total number of urea clearance index (Kt/v) and urea decline rate (URR) recordings that should be completed for all maintenance hemodialysis sessions at the same time x 100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of records of urea clearance index (Kt/v) and Urea Reduction Rate (URR) completed within 6 months recorded by year or real-time hemodialysis room (central) maintenance hemodialysis patients.

Denominator: contemporaneous or real-time contemporaneous hemodialysis room (center) total number of urea clearance index (Kt/v) and urea decline rate (URR) records that all maintenance hemodialysis should be completed.

In the region

Molecule (a): number of completed urea clearance index (Kt/v) and urea decline rate (URR) records within 6 months recorded for all maintenance hemodialysis patients in the annual or real-time region.

Denominator: total number of urea clearance index (Kt/v) and urea decline rate (URR) records that should be completed for all maintenance hemodialysis in the same period or real-time zone.

[ molecular description ]

According to the annual statistics, 1 month is calculated according to 31 days.

The patient should record urea clearance index (Kt/v) and urea decline rate (URR) levels for at least 1 time within 6 months of continuous hemodialysis in a hemodialysis room (center). If the patient completes a plurality of records within a time schedule after the data is actually recorded, only the last record data within the time schedule is included as the recorded data of the completion rate and the control rate.

The numerator of the real-time urea clearance index (Kt/v) and urea decline rate (URR) completion rate is counted as the number of patients completed within the last schedule.

If the test is not completed within the test completion schedule of the urea clearance index (Kt/v) and the urea decline rate (URR) of the patient, the patient records for the year for 1 time, the time span between 2 records is less than 6 months, and the record is regarded as not completed for more than 6 months.

The admission statistics of newly entered patients after 3 months of continuous dialysis in the hemodialysis room (center) but not considered incomplete for the incomplete test within 3 months, the statistics of the completion rate of the recordings were calculated starting on the day of patient enrollment.

[ Inclusion in groups ]

The number of persons who completed Kt/V and URR tests every 6 months within the test schedule at a certain time point.

Number of Kt/V and URR tests completed every 6 months within a certain time period.

[ exclude population ]

Test results for patients who did not complete the Kt/V and URR tests in the local hemodialysis room (center) but who for some reason had withdrawn the dialysis unit within 6 months.

[ Specification of the denominator ]

The number of times that the hemodialysis room (center) maintenance hemodialysis patient should finish urea removal index (Kt/v) and urea decline rate (URR) regularly records the number of times that the patient should record the test results for 12 months of continuous dialysis treatment in a dialysis room (center) + (the number of patients who newly enter the current year accumulated maintenance hemodialysis treatment is more than or equal to 6 months and less than 12 months x 2-the patient who newly enters the current year accumulated maintenance hemodialysis treatment is more than or equal to 6 months and less than 12 months and only records 1 test result + the patient who records 1 test result for the current year hemodialysis patient in the current year hemodialysis treatment and less than 6 months.

[ Inclusion in groups ]

Hemodialysis patients who completed 1 urea clearance index (Kt/v) and urea decline rate (URR) record for more than 3 months < 6 months of continuous dialysis and hemodialysis for more than 6 months of continuous dialysis were included in the statistics regardless of whether the records were completed.

[ exclude population ]

The newly entered maintenance hemodialysis patients who had not completed urea clearance index (Kt/v) and urea decline rate (URR) records for a while after continuous dialysis for < 6 months did not include statistics on the completion rate of urea clearance index (Kt/v) and urea decline rate (URR) records.

[ data elements ]

Maintenance hemodialysis patient

Urea clearance index (Kt/v) and Urea Reduction Rate (URR) records

[ basic data set ]

And controlling dialysis quality.

[ data Collection method ]

The Kt/V and URR records may be automatically calculated by the hemodialysis management system obtaining the data needed for the calculation on the LIS, or may be obtained by linking the hemodialysis machine through the hemodialysis management system through the OCM function of the hemodialysis machine, or manually filled in by medical personnel during the workflow after being read by the OCM function on the hemodialysis machine.

The urea removal index (Kt/v) and Urea Reduction Rate (URR) are set on the local hemodialysis management system, and the progress is recorded and counted according to the above rules.

[ analytical advice ]

Is free of

Incidence of hepatitis B and hepatitis C in patients undergoing maintenance hemodialysis

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-31

[ DEFINITIONS ]

The proportion of maintenance hemodialysis patients with hepatitis b and hepatitis c occurs newly every year.

[ MEANS FOR solving PROBLEMS ]

Reflecting the hospital infection management situation of the medical institution.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The incidence of hepatitis B and hepatitis C in patients with maintenance hemodialysis is 100 percent of the number of newly increased hepatitis B and hepatitis C patients per year in patients with maintenance hemodialysis per total number of patients with concurrent maintenance hemodialysis

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): the number of patients with hepatitis B and hepatitis C increases every year in the hemodialysis room (center).

Denominator: total number of concurrent maintenance hemodialysis patients.

In the region

Molecule (a): regional hemodialysis room (center) has a new number of patients with hepatitis B and hepatitis C each year

Denominator: total number of maintenance hemodialysis patients in the contemporaneous region. .

[ molecular description ]

According to natural seasons and natural years.

The new patients include patients who have been newly enrolled for 3 months in the quarter or year or who have been tested by the original maintenance hemodialysis patients for hepatitis B and hepatitis C markers that switch from negative to positive.

The quarterly or annually increasing patients dialyzed in the isolation area are considered to be newly increased hepatitis b and hepatitis c maintenance hemodialysis patients. The judgment of newly added patients is not judged by a blood-borne infectious disease marker because the situation that the virus copy number is changed to negative can be taken as the misjudgment prevention.

The incidence of hepatitis B and hepatitis C in patients with maintenance hemodialysis can be separately counted.

[ Inclusion in groups ]

All new patients were isolated from hemodialysis in the hemodialysis compartment (central) hepatitis b and hepatitis c areas.

The new patients who were newly added in the last year are 3 months old in the present year, but the patients who had quit in the present year are also included in the statistics of newly added patients in the present year.

[ exclude population ]

Patients who are positive for hepatitis C antibody and negative for HCV-RNA dialyzed against a relatively fixed bed in a non-isolated area are excluded.

A newly entered hemodialysis patient has begun to maintain dialysis in a local area where a calculation of annual incidence rates requires that the patient be within the year of the present calculation when dialysis in the hemodialysis room or area has been performed for up to 3 months. If the above condition is not met, no statistics are included.

[ Specification of the denominator ]

The hemodialysis room (center) is counted by the year that the patient should be admitted to the unit year maintenance hemodialysis patient for 3 months after the unit continuous dialysis, whether the new time is in the current year or not.

Check the repetition in the region according to the ID card, and count the dialysis age of regular hemodialysis in the region for 3 months.

[ Inclusion in groups ]

Hemodialysis room (central) all maintenance hemodialysis patients in the area.

The stay on hemodialysis patients leave the dialysis room (center) or the area within a statistical quarter and remain counted as stay on hemodialysis patients for that quarter.

If the maintenance hemodialysis patient exits the hemodialysis room (center) or area for various reasons during the year or season, the dialysis institution is still taking statistics.

[ exclude population ]

Is free of

[ data elements ]

Maintenance hemodialysis patient

Blood borne infectious disease marker for hemodialysis patient

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Calculated from data entered on the hemodialysis management system.

[ analytical advice ]

Is free of

Timed test completion rate of blood-borne infectious disease markers of maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-32(NEP-D-04)

[ DEFINITIONS ]

The proportion of patients on maintenance hemodialysis who completed the test for markers of blood-borne infectious diseases was completed every 6 months. (national health professional medical quality control index of Commission Kidney disease)

Maintenance hemodialysis patients complete a ratio of the number of patients tested for the blood-borne infectious disease marker to the number of times they should be tested.

[ MEANS FOR solving PROBLEMS ]

Reflecting the infection management situation of the medical institution hospital.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The timing test completion rate of the blood-borne infectious disease marker of the maintenance hemodialysis patients is equal to the number of patients completing the blood-borne infectious disease marker test every 6 months/the total number of the maintenance hemodialysis patients at the same period is multiplied by 100 percent

The blood-borne infectious disease marker timing test completion rate of the maintenance hemodialysis patients is recorded as the blood-borne infectious disease marker test times of the maintenance hemodialysis patients/the blood-borne infectious disease markers of all the maintenance hemodialysis patients in the same period multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): number of times actually recorded for blood borne infectious disease marker tests of annual hemodialysis room (central) maintenance hemodialysis patients.

Denominator: number of times all blood borne infectious disease markers of maintenance hemodialysis patients in the same period hemodialysis room (center) should be tested

[ molecular description ]

For specific test of hepatitis B and hepatitis C virus markers, see "standard operating protocol for blood purification (SOP)", (2020

The blood-borne infectious disease marker tests of patients with maintenance hemodialysis comprise four pathogen antibody tests of hepatitis B, hepatitis C, syphilis and AIDS.

On the basis of the four statistics, each blood permeable chamber blood-borne infectious disease marker is respectively counted, and if 1 item is absent, the blood-borne marker is not tested completely.

The 1 st test for blood borne infectious disease markers every 6 months was calculated from the time the patient was enrolled when new.

If 1 patient is on dialysis treatment in other hemodialysis rooms (centers) within a period of time after dialysis is terminated in one hemodialysis room, the patient returns to the original hemodialysis unit again at present, and four blood-borne infectious disease markers are rechecked according to newly entered patients.

The newly entered patient needs to add 1 test of the blood-borne infection marker at month 3, so the test completion rate of the newly entered patient at month 3 in the statistical process is not in the quality control range of the index, and the completed test at month 3 is paid attention to and excluded.

If 1 maintenance dialysis patient had a hemodialysis treatment and an interruption in a dialysis facility, such patients could be distinguished on the hemodialysis management system and tracked on the quality control management system. Discontinuation was defined as 2 dialysis treatments 1 month apart, 31 days.

The completion of the test 1 of this year is related to the completion of the test 1 of the last 1 year, and the completion of the test 1 of this year is related to the completion of the test 1 of the third next 1 year.

If the time of 2 monitoring is more than or equal to 6 months, 1 unfinished time in the year is counted. This year is counted as 1 time regardless of the number of tests. 2 tests of one year < 6 months.

The interval between the 1 st test in the second year and the last test in the last 1 year of the newly-entered patient is less than 6 months, and the test in the last year is calculated.

[ Inclusion in groups ]

Maintenance hemodialysis patients need continuous dialysis treatment in one dialysis center for 6 months and cannot be included with the dialysis treatment discontinuation in other dialysis institutions.

[ exclude population ]

Patients with more than 6 months are monitored more than 2 times a year, and if there are 2 tests, the time of more than 6 months can only be counted as 1 time for completion.

Since the patients are statistical patients and are maintenance hemodialysis patients, if the patients are newly entered in the year, whether the 1 st test is completed or not is not within the statistical range of the sub-index, and whether the 3 rd month test is completed or not is not included in the statistics.

[ Specification of the denominator ]

The number of patients who continuously dialyze for 12 months in a dialysis mechanism is multiplied by 2+ the number of patients who continuously dialyze for more than 6 months in a dialysis mechanism and dialyze for more than 6 months in the same mechanism for more than 12 months in the same year

The system schedule was done for 1 month in 31 days, with 6 months as the check deadline. The statistics are monthly, so that the statistics actually exceed about 1 week without any return and are counted as incomplete. However, the number of tests that should be performed per patient per year cannot be less than 2, and only 1 test is required in this year due to the difference between the 31-day monthly schedule and the natural month, and the 2 nd test is completed by default at 31 days 12 and 31 days in this year.

If a newly entered patient is treated by dialysis in a hemodialysis room (center) for 6 months continuously, the examination should be repeated 1 time in the year, and if a newly entered patient is treated by dialysis in a dialysis machine continuously, the examination should be repeated 2 times per year in each year after the second year.

The statistical time interval is generally one natural year and less than one natural year, and statistics is carried out according to the actual natural month of the natural year.

The definition of a maintenance hemodialysis patient differs from that of other index sets in that the blood-borne infectious disease markers should be re-tested after the hemodialysis treatment of another dialysis institution returns to the original hemodialysis unit for various reasons. The test was added 1 month 3 into the hemodialysis chamber (center) still following the new entry patient, and this added test was not included in the statistics.

Since there are cases where a patient resumes dialysis again after a dialysis unit exits dialysis, a larger number of patients may be present than in maintenance dialysis when cross-sectional investigations are performed using formula 1. If the second formula is used for counting, the patient may have a failure such as counting of the completion rate in the current year due to the fact that the patient has an interruption of the hemodialysis treatment in a certain institution.

Routine dialysis patients should re-test for markers of blood-borne infections from one unit to another.

[ Inclusion in groups ]

All maintenance hemodialysis patients who had been continuously dialyzed in one dialysis room (center) for up to 6 months were included.

[ exclude population ]

A patient leaves the dialysis facility during the year and if the time for the blood-borne infectious disease marker test has not expired, the patient is no longer enrolled for the year. Statistics for the year should be included if the test period has been exceeded before leaving.

[ data elements ]

Maintenance hemodialysis patient

Registering hemodialysis patients

Hematogenous spread disease of hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Because of the compartmental dialysis problems involved in dialysis patients, the results of the hemodialysis patient's bloodborne infectious disease markers need to be confirmed by a hemodialysis room (central) physician for deliberate entry, so direct synchronization from Lis and automatic patient bloodborne infectious disease marker modification by the system and patient compartmental modification by the system are generally not employed. The system only reads the result of the blood-borne infectious disease marker in Lis, and does not judge further.

The time of the test is entered manually by the medical staff. But is the basis data for the test that can be further queried by the quality control management system.

[ analytical advice ]

Is free of

The indexes obtained in the quality control process of the quality control system are used, and the system can be continuously maintained and monitored according to the index operation standards in actual work.

(II) a hemodialysis quality control result system:

qualification rate of biological pollutant (bacteria culture) for dialysis

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-33(NEP-D-02)

[ DEFINITIONS ]

Hemodialysis room (center) dialysis accounts for the proportion of the qualified month in the current year with water biological pollutants (bacteria culture).

The colony count of the treated water is less than or equal to 100CUF/ml every month, the endotoxin is detected to be less than or equal to 0.25EU/ml every 3 months, and the standard of hemodialysis and related treatment water (YY0572-2015) is met.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

[ equation ]

The annual qualification rate of the dialysis water bacterial culture is equal to the number of months qualified by the dialysis water biological pollutant (bacterial culture) test/the number of times of the same-period dialysis water biological pollutant (bacterial culture) test multiplied by 100 percent

[ rules of calculation ]

Molecule (a): the dialysis was checked for monthly parts using water bio-contaminants (bacterial culture).

Denominator: the monthly number of patients were received by the dialysis room (center) in the year.

[ molecular description ]

The determination period is calculated according to 1 month, which is a natural month.

The calculation result is the 1 st result in the current month. If the 1 st dialysate bacterial culture in a certain month is not qualified, the dialysate bacterial culture is not qualified in the same month.

If the test is not carried out within a certain month in the year, the test is regarded as unqualified treatment.

[ Inclusion in groups ]

Hemodialysis room (center) all months tested for water bio-contamination for dialysis.

The time for reporting the result of the review is based on the sampling time, and the time between the sampling time and the time for reporting the result is reasonable.

[ exclude population ]

And (3) failing for 2 times continuously, jointly searching the reason for the hemodialysis room (center) and/or the functional department or manufacturer of the medical institution, and rechecking the reason as soon as possible after the reason is rectified, wherein the rechecking result is not taken as the result of the monthly test and is included into statistics.

[ Specification of the denominator ]

The total times of bacterial culture which the dialysis solution should complete in a year are less than or equal to 12 times in 1 year.

The number of times that the newly opened dialysis room (center) should be checked is counted according to the number of months of actual opening.

[ Inclusion in groups ]

The total times of bacterial culture which is required to be finished by water for annual dialysis are less than or equal to 12 times in 1 year.

[ exclude population ]

If there were multiple test results within 1 month of the hemodialysis chamber (center), results > 1 were not included in the statistics.

[ data elements ]

Biological contaminant for dialysis water

Water bacteria culture for dialysis

Number of endotoxin tests for water for dialysis

Dialysis water quality parameter checking time

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The dialysis water bacteria culture is self-tested by the medical institution and can be read from the Lis unit, and then directly read from the system.

For example, the results of the water bacteria culture for dialysis cannot be read from Lis and need to be manually filled in cfu/ml.

[ analytical advice ]

The result of the bacterial culture is more than 100cfu/ml, the condition of the hemodialysis room (center) needs to be immediately analyzed, and the bacterial culture is repeated after the adjustment and the modification as soon as possible until the culture result is qualified

If the dialysate bacteria culture is unqualified for 2 times, the dialysate bacteria culture is used as an early warning index and is uploaded to a hemodialysis quality control management system.

Qualification rate of biological pollutant (endotoxin) for dialysis

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-34

[ DEFINITIONS ]

Hemodialysis room (center) dialysis accounts for the proportion of the year in which water biological contaminants (endotoxins) are qualified for testing.

[ MEANS FOR solving PROBLEMS ]

Reflecting the management condition of the hemodialysis room (center) for ensuring the dialysis quality and safety.

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

[ equation ]

The test qualification rate of biological contaminant (endotoxin) for dialysis is the quarter number qualified for the test of endotoxin level for water for dialysis/the quarter number tested for endotoxin level for water for dialysis at the same period is multiplied by 100 percent

[ rules of calculation ]

Molecule (a): the number of times the endotoxin level test in the water for dialysis was passed was determined for the period.

Denominator: the number of tests for endotoxin levels in the water used for dialysis was determined over the period.

[ molecular description ]

The determination period is calculated according to 1 month, which is one natural month, and 3 natural months are 1 quarter.

The calculation result is the 1 st result in the current season. If the 1 st dialysis water endotoxin level test result in a certain quarter is not qualified, then when the quarter is not qualified, endotoxin tests with other quarters > 1 are not accumulated for statistics.

[ Inclusion in groups ]

Taking out only the result of the 1 st dialysis water endotoxin level test in each quarter as a qualified result

[ exclude population ]

If a certain quarter within the year is not examined, it is treated as an unqualified quarter.

The results of the qualified dialysis water endotoxin test > 1 time per quarter were not included repeatedly.

[ Specification of the denominator ]

The total number of times of endotoxin test with water for annual dialysis is less than or equal to 4 times in 1 year.

If the newly opened dialysis room (center) should be checked the number of times is counted in the number of seasons in which the business is actually opened.

[ Inclusion in groups ]

The annual dialysis water is used for completing the total times of endotoxin level test, and the number of times is less than or equal to 4 in 1 year.

[ exclude population ]

If there were multiple test results within 1 quarter of the hemodialysis chamber (center), results > 1 were not included in the statistics.

[ data elements ]

Biological contaminant for dialysis water

Endotoxin levels in water for dialysis

Number of endotoxin tests for water for dialysis

Dialysis water quality parameter checking time

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the endotoxin level test in the water for dialysis is carried out by the medical unit and can be read from the LIS of the unit, the endotoxin level test can be directly read from the system.

If the endotoxin level test results for dialysis are provided by a third party and cannot be read from the LIS, they are manually filled out and the results are uploaded in the form of a picture in EU/ml.

[ analytical advice ]

The result of endotoxin test is more than 0.25EU/ml, and the hemodialysis room (center) needs to immediately perform condition analysis and repeat endotoxin test after being corrected as soon as possible until the test result is qualified.

And if the endotoxin in the dialysate is not qualified after 3 times of continuous dialysis, the endotoxin is used as an early warning index and is uploaded to a quality control management system.

Dialysis machine dialysate bacterial culture qualification rate

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-35

[ DEFINITIONS ]

The qualified cases of dialysate bacterial culture of the dialysis machine operated in the hemodialysis room (center) account for the proportion of the completed cases of dialysate bacterial culture inspection actually recorded in the same period.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

[ equation ]

The dialysis machine dialysate bacteria culture qualification rate is equal to the qualified example of the dialysate bacteria culture in the hemodialysis room (center) running the dialysis machine/the qualified example of the dialysate bacteria culture inspection actually recorded in the same period is multiplied by 100 percent

[ rules of calculation ]

Molecule (a): and (4) operating the dialysis machine dialysate in a determined time period for qualified bacteria culture.

Denominator: the period of determination is the same as the period of time in which all actually recorded dialysate bacteria culture tests are completed.

[ molecular description ]

The maximum allowable level of standard dialysate bacterial culture is less than 100CFU/ml, and the intervention level is 50 CFU/ml; the maximum allowable level of ultra-pure dialysate for bacterial culture is less than 0.1 CFU/ml. .

It is also acceptable for the dialysate bacteria culture to reach the intervention level.

The dialysis machine of the hemodialysis room (center) newly opened in the year should complete one dialysis liquid culture before use, and then put into treatment after the culture result is qualified. The check-out date display is required prior to administrative review.

The time window for the test should be determined according to SOP regulations, suggesting that the total number of stations is equally distributed over 12 months. And the system uploads data to the quality control management system 12 months and 31 days before the current year.

If the first bacterial culture of the dialysate of a dialysis machine is unqualified in the current year, the reason should be immediately searched and measures should be taken until the bacterial culture result turns negative. The hemodialysis machine should not be put into dialysis treatment of the patient until the next dialysate bacterial culture turns negative. And if the test result is normal, the test result is used as unmonitored data to be displayed on the quality control management system.

Since repeated inspection of a dialysis machine may occur, but there is an undetected condition at the same time, such a qualification rate may not necessarily reflect the actual condition of reaching standards. The number of the dialysis machine which is not qualified in bacterial culture and the total number of the dialysis machines can be presented, so that the proportion of machines which are not qualified in the dialysate can be displayed.

[ Inclusion in groups ]

Time hemodialysis room (center) all dialysate bacterial cultures and qualified cases performed on standard dialysate and ultrapure dialysate standards.

[ exclude population ]

Time hemodialysis room (center) all instances of dialysate bacterial culture failing the standard performance of standard dialysate and ultrapure dialysate

[ Specification of the denominator ]

Taking 1 year as a statistical time interval, and performing statistics according to natural months.

All dialysis machine dialysate bacteria were cultured for a period of time.

[ Inclusion in groups ]

The hemodialysis room (center) performed practically the total number of hemodialysis machines that cultured dialysate bacteria in the year. Since each dialysis machine was incubated with dialysate bacteria at least 1 time per year, all the results of each examination were included in the statistics

The most recent results were included before the hemodialysis machine was taken for treatment.

[ exclude population ]

Since all dialysis machines must be qualified in dialysis water before the results are not included in the statistics before the most recent results are obtained before the hemodialysis machine is put into therapeutic use.

Dialysate bacterial cultures prior to the last outcome before the hemodialysis machine was put into therapeutic use were not included in the statistics.

[ data elements ]

Dialysis machine with unique number, total number, dialysis liquid bacterial culture result, dialysis liquid quality, parameters, dialysis liquid quality inspection time, dialysis liquid quality inspection result and high-throughput dialysis low-throughput dialysis equipment

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the dialysate culture is self-tested by the medical facility and can be read from the unit's LIS, it is read directly from the system.

If the results of the dialysis water bacterial cultures cannot be read from the LIS, they need to be manually filled out and the original test results are uploaded in CFU/ml.

If the result is provided by a third party verification authority, the original copy of the third party verification result is uploaded.

[ analytical advice ]

If the bacteria culture of the dialysis machine fails, the bacteria culture is immediately corrected until the test result is qualified.

If the bacterial culture qualification rate of the dialysate of the dialysis machine is obviously lower than the local average level, the bacterial culture qualification rate is used as an early warning index and is uploaded to a quality control management system.

Dialyzate endotoxin inspection qualification rate of dialysis machine

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-36

[ DEFINITIONS ]

The qualified cases of the dialysate endotoxin test of the dialysis machine operated in the hemodialysis room (center) account for the proportion of the completed cases of the dialysate endotoxin test actually recorded in the same period.

[ INDICATOR SOURCE/DOCUMENT ]

Standard operating procedure 2020 edition for blood purification

[ equation ]

The qualified rate of the dialysate endotoxin test of the dialysis machine is multiplied by 100 percent in the cases that the dialysate endotoxin test of the hemodialysis room (center) is qualified when the dialysate is operated by the dialysis machine/all actually recorded dialysate endotoxin test completion cases in the same period

[ rules of calculation ]

Molecule (a): defined period) was run for the qualified example of the endotoxin test on the dialysate from the dialysis machine.

Denominator: the determination period was synchronized with the completion of all actually recorded dialysate endotoxin tests.

[ molecular description ]

The maximum allowable level of standard dialysate endotoxin test is less than 0.5EU/ml, and the intervention level is 0.25 EU/ml; the maximum allowable endotoxin test level of the ultrapure dialysate is less than 0.03 EU/ml.

It was also acceptable that the dialysate endotoxin test reached the level of intervention.

The dialysis machine of the hemodialysis room (center) newly opened in the year should complete one dialysis liquid endotoxin test before use and put into treatment after the result is qualified. The check-out date display is required prior to administrative review.

If the dialysate of a dialysis machine fails endotoxin test for the first time in the current year, the reason should be immediately searched and measures should be taken until the endotoxin test result turns negative. The hemodialysis machine should not be put into dialysis treatment of the patient until the next dialysate endotoxin test result turns negative. And if the test result is normal, the test result is used as unmonitored data to be displayed on the quality control management system.

Since repeated inspection of a dialysis machine may occur, but there is an undetected condition at the same time, such a qualification rate may not necessarily reflect the actual condition of reaching standards. The number of machines with toxin tests in the dialysis machine which fail and the total number of dialysis machines can also be presented, so that the proportion of machines with dialysate which fails can be displayed.

The hemodialysis filter is defined at the local business system as a standard for performing ultrapure dialysate, the normal dialysis machine performs according to the ultrapure dialysate standard if it is high-pass dialysis with the dialysis doctor's order as a high-pass dialyzer, and the other dialysis machines perform according to the standard dialysate standard.

[ Inclusion in groups ]

Time hemodialysis room (center) all dialysis fluid endotoxin tests performed on standard dialysis fluid and ultrapure dialysis fluid standards and qualified cases.

[ exclude population ]

Time hemodialysis room (center) all instances of dialysate endotoxin test failure performed with standard dialysate and ultrapure dialysate

[ Specification of the denominator ]

All dialysis machine dialysate endotoxin test cases in a period of time.

[ Inclusion in groups ]

The hemodialysis room (center) performed the total number of hemodialysis machines that performed the dialysate endotoxin test in fact in the year. Since each dialysis machine had at least 1 endotoxin test per dialysis machine year, all the test results were included in the statistics

[ exclude population ]

The dialysate endotoxin test was not included in the statistics prior to the last outcome before the hemodialysis machine was put into therapeutic use.

[ DATA ELEMENT ] dialyser unique number dialyser total number dialyser endotoxin test qualified standard dialyser endotoxin test result dialyser quality parameter each dialyser quality parameter test time dialyser quality parameter test result dialyser equipment high-flux dialysis low-flux dialysis

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

If the results of the endotoxin test for dialysis were not read from the LIS, they were manually filled out and the original test results were uploaded in CFU/ml.

[ analytical advice ]

If the toxin in the dialysis machine fails, the toxin is immediately corrected until the test result is qualified.

And if the inspection qualification rate of the endotoxin in the dialysate of the dialysis machine is obviously lower than the local average level, the inspection qualification rate is uploaded to a quality control management system as an early warning index.

Incidence of hypotension in hemodialysis

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-37

[ DEFINITIONS ]

During dialysis, the systolic pressure drop is more than 20mmHg and the mean arterial pressure drop is more than 10mmHg, and hypotension is caused.

It refers to the proportion of the cases or population of people with hypotension in the hemodialysis process to the number of people in the hemodialysis treatment or the total population.

[ MEANS FOR solving PROBLEMS ]

Reflecting the dialysis quality management level of hemodialysis patients in a hemodialysis center.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The incidence of hypotension in hemodialysis ═ the number of cases of hypotension during hemodialysis/the number of cases of contemporaneous hemodialysis treatment × (100)%

[ rules of calculation ]

Hemodialysis chamber (center): according to the example

Molecule (a): hemodialysis patients in hemodialysis room (center) have cases of hypotension during dialysis

Denominator: total number of actual dialysis treatments for contemporary hemodialysis patients.

Hemodialysis chamber (center): according to the number of people

Molecule (a): the number of people who develop hypotension during dialysis in hemodialysis rooms (centers) over time

Denominator: total number of persons dialyzing in hemodialysis room (center) at the same time

In the region: according to the example

Molecule (a): the number of instances in which hemodialysis patients experience hypotension during dialysis in the area.

Denominator: the total number of hemodialysis treatments in or within the same session area.

In the region: according to the number of people

Molecule (a): the number of hemodialysis patients in an area who experience hypotension during dialysis.

Denominator: the total number of hemodialysis treatments in the same area or zone.

[ molecular description ]

The statistics were started based on the blood pressure monitored for the first time at the start of the dialysis treatment. The systolic blood pressure at a certain time point was decreased to 20mmHg below any previously monitored systolic blood pressure value, or the mean arterial pressure was decreased by 10mmHg before any previous time, and was symptomatic for hypotension.

Symptomatic hypotension is judged by the nurse responsible for the treatment and is determined on the local system to be symptomatic hypotension.

Mean arterial pressure +1/3 pulse differential pressure

If the number of dialysis people in a hemodialysis room (center) is counted, no matter the number of times of hypotension in the dialysis process occurs in one person, one person is calculated at one time, and the calculation is not repeated.

[ Inclusion in groups ]

All cases or patient population during dialysis where symptomatic hypotension occurred during dialysis.

[ exclude population ]

The dialysis hypotension is related to the dialysis process, and if the blood pressure during evaluation before dialysis and the blood pressure monitored before dialysis treatment reach the standard of the dialysis hypotension, the blood pressure is not included in statistics regardless of the dialysis process.

If the patient enters the dialysis room (center) hypotension has occurred, e.g. below 90mmHg, symptomatic or asymptomatic, as statistics are not included regardless of the dialysis process.

Patients who had symptomatic hypotension during dialysis but did not appear during the statistical period, did not include statistics for this period.

[ Specification of the denominator ]

The statistical time interval is self-defined and is displayed according to natural seasons by default.

Different groups of people can be distinguished during statistics, such as registered hemodialysis patients and maintenance hemodialysis patients.

[ Inclusion in groups ]

All patients had their hemodialysis treatments included statistics.

[ exclude population ]

Patients for whom the patient does not have dialysis treatment information at the dialysis room (center) for various reasons are not included in the statistics during the statistics period. For example, if the patient was transferred out of the dialysis room (center) in 12 months of the previous year, and there is no treatment information in the first quarter of the year, then the patient is not included in the statistics.

[ data elements ]

Hemodialysis patient-registered hypotension during hemodialysis

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Data is read from the hemodialysis management system by the data collector directly from the hemodialysis machine or manually entered by a nurse at the mobile or PC end of the hemodialysis management system.

The rule of hypotension during hemodialysis is defined in the system, and whether the change of the blood pressure value during dialysis reaches the standard can be automatically calculated in the business system, for example, when the standard is reached and the hemodialysis evaluation is carried out according to the condition monitored in the dialysis process of a patient after the end of dialysis treatment, medical staff determines whether the hypotension is generated during a dialysis process. If the statistics show that the blood pressure is low in one dialysis process, the record is 1 uploading.

[ analytical advice ]

The incidence of hypotension in hemodialysis is significantly higher than average and requires comprehensive analysis to find the cause.

Hypertension control rate in hemodialysis

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-38

[ DEFINITIONS ]

The number of cases (number of persons) of hypertension occurring during hemodialysis in hemodialysis patients accounts for the number of cases (number of persons) of the whole hemodialysis treatment during a certain period.

[ MEANS FOR solving PROBLEMS ]

Reflecting the management level of dialysis quality for hemodialysis patients in individual hemodialysis rooms (centers) and medical institutions in the area.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Hemodialysis chamber (center): according to the example

Molecule (a): hemodialysis Chamber (Central) hemodialysis patients' cases of hypertension during dialysis

Hemodialysis chamber (center): according to the number of people

Molecule (a): the number of people who have hypertension during dialysis in hemodialysis room (center) for a period of time

In the region: according to the example

Molecule (a): the case of hypertension during dialysis occurs in hemodialysis patients in the area during dialysis.

In the region: according to the number of people

Molecule (a): the number of hemodialysis patients in an area who experience hypertension during dialysis.

[ molecular description ]

Hemodialysis is not specifically directed to hemodialysis treatment mode but all extracorporeal blood purification treatments performed in a hemodialysis chamber (center).

According to the widely accepted concept of dialysis, the mean arterial pressure during dialysis rises by more than or equal to 15mmHg compared to that before dialysis, which is called intradialytic hypertension. Since there is no definition of hypertension in dialysis, the definition should be improved gradually after the actual quality control work and index analysis.

During dialysis, the mean arterial pressure is increased by more than or equal to 15mmHg compared with the blood pressure before dialysis, and simultaneously the dialysis blood pressure of a hemodialysis patient under the age of 60 is required to be more than 140/90mmHg, the dialysis blood pressure of a patient over the age of 60 is more than 150/90mmHg, and the blood pressure monitored at the 1 st time of dialysis treatment is generally selected as a baseline for data integrity.

If the blood pressure monitoring during hemodialysis reaches the standard of the hemodialysis hypertension within the statistical time period and reaches more than 3 times on different dialysis days, the patient is considered as 1 patient with the hemodialysis hypertension within the time period.

[ Inclusion in groups ],

All cases (number of people) of intradialytic hypertension occurred in hemodialysis treatment in hemodialysis room (center).

[ exclude population ]

Although mean arterial pressure increased by 15mmHg before dialysis during dialysis, systolic blood pressure did not meet the criteria for hypertension in hemodialysis patients was not included in the statistics.

When counted by number, only < 3 times of hypertension occurred in the dialysis period, and the patient was not included in the statistics. A

There were patients who had intradialytic hypertension during dialysis, but did not appear during the statistical period, and the patient did not include the statistics for intradialytic hypertension patients during this period.

[ Specification of the denominator ]

The statistical time interval defaults to a natural quarter and can be customized.

[ Inclusion in groups ]

The total number of hemodialysis treatments (population) within an area or in a hemodialysis room (center) is determined.

[ exclude population ]

If the patient only dialyses < 3 times during this period, the statistics for this period are not included, as counted by number.

[ data elements ]

Registration of hemodialysis patients with maintenance hemodialysis patients systolic mean arterial pressure for hemodialysis treatment times

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The control rate of hypertension in hemodialysis is data generated in the treatment process, and the data is recorded at a mobile working end or a PC end after being measured by a nurse in the treatment process, and the blood pressure of a patient in the treatment process can be directly read if the mobile end and the hemodialysis machine have data transmission interfaces.

Hypertension in dialysis is not defined exactly, the data set does not require correlation with symptoms in the treatment process of patients, and basic data of blood pressure is uploaded and then automatically judged and generated in a quality control management system.

[ analytical advice ]

Since hypertension is not clearly defined in dialysis, if customized statistics of the range of blood pressure values and mean arterial pressure increases can be made in the statistical process, analysis of the interrelationship between the blood pressure increases and other indicators in dialysis can be more comprehensive and reasonable.

Annual hospitalization rate of maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-39

[ DEFINITIONS ]

Number of hospitalizations of hemodialysis patients in hemodialysis room (central) maintenance and annual proportion of patients in maintenance hemodialysis patients.

[ MEANS FOR solving PROBLEMS ]

Reflecting quality control of chronic disease management in hemodialysis patients in individual hemodialysis rooms (centers) and regional medical facilities.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Annual hospitalization rate for maintenance hemodialysis patients-hospitalized maintenance hemodialysis patients/years for patients with contemporaneous maintenance hemodialysis patients x 100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): all maintenance hemodialysis patients in a hemodialysis room (center) were hospitalized for a total of 1 year.

Denominator: contemporaneous hemodialysis room (center) all patients with maintenance hemodialysis patients are aged.

Region(s)

Molecule (a): all maintenance hemodialysis patients in the area were hospitalized for a total of 1 year.

Denominator: patient years for all maintenance hemodialysis patients in the contemporary area.

[ molecular description ]

One admission and discharge was recorded as 1-person admission.

The maintenance hemodialysis patient is a patient who has been continuously dialyzed in a hemodialysis room (center) for 3 months, and the number of all hospitalizations in the year is accumulated, excluding a patient who was admitted in the first 3 months after the start of the dialysis room (center).

If a regular hemodialysis patient in one hemodialysis room (center) is hospitalized in a hospital in another hemodialysis room, the dialysis treatment in the hemodialysis room (center) during the hospitalization period is less than 3 months, and the number of hospitalization times is classified as the hospitalization rate statistics of the original dialysis unit.

The original dialysis room (center) should be followed up in time.

In some provincial areas, the maintenance hemodialysis patients pay for medical care according to the hospitalization mode, so that it is difficult for such patients to count the annual hospitalization rate of the patients through the hospitalization times of the hospitalization system.

[ Inclusion in groups ]

All hospitalized patients with maintenance hemodialysis in the hemodialysis room (center) were hospitalized for any reason.

With respect to the statistics of the annual hospitalization rate of the regional maintenance hemodialysis patients, the statistics of the hospitalization rate of each region are not significant in practice because the patients can be mobile, especially hospitalized, in each region.

In some provincial areas, maintenance hemodialysis patients are paid for their medical care in a hospitalization mode, so that such patients are treated with medical care

[ exclude population ]

Patients undergoing regional hemodialysis are not hospitalized in any dialysis unit if the patient is treated in a dialysis room (center) for less than 3 months and is currently hospitalized in a hospital in another dialysis room, and can be included in the annual hospitalization rate statistics of the total patients in the region.

If the first dialysis of a chronic renal failure patient begins with a hospital stay, the hospital stay is not included in the statistics of the annual stay rate of the patient on maintenance hemodialysis.

If the first hospitalization time of a newly admitted dialysis patient is more than or equal to 3 months, the admission is not counted as the admission rate of the number of hospitalizations of hemodialysis room (central) maintenance hemodialysis patients.

[ Specification of the denominator ]

Patient year-all maintenance hemodialysis patients maintain hemodialysis treatment in hemodialysis room (center) on days (including dialysis days and non-dialysis days)/365

The new patients were not counted in 3 months of hospitalization, but the patient year was counted starting with the registration date.

Annual hospitalization rates are generally counted.

[ Inclusion in groups ]

The maintenance hemodialysis patient leaves the hemodialysis room (center) for various reasons and is subjected to dialysis treatment in other institutions, if the dialysis treatment is carried out for less than 3 months, the patient is returned to the original dialysis room (center), the annual statistics of the patient are continuous, and the differentiation statistics are not carried out according to the new dialysis patient.

Newly added maintenance hemodialysis patients were also enrolled in annual statistics during the first 3 months of hemodialysis treatment in the hemodialysis room (center).

[ exclude population ]

If the patient is interrupted for > 3 months for various reasons in one dialysis room (center), the time of interruption is not taken into account the patient's annual statistics.

Maintenance hemodialysis patients admitted in the last year, with hospitalization spanning 2 years, die or leave the dialysis room (center) after the patient is discharged in the present year, and are not included in the patient's annual statistics during the present year's hospitalization.

[ data elements ]

Maintenance hemodialysis patient

New patient registration time

Time of admission

Time of discharge

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Information on hospitalized maintenance hemodialysis patients may come from the HIS system of the hospital.

Entry in the local system is recommended if a maintenance hemodialysis patient in one hemodialysis room (center) is hospitalized in a hospital where another hemodialysis room is located.

[ analytical advice ]

If the annual hospitalization rate of the maintenance blood patients is obviously higher than the average hospitalization rate, specific reasons need to be analyzed, and the increase of the hospitalization rate caused by human factors, such as non-indication hospitalization and the like, is excluded.

The stay-in-patient cause of hemodialysis patients is in proportion

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-40

[ DEFINITIONS ]

The prevalence of various hospitalizations of the maintenance hemodialysis patients among all hospitalized patients,

[ MEANS FOR solving PROBLEMS ]

Reflecting the quality control of hemodialysis patients in a single hemodialysis room (center) and an in-region medical institution during dialysis.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The hospitalization causes of the maintenance hemodialysis patients are 100% higher than the total number of patients with various hospitalization causes/maintenance hemodialysis patients with the same period of hospitalization

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): patients with maintenance hemodialysis are hospitalized for various reasons.

Denominator: total hospitalization of contemporaneously hemodialysis room (central) maintenance hemodialysis patients.

In or on areas

Denominator: total number of maintenance hemodialysis hospitalized in the same or regional area.

[ molecular description ]

The main statistics of hospitalization are related to complications associated with chronic renal failure. Chronic complications of chronic renal failure include 1. renal anemia 2. disorders of bone mineral metabolism 3. malnutrition, 4. amyloidosis 5. respiratory system 6. cardiovascular system 7. nervous system 8. digestive system 9. skin pruritus 10. restless legs 11 others. .

The reasons for maintaining hospitalization of hemodialysis patients are summarized as 1, cardiovascular disease 2, cerebrovascular disease 3, renal anemia 4, bone mineral metabolic disorder 5, malnutrition 6, infection (non-vascular access) 7, vascular access complications 8, tumor 9 and the like according to the above complications.

The reasons for one hospitalization of a maintenance hemodialysis patient may be more than 1, but are counted as the most prominent hospitalization reason for this hospitalization. Statistics can be collocated simultaneously if necessary.

[ Inclusion in groups ]

The reasons of the left and right hospitalizations are possibly concurrent, if a plurality of reasons exist in one hospitalization and the treatment scheme is adjusted, the reasons of the hospitalization can be calculated in parallel.

[ exclude population ]

If there are several reasons for hospitalization and the complications are not listed, no statistics are included.

Hospitalizations for the first 3 months of the patient's first dialysis were excluded and not included in the hospitalized statistics.

[ Specification of the denominator ]

And (4) counting the years according to each natural year.

Total hospitalizations of all maintenance hemodialysis patients over the year.

The number of hospitalizations is independent of the length of hospitalization.

[ Inclusion in groups ]

For a hemodialysis patient, a hemodialysis patient in a hemodialysis room (center) is a patient who has been continuously dialyzed for 3 months in the institution, and the number of hospitalizations for various reasons in the year is counted.

Maintenance hemodialysis patients are still enrolled in the hemodialysis room (center) year's statistics less than 3 months from the hemodialysis room (center) year for various reasons.

The hemodialysis patient leaves the dialysis institution to be hospitalized in other medical institutions, returns after being discharged, and still enters the dialysis institution for statistics.

When the hemodialysis patient leaves the dialysis mechanism and plans to perform maintenance dialysis in other medical institutions, if the duration is less than 3 months, the hospitalization information of the hemodialysis patient still includes the statistics of the original dialysis institution. If the information can be interconnected and communicated, statistics is brought according to identity recognition, otherwise, the original dialysis unit is required to perform necessary follow-up tracking within 3 months and manually report in time.

[ exclude population ]

The hospitalizations across years, because statistics have already been included in the last year, are not included repeatedly in this year.

[ data elements ]

Hospitalization time of hemodialysis patient

Number of hospitalizations of hemodialysis patients

Reasons for hospitalization of hemodialysis patients

Maintenance hemodialysis patient

Registering hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Hospitalization information for a maintenance hemodialysis patient can be read on the HIS system of the hemodialysis facility.

The patient with maintenance hemodialysis is not hospitalized in the dialysis mechanism, and is scheduled to be hospitalized in other mechanisms. When the patient leaves the hemodialysis mechanism, the hemodialysis responsible doctor manually reports the hospitalization information and the hospitalization reason, and if the patient has an error, the patient can be corrected in time.

Several complications associated with chronic renal failure may coexist in the last hospital stay on the HIS system and treatment is taken, but the cause of the stay that is not the current stay should not be taken into account. This condition is difficult to be judged and recorded by the system, so the hemodialysis responsible physician can judge whether the complication is the reason of the hospitalization according to the specific condition of the hospitalization and whether the treatment of the complication is adjusted by the hospitalization, and manually record the complication.

[ analytical advice ]

The proportions of the various hospitalizations fluctuate within a certain range and if the cause of a certain hospitalization is significantly higher or lower than the average level, the cause should be analyzed.

Annual mortality rate in hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-41

[ DEFINITIONS ]

The death number of annual hemodialysis patients accounts for the total number of annual hemodialysis patients

[ MEANS FOR solving PROBLEMS ]

Reflecting the death status of hemodialysis patients in hemodialysis rooms (centers) and areas, is an important index for dialysis quality control.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The annual death rate of hemodialysis patients is equal to the death number of hemodialysis patients/the total number of hemodialysis patients in the same period multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): total number of hemodialysis patients who died annually.

Denominator: total number of hemodialysis patients in the hemodialysis room (center) at the same time.

In or on areas

Molecule (a): total number of dead hemodialysis patients in all hemodialysis rooms (centers) in the area.

Denominator: the total number of hemodialysis sessions in the same area or region.

[ molecular description ]

The mortality rate of hemodialysis patients was counted per natural year.

The mortality rate of the patients with maintenance hemodialysis is high in the first 3 years, especially in the 1 st year, and the period for counting the mortality rate of the patients with hemodialysis in the first 3 years should be counted to a month.

The dead patients need to be counted by the registered dialysis patients and the unit maintenance hemodialysis patients respectively.

After a maintenance hemodialysis patient terminates dialysis in a hemodialysis room (center), the staff should continue to track the patient's outcome and heading within 3 months to avoid losing data.

Patients who die annually in the area no longer distinguish between enrolled patients and maintenance hemodialysis patients.

[ Inclusion in groups ]

The number of deaths in all the unit maintenance hemodialysis patients, whether in hospital or out of hospital, needs to be totally counted.

In addition to patients who died in the hospital, maintenance hemodialysis patients who died within 3 months from the hemodialysis room (center) were included in the dead demographics of the dialysis room (center).

If the patients with maintenance hemodialysis stop being treated in a certain dialysis room (center) for more than 3 months, the patients who die in hemodialysis in other institutions for less than 3 months do not include the statistics of the annual mortality rate of the patients with maintenance hemodialysis in any hemodialysis room (center).

[ exclude population ]

Not including patients with acute renal failure and other non-chronic renal failure requiring extracorporeal blood purification and ultimately death.

If the maintenance hemodialysis patient terminates the dialysis treatment in a certain dialysis room (center) for 3 months. Patients who died at other institutions in < 3 months of hemodialysis, were not included in the annual mortality statistics of any one hemodialysis room (central) maintenance hemodialysis patient.

[ Specification of the denominator ]

The death rate of 3 years before the maintenance hemodialysis can be counted according to months.

Annual mortality statistics were performed on the number of enrolled and maintenance hemodialysis patients.

[ Inclusion in groups ]

Hemodialysis patients enrolled for dialysis were all included in the statistics.

The hemodialysis patient leaves the dialysis institution to perform maintenance dialysis to other medical institutions, and if the period is less than 3 months, the statistics of the annual death rate of the original dialysis institution are still included. If the information can be interconnected and communicated, statistics is brought according to identity recognition, otherwise, the original dialysis unit is required to perform necessary follow-up tracking within 3 months and manually report in time.

[ exclude population ]

If a maintenance hemodialysis patient within the annual area dies during less than 3 months of dialysis in the hemodialysis room (center), then the hospitalization does not include statistics of the mortality of the maintenance hemodialysis patient for the dialysis institution.

If the maintenance dialysis patient does not belong to any dialysis facility in all regions, now being treated by dialysis at a dialysis facility and dying, the patient is not enrolled in annual mortality statistics for the facility during the less than 3 months of treatment, nor in annual mortality statistics for hemodialysis patients in the region.

Patients who have just entered maintenance hemodialysis are not enrolled in deaths of less than 3 months of dialysis because the individual ICU is now beginning extracorporeal blood purification treatment of critically ill patients and their data are currently poorly enrolled.

[ data elements ]

Hemodialysis patient death time maintenance hemodialysis patient registration hemodialysis patient

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The in-hospital death information for hemodialysis patients can be read on the HIS of the medical facility.

Hemodialysis patients are not hospitalized in the dialysis institution and die outside the hospital, and then the hemodialysis room (center) is responsible for manual reporting of doctors after follow-up visits. If the error occurs, the correction is carried out in time.

Hemodialysis patients leave the dialysis machine to simulate maintenance dialysis in other medical institutions, and if the duration of death is less than 3 months, the statistics of the original dialysis institution are included. If the information can be interconnected and communicated, statistics is brought according to identity recognition, otherwise, the original dialysis room (center) personnel are required to carry out necessary follow-up tracking and manually report in time.

[ analytical advice ]

Is free of

The death cause of hemodialysis patients is in proportion

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-42

[ DEFINITIONS ]

Annual hemodialysis patients account for a proportion of the number of various causes of death in the annual hemodialysis.

[ DEFINITIONS ]

Reflecting the conditions of the causes of death of hemodialysis patients in hemodialysis rooms (centers) and areas, important indicators for dialysis quality control and improvement.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The annual death cause of hemodialysis patients is 100% compared with the number of the patients with various death causes/the total number of deaths of patients with hemodialysis at the same period

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): annual hemodialysis room (center) number of patients with various causes of death.

Denominator: total number of patients who had blood flow through the hemodialysis room (center) at the same time.

In or on areas

Molecule (a): the total number of all hemodialysis compartments (central) in the area, hemodialysis patients for various causes of death.

Denominator: total mortality for all hemodialysis in the same area or zone.

[ molecular description ]

The cause of death for hemodialysis patients is compared to 1, which is generally counted at least every natural year.

The causes of death in chronic renal failure hemodialysis are classified into 1, cardiovascular events 2, cerebrovascular events 3, hemorrhagic diseases such as gastrointestinal hemorrhage 4, infections 5, and others, according to the classification of the national hemodialysis patient case information registration system.

The most prominent cause of death is selected as the cause of death if the patient has 2 or more causes of death.

The death cause composition ratio of the patients is counted, and the ages, sexes, dialysis ages, primary morbidity of the patients and the like of the death patients are also counted and displayed.

[ Inclusion in groups ]

In addition to patients who died in the hospital, maintenance hemodialysis patients who died within 3 months of leaving the hemodialysis room (center) were still included in the original dialysis room (center) mortality demographics.

If the maintenance hemodialysis patients stop being treated in a certain dialysis room (center) for more than 3 months, patients who died in hemodialysis in other institutions for less than 3 months are not included in the statistics of annual mortality of any hemodialysis room (center). But included statistics of annual mortality in the area of death.

[ exclude population ]

If the maintenance hemodialysis patient ends up in a certain dialysis room (center) for 3 months. Patients who died at other institutions in < 3 months of hemodialysis were not included in any of the hemodialysis rooms (central) annual mortality statistics.

[ Specification of the denominator ]

Annual hemodialysis mortality cause proportion statistics were performed according to the number of deaths of enrolled and maintenance hemodialysis patients.

[ Inclusion in groups ]

All patients with chronic renal failure who died from dialysis. The patients were treated with hemodialysis and maintenance hemodialysis patients who were continuously dialyzed in a hemodialysis room (center) for 3 months after the treatment.

[ exclude population ]

Statistical statistics on non-inclusion of causes of death in patients who have just entered maintenance hemodialysis for less than 3 months of death because the individual ICUs have now begun extracorporeal blood purification treatment in critically ill patients and their data are currently difficult to include.

[ data elements ]

Quality control of dialysis

[ basic data set ]

Causes of death in hemodialysis patients

Maintenance hemodialysis patient

Registering hemodialysis patients

[ data Collection method ]

The in-hospital death information for a maintenance hemodialysis patient can be read on the HIS of the medical facility.

The cause of death is traceable, with in-hospital deaths being based on HIS results and out-of-hospital deaths being reported manually by a hemodialysis room (central) physician after follow-up on patient events

The reason why the hemodialysis patient quits the hemodialysis treatment

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-43

[ DEFINITIONS ]

The number of the annual hemodialysis patients who have various reasons for the hemodialysis is the ratio of the total number of the annual hemodialysis patients who have quit the hemodialysis.

[ MEANS FOR solving PROBLEMS ]

Reflecting the condition of hemodialysis patients exiting hemodialysis in hemodialysis rooms (centers) and medical institutions in areas.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The reason why hemodialysis patients withdraw hemodialysis annually is defined as the number of hemodialysis patients who withdraw hemodialysis individually/the total number of hemodialysis patients who withdraw hemodialysis in a contemporary hemodialysis patient × 100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): the number of hemodialysis patients who have withdrawn from hemodialysis at various reasons throughout the year.

Denominator: the total number of hemodialysis patients who were withdrawn from the hemodialysis room (center) at the same time.

In or on areas

Molecule (a): the total number of hemodialysis patients in all hemodialysis rooms (centers) in the area who have been removed from hemodialysis is various.

Denominator: the total number of subjects who withdraw from hemodialysis in the same period zone or zone.

[ molecular description ]

The reason why hemodialysis patients withdraw from hemodialysis annually is 1 time compared to the statistics per year.

The reason why hemodialysis patients with chronic renal failure maintenance quit hemodialysis is classified according to the classification of the case information registration system of national hemodialysis patients into 1, death 2, kidney transplantation 3, abandoning treatment 4, transferring to peritoneal dialysis patients 5, transferring to dialysis 6 and other cases

Since the transfer to other hemodialysis rooms (centers) or Shenzhen outside the market is not due to the withdrawal of dialysis, the reason for withdrawing dialysis is statistically not included in patients who are transferred to dialysis in the institution due to various reasons, but the withdrawal and the transfer are considered together when the regional hemodialysis resources are mastered, so that the transfer and withdrawal of hemodialysis patients are statistically collected together to be used for analyzing the prevalence of regional hemodialysis patients.

The place of transfer-out of hemodialysis is classified into 1 other medical institutions 2 in this city, 3 medical institutions in other cities in this province, and 3 medical institutions in foreign province according to the classification of the national hemodialysis patient case information registration system. There is a clear differentiation and classification of the outgoing patients on the local hemodialysis system.

Since patients with death and kidney transplantation are not counted out of dialysis statistics on the national hemodialysis patient case registration system, statistics that exclude death and transplantation from the statistics should also be made.

Patients who were defined to be more than 3 months away from the dialysis room (center) of the area were transferred out for regional hemodialysis statistics.

[ Inclusion in groups ]

All patients who withdrew from hemodialysis, including death and kidney transplantation, were included in the study. Since patients who died and transplanted are not counted out of dialysis statistics on the national hemodialysis patient case registration system, statistics that exclude death and transplantation from the statistics should also be made.

In the case of a patient who has exited hemodialysis for any reason during the year except death, if the patient re-enters the hemodialysis treatment in the hemodialysis room (center) in the area within 3 months, the patient who has exited the dialysis in the area is no longer considered to be the patient who has exited the dialysis in the area. The number of people who take in and out of hemodialysis in a hemodialysis room (center)

[ exclude population ]

If the patient goes through the year, the patient who enters the hemodialysis room (center) in the area again within 3 months after the patient leaves the dialysis is not taken as a new patient or a patient who leaves the hemodialysis treatment.

A patient who has withdrawn from hemodialysis for any reason during the year except death will no longer be a patient who has withdrawn from dialysis in the present area if they return to the hemodialysis room (center) in the present area within 3 months.

Patients who are also undergoing maintenance peritoneal dialysis simultaneously with maintenance hemodialysis are not included in the statistics of patients who are withdrawing from hemodialysis.

In the regional annual transfemoral dialysis patient-to-patient registration, transfemoral of a certain dialysis room (center) is defined as a patient who leaves the dialysis room (center) of the region for more than 3 months, and the transfemoral patient is not included if dialysis is resumed more than or equal to 3 months after dialysis is stopped in the region in the current year.

[ Specification of the denominator ]

Withdrawal from hemodialysis generally refers to a patient who has terminated hemodialysis treatment, but patients who have withdrawn from a hemodialysis compartment (center) or a hemodialysis compartment (center) within a withdrawal area are also included.

[ Inclusion in groups ]

A hemodialysis patient who is withdrawn from an annual hemodialysis room (center) refers to a patient who terminates a hemodialysis treatment.

Patients who newly started hemodialysis treatment dropped out of dialysis within 3 months, and only the statistics of the percentage of registered hemodialysis patients who dropped out of hemodialysis.

[ exclude population ]

Patients who newly started hemodialysis treatment and exited dialysis treatment within 3 months did not incorporate withdrawal maintenance hemodialysis patient statistics because each ICU has now started extracorporeal circulation blood purification treatment of critically ill patients, whose data are currently difficult to incorporate into statistics.

[ data elements ]

Hemodialysis patient stopping dialysis time

Maintenance hemodialysis patient

Registering hemodialysis patients

Reason for withdrawal of maintenance hemodialysis treatment

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The reason for hemodialysis patients to withdraw from hemodialysis is manually filled in by a hemodialysis room (central) physician, depending on the reason for patient withdrawal.

The default is to fill in the exit on the day, or the time of the exit is manually filled in by the staff.

[ analytical advice ]

None.

Long-term dialysis vascular access composition ratio for maintenance hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-44

[ DEFINITIONS ]

The hemodialysis patients are compared with the total number of hemodialysis patients in various long-term dialysis vascular accesses.

[ MEANS FOR solving PROBLEMS ]

Reflecting the proportion of hemodialysis patients' long-term vascular access in the hemodialysis compartment (center) and area, is related to the dialysis quality of the dialyzed patient.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The long-term dialysis vascular access constitution ratio of hemodialysis patients is equal to the number of hemodialysis patients with various long-term dialysis vascular accesses/the total number of hemodialysis patients in the same period multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): the number of hemodialysis patients with various long-term dialysis vascular access.

In or on areas

Molecule (a): the number of hemodialysis patients in various chronic dialysis vascular access years or in all areas of dialysis.

Denominator: total number of all hemodialysis patients in the same area or zone.

[ molecular description ]

The long-term dialysis vascular access for hemodialysis patients comprises 1, autologous arteriovenous internal fistula 2, graft internal fistula 3, central venous catheter (catheter with tunnel and terylene sleeve) 4, and other types

Given that some hemodialysis compartments (centers) employ some unconventional or irregular vascular access as a hemodialysis long-term vascular access, such as the case of directly puncturing an artery as a blood outflow tract or using a temporary hemodialysis catheter instead of a long-term vascular access, an "other" category is added to the long-term hemodialysis vascular access.

If there is an irregular long-term vascular access present, statistics can be included for the categories of other vascular access listed separately.

The temporary central venous dialysis catheter cannot be used as a long-term hemodialysis vascular access and is not included in the long-term vascular access, but the use rate of the first-time maintenance hemodialysis internal fistula is still low at present, and the temporary central venous hemodialysis catheter is widely used as a vascular access excessive in the maturation process of the internal fistula in various hemodialysis rooms (centers). In view of the current situation, the quality control index of the utilization rate of the first-time maintenance hemodialysis internal fistula is increased to evaluate the standard reaching rate of the 'first internal fistula' of the maintenance hemodialysis patient.

Some patients may have 2 hemodialysis vascular accesses existing at the same time, but only one is currently used, so the vascular access currently used is taken as a statistical access. In general, where both CVC and AVF or AVG are present, the pathway now being used is typically the CVC.

One patient may have 2 or more vascular accesses in sequence for various reasons during the statistical period, but only the vascular accesses currently in use are counted.

For a withdrawn maintenance hemodialysis patient, the long-term vascular access type used before withdrawal is taken as the vascular access type included in the statistics

For example, for a patient who needs operation recovery function due to failure of long-term vascular access of a hemodialysis patient, due to the fact that temporary vascular access transition is applied at present, statistics is conducted according to the type of the long-term vascular access planned for the completed operation before the long-term vascular access is not used at the statistical time point, and if no other long-term vascular access is available except the temporary vascular access, statistics is conducted according to the type of the last used long-term vascular access.

[ Inclusion in groups ]

All chronic renal failure hemodialysis patients were enrolled.

The statistics of the maintenance hemodialysis patients in the area are counted after the patients are checked for duplication according to the identity cards.

[ exclude population ]

Patients who were temporarily dialyzed (patients who had progressed off dialysis for 3 months for various reasons in the dialysis room (center)) did not include statistics.

[ Specification of the denominator ]

Typically by year.

Chronic renal failure patients need long-term maintenance hemodialysis, and the dialysis is counted by registered dialysis patients when the dialysis is less than 3 months.

All patients on a regional level for maintenance hemodialysis were counted, including patients who had exited for a statistical period of time but had been on regional for > 3 months of dialysis time.

The maintenance hemodialysis patients who are currently dialyzing can be counted according to the last time point.

Since the actual situation of each dialysis center is different, the blood vessel access of some dialysis centers is not maintained by the medical institution, and therefore, the blood vessel access quality control level of a certain dialysis institution cannot be represented. But can reflect the level of quality control of the vascular access at the regional or intralesional level.

[ Inclusion in groups ]

Inclusion in all chronic neurological failures requires maintenance hemodialysis patients.

A maintenance hemodialysis patient in an annual area exits the dialysis room (center) when a hemodialysis mechanism dialyzes for less than 3 months, but the patient still dialyzes in the regional dialysis room (center) enters the regional maintenance hemodialysis patient long-term vascular access statistics.

[ exclude population ]

If a maintenance hemodialysis patient is hemodialysis in the dialysis room (center) for less than 3 months during the year, the patient is not included in the institution for the statistics of the annual long-term vascular access composition ratio.

[ data elements ]

Maintenance hemodialysis patient

Registering hemodialysis patients

Long term hemodialysis vascular access types

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The vascular access type of a hemodialysis patient is manually reported to the local system by the hemodialysis director's physician at the first patient visit registration by querying medical history and physical examination.

The hemodialysis workflow should have the steps of assessing the vascular access before each hemodialysis, and if the vascular access of the patient changes, the vascular access should be changed in time. It is suggested that the local system should be able to modify the patient's vascular access in real time based on pre-dialysis assessments.

If a long-term dialysis patient with dialysis age of more than 3 months begins hemodialysis in the hemodialysis room (center), the local system automatically brings the patient into statistics after the patient has been dialyzed for 3 months, and manual reporting is not needed.

[ analytical advice ]

According to the requirements of Chinese hemodialysis blood vessel access guidelines, the proportion of autologous arteriovenous internal fistula is more than 80%, the graft internal fistula is more than 10%, and the catheter with a tunnel and a terylene sleeve is less than 10%.

Patency rate of internal arteriovenous fistula of maintenance hemodialysis patient

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-45

[ DEFINITIONS ]

The ratio of the number of days a maintenance hemodialysis patient is unobstructed as a dialysis access (internal arteriovenous fistula) being used over a period of time to the patient's day.

[ MEANS FOR solving PROBLEMS ]

Reflecting the condition of long-term vascular access (arteriovenous internal fistula) maintenance of hemodialysis patients with hemodialysis room (central) maintenance is related to the dialysis quality of the dialysis patients.

The index and the composition ratio of the long-term vascular access of hemodialysis jointly maintain the index of vascular access quality management of patients with hemodialysis.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The patency rate of arteriovenous internal fistula of a maintenance hemodialysis patient is equal to the patency days of the arteriovenous internal fistula of the maintenance hemodialysis patient/the total days of the maintenance hemodialysis patient using the arteriovenous internal fistula at the same period multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): days for a maintenance hemodialysis patient to have an internal fistula as a dialysis access cleared.

Denominator: contemporaneous hemodialysis compartment (center) total patient day for all maintenance hemodialysis with an arteriovenous internal fistula.

In the region

Molecule (a): all maintenance hemodialysis patients in the area were days with patent internal fistulas for the dialysis access.

Denominator: total patient days for all maintenance hemodialysis sessions using arteriovenous fistulas in the contemporary area.

[ molecular description ]

The arteriovenous internal fistula of a maintenance hemodialysis patient comprises 1, an autologous arteriovenous internal fistula, 2, a graft internal fistula, 3 and the like.

Since many procedures are performed on the vascular access in some medical facilities, there are many patients who are treated due to the access problem, and it cannot be said that the number of patients in the vascular access in the medical facility is large and the access maintenance level is poor, but the contrary is true.

The patency rates of different arteriovenous internal fistulas should be counted respectively.

Complications of various arteriovenous fistulas are fistula thrombosis, fistula infection, aneurysm or pseudoaneurysm, and if access complication management is appropriate, use of the patient's dialysis access is uninterrupted, maintenance of the hemodialysis compartment (central) access is considered to be successful, and the vascular access is considered to be patent.

One internal fistula interrupting use refers to applying a temporary vascular access (such as a temporary catheter, a catheter with a tunnel dacron sleeve, or other temporary vascular access) to transition until a new arteriovenous internal fistula is used to begin hemodialysis.

[ Inclusion in groups ]

All patients on maintenance hemodialysis and who started dialysis treatment using an arteriovenous fistula as a vascular access are enrolled daily.

After the internal fistula operation for the first time and after the internal fistula maturation period, the days for which the internal fistula is unobstructed are counted from the start of using the internal fistula as a dialysis access. And if the internal fistula is not mature within 3 months after the first internal fistula forming, counting days for which the internal fistula is not smooth from 3 months later.

The function of the internal arteriovenous fistula appears in less than or equal to 3 months in a newly entered hemodialysis chamber (center) of a patient who is regularly hemodialysis, and the day of the patient with complete loss of the internal arteriovenous fistula in the previous hemodialysis chamber (center) is counted until the 3 rd end of the patient after leaving. The obstructed time spans 3 months and then is counted as the time for completely losing the internal fistula of the newly-entered hemodialysis chamber (center).

The time interval until the access is available again or another access matures to allow normal use is counted as the time for the long-term access to be obstructed until the access can be reused.

[ exclude population ]

Patients who had been on-the-fly dialyzed (patients who had been on dialysis for various reasons in the dialysis center for less than 3 months) did not include statistics on vascular access in the dialysis room (center).

The arteriovenous internal fistula which is newly established and is in the mature period of a patient undergoing primary dialysis does not include molecules for counting in the period of time because the internal fistula is not used as a dialysis vascular access for carrying out maintenance hemodialysis.

Statistics for dialysis long-term vascular access are not included if a temporary catheter is present for use as a long-term access, or other non-standard long-term vascular access.

[ Specification of the denominator ]

The day of the patient in the hemodialysis room (center) is generally counted by year.

The total patient day includes all the days of maintenance hemodialysis patients within the statistical time period, as well as the days of maintenance hemodialysis patients who were withdrawn for any reason within the statistical time period.

All patients on maintenance hemodialysis were counted in the field, including patient days for several hemodialysis rooms (centers) dialysis treatments for a period of time ≧ 3 months.

[ Inclusion in groups ]

Patients treated for hemodialysis with an arteriovenous internal fistula as a vascular access were counted.

Patients were counted from the first dialysis treatment using an arteriovenous fistula as a vascular access. The time of internal fistula use discontinuation thereafter includes patient day statistics for the time of maturation of the new arteriovenous internal fistula.

Patients with regular hemodialysis were not included in the statistics for less than 3 months in the dialysis room (center), and the patient day was counted from the time of the new introduction after 3 months.

Regional maintenance hemodialysis patients exit the facility for less than 3 months of dialysis in a dialysis room (center), but remain in the local region and are included in the regional maintenance hemodialysis patient day statistics.

[ exclude population ]

The patient is counted from the beginning of dialysis treatment using the arteriovenous fistula as a vascular access for the first time, but the patient is not included in the statistics on the patient day for less than 3 months from dialysis to another patient.

Maintenance hemodialysis patients were hemodialysis in the dialysis room (center) for less than 3 months, and the patient was not included in the patient day statistics for the period of time in the facility.

Patients who enter regular hemodialysis newly, such as arteriovenous internal fistula, can not mature and use after 3 months or more after operation, can not use or use and is interrupted, and the part exceeding 3 months is not included in statistics of patient days.

[ data elements ]

Maintenance hemodialysis patient

Long term hemodialysis vascular access types

Vascular access start time

Vascular access end of use time

Patient registration time

[ basic data set ]

General classes

[ data Collection method ]

The vascular access type of a hemodialysis patient is manually reported to the local system by the hemodialysis director's physician at the time of patient visit by querying medical history and physical examination.

Because the statistics of the patency rate of the internal fistula may be biased when the patient goes to another medical institution for surgical treatment after the internal fistula is completely lost, the local hemodialysis management software can maintain the names of all medical institutions in the area and the loss time of the internal fistula. The names of all hemodialysis chambers (centers) are noted on the quality control platform to ensure accuracy.

The hemodialysis quality control management system is used for counting the internal fistula patency rate of each hemodialysis room (center) after the patient identity card is checked and repeated.

[ analytical advice ]

If the patency rate of the arteriovenous internal fistula of a maintenance hemodialysis patient is obviously higher than that of the patient needing to be analyzed averagely, because some hemodialysis rooms (centers) do not carry out internal fistula operation, a medical institution with postoperative conditions can be reached after an internal fistula occlusion event occurs, and the internal fistula of the part of patients needs the hemodialysis rooms (centers) to fill in the internal fistula in detail to return. Avoid the occurrence of the increase of the patency rate of the false internal fistula due to the fact that the internal fistula is not filled.

Incidence of catheter-related infection in hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-46

[ DEFINITIONS ]

The frequency of catheter-related infections in hemodialysis patients undergoing hemodialysis treatment with hemodialysis catheters as vascular access.

[ MEANS FOR solving PROBLEMS ]

Reflecting the prevention and control capabilities of hemodialysis patient catheter-related infections in hemodialysis rooms (centers) and regional medical facilities.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Hemodialysis patient's catheter-related infection incidence rate-total hemodialysis patient's hemodialysis catheter-related infection cases/total hemodialysis patient's hemodialysis catheter-using days in the same period × 1000 ‰

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): all patients who used catheters for vascular access dialysis developed catheter-related infections annually.

Denominator: contemporaneous hemodialysis room (center) total days of dialysis catheter use by all hemodialysis patients.

In the region

Molecule (a): all patients who apply catheters as vascular access dialysis annually in the region develop catheter-related infections.

Denominator: total days of dialysis catheter use by all hemodialysis patients in the same session.

[ molecular description ]

The catheter is particularly a hemodialysis catheter, and comprises a temporary hemodialysis catheter and a hemodialysis catheter with a tunnel and a terylene sleeve.

Judging catheter related infection according to related standards of intravascular catheter related infection treatment guidelines, namely, local infection, namely, hard nodule, erythema, fever, tenderness or secretion of the local skin of the intubated catheter; (xii) phlebitis, which is caused by painful diffuse erythema at subcutaneous running part of the catheter except physicochemical factors; thirdly, the catheter is used for bacterial planting, wherein the intubation part has no infection symptom, and the quantitative or semi-quantitative bacteria culture of the catheter at the far end is positive; catheter-related blood circulation infection, namely separating the same pathogen from the quantitative or semi-quantitative bacteria culture of the catheter and other blood bacteria culture of venous extraction, simultaneously accompanying the clinical manifestation of blood infection and defining the infection source except the catheter.

The catheter-related bloodstream infection is recommended to be tested by blood culture. Catheter-related bloodstream infections should be counted individually.

The number of infections was counted as the duration of the infection. Most catheters need to be pulled out after catheter-related infection hair dyeing, and some catheters continue to use the original catheters after infection is improved after the antibiotics are applied quickly. The duration of infection was not further counted.

The duration of the catheter-related infection is difficult to determine on the information system, whether it is a second infection or whether the infection recurs at the discretion of the physician.

Diagnosis of hemodialysis catheter-related bloodstream infections should be the result of a blood bacterial culture, but a preliminary diagnosis can be made based on clinical findings. The results of the presence or absence of blood bacteria culture should be differentiated statistics. For example, the proportion of blood bacteria cultured in all catheter-related infected patients is counted.

One-time catheter-related infection refers to improvement or death with severe complications or persistence after one-time infection treatment until the catheter is replaced or retained. Entered 1 time on the local system by a hemodialysis room (central) nurse or physician. This is to be separated from the infection entered when the patient is in an infected state, and evaluated by a nurse before and after dialysis. For example, patients with dialysis catheter port infections were evaluated for catheter-related infections at some week of pre-dialysis evaluation, but each evaluation of infection did not represent another 1 infection.

[ Inclusion in groups ]

All hemodialysis rooms (centers) use catheter dialysis to develop patients with catheter-related infections.

And (5) checking the identity card and time in sequence and then counting.

[ exclude population ]

Is free of

[ Specification of the denominator ]

All registered hemodialysis patients in the dialysis center who used hemodialysis catheters as vascular access were enrolled into the statistics, both temporary dialysis catheters and long-term dialysis catheters were included.

[ Inclusion in groups ]

All patients who applied the catheter for hemodialysis treatment were counted for a period of time.

Regardless of whether or not a hemodialysis catheter is used as a vascular access at the time of hemodialysis at present, 1 catheter day is counted as long as the catheter is not removed.

[ exclude population ]

Is free of

[ data elements ]

Maintenance hemodialysis patient

Registering hemodialysis patients

Long term hemodialysis vascular access types

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Infection of hemodialysis catheters is judged by a hemodialysis room (central) physician based on the patient's actual condition. The related infection of the catheter is judged according to the related standard of the related infection treatment guide of the catheter in blood vessels, namely, the local infection, the phlebitis, the bacterial colonization of the catheter and the related blood circulation infection of the catheter. The evaluation is recorded at the mobile terminal or the PC terminal before hemodialysis, and statistics are respectively recorded.

If the time of 2 infections is relatively close, it is sometimes difficult to distinguish whether the infection is recurrent or reinfection. The frequency of catheter-related infection is counted correctly, the outcome of the catheter-related infection of a patient must be counted, and the current situation is recorded from the first recording to each pre-transparent evaluation after the catheter-related infection until the infection is counted as 1 time for recovery, improvement, catheter withdrawal or death.

[ analytical advice ]

If the incidence of catheter-related infections in hemodialysis patients is significantly above or below the average level, the cause needs to be analyzed and looked for. Catheter-related infection is a continuous process, a catheter infection is defined with an accurate time node, and a hospital infection system may not be able to obtain complete information of a catheter infection of a patient since a maintenance hemodialysis patient is not an inpatient

Number of patients with negative positive conversion of blood-borne infectious disease of hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-47

[ DEFINITIONS ]

The number of patients who turned positive from negative to positive for hepatitis B, hepatitis C, syphilis and AIDS antibodies in hemodialysis patients maintained in a hemodialysis room (center).

A new entry of maintenance hemodialysis patient at the time of the third month review may have been infected prior to introduction if a negative positive is positive. But is also defined as turning positive.

[ MEANS FOR solving PROBLEMS ]

Reflecting the prevention and control of blood borne infectious diseases of medical institutions in hemodialysis rooms (centers) and areas, and is an important nosocomial infection prevention and control index and an early warning index.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The number of patients who have a negative conversion of the blood-borne infectious disease of the hemodialysis patient is the sum of the number of patients who have a negative conversion of the blood-borne infectious disease marker.

[ rules of calculation ]

Total number of all maintenance hemodialysis patients who turned negative to positive for blood borne infectious disease markers for some time in a hemodialysis room (center).

[ DEFINITION ]

The blood borne infectious diseases in the hemodialysis room (center) are defined as hepatitis B, hepatitis C, syphilis and AIDS.

Hemodialysis room (center) the patient who found the 1 st positive turn should be screened for other patients in the same hemodialysis treatment area.

The number of 4 different species of blood-borne infections turning positive also needs to be counted separately.

1 patient with maintenance hemodialysis newly enters a certain hemodialysis room (center) to be screened for the first time and 3 months and is confirmed to be a patient with negative to positive hematogenous infectious disease, and the previous hemodialysis room (center) is reminded to carry out patient screening.

[ Inclusion in groups ]

All dialysis centers maintain hemodialysis patients.

[ exclude population ]

Is free of

[ data elements ]

Maintenance hemodialysis patient

Blood-borne infection disease of hemodialysis

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The newly entered patient was reviewed 1 time per month at month 3 and 1 time every 6 months thereafter, according to the hemodialysis infectious disease test protocol. The hemodialysis room physician further confirms that the virus marker of the patient turns positive according to the result of the review and other confirmed test methods.

After finding patients with negative to positive virologic index in case 1, the patients to be screened should be preliminarily determined, and the screening work for the infectious markers of the patients should be completed as soon as possible.

When a patient with a positive virology index of the 1 st case is found, the virus should be used as an early warning index to be synchronously uploaded to a quality control management system. Patients who presented 3 or more virological indicators in the same time period turning positive were reported immediately to the hospital and local authorities by physicians and managers.

[ analytical advice ]

The important intra-tube infection management data is not a quality control index. When an event is found, early warning is needed on a quality control management system, and a new patient who possibly has an infection event can be informed of the original hemodialysis room (center) where the hospital infection event possibly exists.

Disinfection qualification rate of hemodialysis treatment room

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-48(NEP-D-01)

[ DEFINITIONS ]

The number of months qualified for disinfection in the treatment room of the hemodialysis center is a proportion of the year.

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The disinfection qualification rate of the hemodialysis treatment room is equal to the disinfection qualification month of the hemodialysis treatment room/12 multiplied by 100 percent

[ rules of calculation ]

Molecule (a): the annual hemodialysis room (central) treatment room was disinfected for a qualified month.

Denominator: total number of months to be checked in the same year.

[ molecular description ]

The qualified standard of the hemodialysis treatment room for disinfection is as follows: the average colony number of the air is less than or equal to 4.0(5 minutes) CFU/dish and the average colony number of the surface of the article is less than or equal to 10.0CFU/cm 2.

The number of air colonies and the average number of colonies on the surface of the article reach the standard, and the disinfection of the treatment room in the month is judged to be qualified.

If no data exist in the month or data are not uploaded due to other reasons, the data in the month are considered to be missed and are defined as unqualified.

[ Inclusion in groups ]

The month that the air and article surfaces of the hemodialysis treatment room are qualified in the current year,

[ exclude population ]

Air sterilization and surface sterilization of articles have one test failure, and even if other test items are qualified, the test failure is considered as a failed month.

[ Specification of the denominator ]

The statistics of the patient receiving and treating in the current month are started from the hemodialysis room (center), if the current year is less than 12 months, the statistics are carried out according to the actual natural month, for example, the patient receiving and treating in 6 months, the number of the actual inspected months in the current year is 7, because the patient receiving and treating can be started after the first inspection is qualified.

The patient was treated in a natural year with a dialysis room (center) denominator of 12 every month.

[ Inclusion in groups ]

The statistics are started in the current month when the patient is collected from the hemodialysis room (center), and if the current year is less than 12 months, the statistics are performed according to the actual natural month, for example, the patient is collected in 6 months and 1 day, so that the number of the actual months to be tested in the current year is 7.

[ exclude population ]

Is free of

[ data elements ]

Hemodialysis room (central) layout

Average number of colonies in air

Average number of colonies on surface of article

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

And synchronizing the LIS according to a time window every month or manually filling and uploading a report, and closing the window if filling is not completed in a specified time window, wherein the window is defined as unqualified.

The time window for uploading or filling in of the bacterial culture may be extended to the first 5 days of the second month. Since no bacterial growth can be reported for 5 days of bacterial culture, the time window for reporting can be extended up to day 5 of the following month, as the test is the last day of the previous month.

The exact information can be said to be that the report cannot be filled out (such as relocation, decoration, etc.) due to uncontrollable reasons, and an open report window can be applied to the quality control center.

[ analytical advice ]

The completion rate should reach 100%, if not completed, it should be used as early warning index to early warn on the quality control system.

Hypertension control rate in hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-49

[ DEFINITIONS ]

Hemodialysis patients the proportion of patients under 60 years of age with a blood pressure < 140/90mmHg before dialysis and patients over 60 years of age with a blood pressure < 150/90mmHg to the number of patients on total maintenance hemodialysis at the same time.

The blood pressure monitoring value of the hemodialysis patient at the 1 st dialysis treatment time is smaller than a certain blood pressure value, and accounts for the proportion of the blood pressure monitoring values of all dialysis patients at the same time point in the same period.

[ MEANS ] reflect the quality of hypertension treatment in hemodialysis centers.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The control rate of hypertension in hemodialysis patients is equal to the total amount of patients with blood pressure < 140/90mmHg before dialysis and patients with blood pressure < 150/90mmHg above 60 years old/the number of patients with synchronized maintenance hemodialysis × 100%

The control rate of hypertension of hemodialysis patients is equal to the total times of blood pressure monitoring values of all maintenance hemodialysis patients in the same period of time, wherein the blood pressure monitoring value of the hemodialysis patients in the certain age group in the dialysis treatment period is less than the blood pressure value, and the total times are 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): the blood pressure monitoring value of a hemodialysis patient in a certain age group at a certain time point of dialysis treatment is smaller than a certain blood pressure value.

Denominator: contemporary hemodialysis room (center) total number of hemodialysis treatments for all maintenance hemodialysis patients.

In the region

Molecule (a): hemodialysis patients in a hemodialysis room (center) in a region are treated by dialysis, and the blood pressure monitoring value at a certain time point is smaller than a certain blood pressure value.

Denominator: hemodialysis compartment (center) in the contemporary area is the total number of hemodialysis treatments for all maintenance hemodialysis patients.

[ molecular description ]

Because there is no uniform standard for the definition of dialysis hypertension of hemodialysis patients, the settings of blood pressure and age group are open and can be customized.

The total number of times of patients under 60 years of age with blood pressure < 140/90mmHg before dialysis and patients over 60 years of age with blood pressure < 150/90mmHg are displayed by default according to the requirements of national index.

The upper and lower limits of systolic pressure and diastolic pressure can be set on the local hemodialysis management system and can be customized.

The blood pressure before dialysis suggests selecting the 1 st monitored blood pressure value of the dialysis treatment, and the blood pressure after dialysis selects the last 1 monitored blood pressure value of the end of the dialysis treatment. Selecting other blood pressure values may result in the absence of a measurement. Such as blood pressure selected for a visit or a self-test leaving a hemodialysis room, poor compliance of a normotensive patient may result in the loss of blood pressure measurements, resulting in a severe bias in control rate.

The age is calculated according to the age value being less than a certain age value and being greater than or equal to a certain age value.

[ Inclusion in groups ]

Blood pressure values measured before and after dialysis for all maintenance or registered hemodialysis patients.

The blood pressure values of patients who had been dialyzed continuously for 3 months in the region or region range were all included in the statistics.

[ exclude population ]

Blood pressure data of the first 3 months of patients leaving a hemodialysis room (center) and returning to the unit again for 3 months should be counted starting in the third month of re-entering the dialysis center without being taken into the statistical office. ,

[ Specification of the denominator ]

The number of blood pressure monitoring of a hemodialysis patient is the number of dialysis treatments, and since the blood pressure control rate of a maintenance hemodialysis patient is counted, only patients who continuously dialyzed for 3 months in the hemodialysis room (center) are counted.

Patients with less than 3 months of new hemodialysis can customize the statistics.

[ Inclusion in groups ]

All maintenance hemodialysis patients were dialyzed against hemodialysis treatment with blood pressure monitoring and the statistics were all included.

[ exclude population ]

Newly entered hemodialysis patients do not receive statistics of the hypertension control rate for less than 3 months of continuous dialysis.

[ data elements ]

Hemodialysis patient age of hemodialysis patient for maintenance hemodialysis patient registration

Time of registration of hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

[ analytical advice ]

To reduce the influence of dialysis treatment itself on blood pressure, the blood pressure value before dialysis is temporarily used for statistics, which may bias the result, but at present, there is no optimal blood pressure measurement method for hemodialysis patients.

Renal anemia control rate

[ quality control index set ] hemodialysis quality control index set

[ quality control index number ] IIHAD-50

[ DEFINITIONS ]

The proportion of maintenance hemodialysis patients with hemoglobin more than or equal to 110g/L to the number of total maintenance hemodialysis patients in the same period.

The proportion of the cases in which hemoglobin actually recorded by the maintenance hemodialysis patient is greater than or equal to a certain value to the total number of anemia tests of the maintenance hemodialysis patient actually recorded at the same time

[ MEANS FOR solving PROBLEMS ]

Reflecting the quality of anemia treatment in hemodialysis centers.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The control rate of renal anemia of hemodialysis patients is equal to or more than 110g/L of the number of patients in maintenance hemodialysis/the number of patients in synchronous maintenance hemodialysis multiplied by 100 percent

The control rate of renal anemia in hemodialysis patients is 100% of the number of hemoglobin tests performed on maintenance hemodialysis patients who actually recorded hemoglobin at a certain value or more

The first formula is the control rate at a certain point in time and the second formula is the control rate accumulated over a period of time.

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): the case where hemoglobin actually recorded in a hemodialysis chamber (central) maintenance hemodialysis patient is equal to or greater than a certain value.

Denominator: and (4) actually recording the hemoglobin test times of the patients with the concurrent maintenance hemodialysis according to the progress of the patients.

In the region

Molecule (a): the case where hemoglobin actually recorded in a hemodialysis patient is equal to or greater than a certain value in a hemodialysis chamber (central) maintenance in the area.

[ molecular description ]

Statistics of the anemia control rate of hemodialysis patients are calculated as the value of the hemoglobin concentration in the blood routine in g/L. The hemoglobin standard value of a hemodialysis patient is greater than or equal to 110g/L by default.

The hemoglobin concentration including statistics can be customized range statistics.

Maintenance hemodialysis patients are required to assess the status of renal anemia every 3 months.

[ Inclusion in groups ]

The last hemoglobin concentration of all patients on maintenance hemodialysis was included in the statistics within each patient schedule. The specific conditions and ranges of inclusion are selected by user.

The patient is returned to the original dialysis unit for dialysis in the maintenance hemodialysis after leaving the hemodialysis room (center) for less than 3 months, and the anemia control rate is continuously calculated.

If the test result is not included in any dialysis room (center) in the region, statistics are carried out in the whole region.

[ exclude population ]

Patients leaving a hemodialysis room (center) for 3 months are again returned to the unit as calculated for the newly entered patient. The test results of the leave phase were not included in the statistics.

If the dialysis is less than 3 months in any hemodialysis room (center) within the regional scope, the statistics are not carried out in any dialysis room (center).

[ Specification of the denominator ]

The patient is determined to be 93 days in 3 months, the time span of 2 times of test results should be recorded is less than 93 days, and 1 time is considered to be incomplete. And the next test schedule is calculated for the start on day 94 of the previous schedule.

Since maintenance hemodialysis patients assess anemia every 3 months, the schedule needs to be readjusted if there are multiple tests repeated within the prescribed schedule, with the last test in the schedule being recorded as a single result. If the progress is across years, the time limit of the first recorded test result of the year and the starting time of the progress of the last year are continuously calculated.

Newly entered patients with maintenance hemodialysis are subjected to statistics after 3 months of continuous dialysis, and the starting period of statistics is calculated according to the introduction time point.

And if the real-time anemia control rate of the hemodialysis room (center) is counted, calculating the control rate according to the last test result in the anemia test progress. The fact that the anemia test is completed several times within 1 patient schedule may be caused by the fact that the doctor is adjusting the medicine for treating the anemia, so that the last test value of the patient schedule is set as a statistical value to indicate that the control condition of the patient is objective.

A maintenance hemodialysis patient leaves the hemodialysis room (center) on-schedule, but has completed an on-schedule test, and the on-schedule test results are recorded according to the rules.

In the region, if 1 patient is treated in several dialysis institutions, the test result is recorded once according to the rule after the duplication checking of the identity card.

[ Inclusion in groups ]

All maintenance hemodialysis patients were included in the statistics. Patients who are less than 3 months should not be included with the statistics, and if patients within 3 months should be included with the statistics, the start time of the statistics is calculated according to the lead-in time of the new patient. Patients with non-maintenance hemodialysis can also be counted.

If the dialysis time of the patient in the area is more than or equal to 3 months, the statistics of the regional dialysis patient are included after check weighing.

[ exclude population ]

Newly entered hemodialysis patients in a dialysis room (center) are continuously dialyzed for less than 3 months and are not included in the statistics of the control rate of the center.

More than 1 replicate test within one patient schedule is no longer included repeatedly, only 1.

The control rate of the now-maintaining hemodialysis patients is counted and the patients who have been withdrawn are no longer included in the statistics.

[ data elements ]

Maintenance hemodialysis patient

Registered hemodialysis patients

Haemoglobin concentration in dialysis patients

Time of registration of hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The test record may be obtained at Lis.

[ analytical advice ]

None.

Blood calcium control rate for hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-51

[ DEFINITIONS ]

The proportion of maintenance hemodialysis patients with blood calcium levels of 2.10-2.50mmol/L to the total number of maintenance hemodialysis patients in the same period.

The proportion of the cases with blood calcium level of 2.10-2.50mmol/L in the maintenance hemodialysis patients accounts for the total times of blood calcium level tests of the maintenance hemodialysis patients actually recorded in the same period

[ MEANS FOR solving PROBLEMS ]

Reflecting the quality of treatment of calcium and phosphorus metabolism disorder of the hemodialysis center.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The blood calcium control rate of hemodialysis patients is equal to the number of patients with maintenance hemodialysis with blood calcium level of 2.10-2.50 mmol/L/number of patients with concurrent maintenance hemodialysis × 100%

The blood calcium control rate of hemodialysis patients is equal to the test times of blood calcium level of example/contemporary maintenance hemodialysis patients with blood calcium level of 2.10-2.50mmol/L, which are actually recorded according to the patient schedule, multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis Chamber (Central) maintenance hemodialysis patients had blood calcium levels of 2.10-2.50 mmol/L.

Denominator: and (4) testing the blood calcium level of the patient according to the actual record of the patient schedule of the patient during the period of the maintenance hemodialysis patient.

In the region

Molecule (a): regional hemodialysis chamber (central) maintenance hemodialysis patients have blood calcium levels of 2.10-2.50 mmol/L.

Denominator: and (4) recording the blood calcium test times of the patient according to the patient schedule of the patient in the period maintenance hemodialysis patient.

[ molecular description ]

Statistics of the blood calcium control rate of hemodialysis patients are calculated as the value of blood calcium in a blood electrolyte test in mmol/L.

Blood calcium levels that are included in the statistics can be custom-ranged statistics.

Maintenance hemodialysis patients require 1 evaluation of blood calcium levels every 3 months.

The actual schedule of the maintenance hemodialysis patient is more than or equal to 1 test result except for newly-entered patients, and after 3 months, each quarter should have 2 or more test results.

And counting the control rate of the patient undergoing maintenance hemodialysis, counting the results within the range of the progress inquiry from the day of counting of the patient undergoing dialysis in a certain institution.

[ Inclusion in groups ]

All patients on maintenance hemodialysis were counted for the last blood calcium level within each patient's schedule. The specific conditions and ranges of inclusion are selected by user.

The patient is returned to the original dialysis unit for dialysis in the maintenance hemodialysis in less than 3 months after leaving the hemodialysis room (center), and the blood calcium level control rate is still continuously calculated.

The results of the test were not included in any dialysis room (center) within the area, and statistics were performed throughout the area.

[ exclude population ]

[ Specification of the denominator ]

The patient was rated 93 days for 3 months, and 2 tests should be recorded with a time span of < 93 days, and more than 1 test is considered incomplete. And the next test schedule is calculated for the start on day 94 of the previous schedule.

If 1 patient is treated in several dialysis institutions in the area, the test result is recorded once according to the rule after the duplication checking of the identity card.

[ Inclusion in groups ]

All maintenance hemodialysis patients were included in the statistics. Patients who are less than 3 months should not be included with the statistics, and if patients within 3 months should be included with the statistics, the start time of the statistics is calculated according to the lead-in time of the new patient.

[ exclude population ]

More than one replicate test within a patient schedule is no longer included as a repeat of statistics, only counted once.

[ data elements ]

Maintenance hemodialysis patient

Registered hemodialysis patients

Blood calcium levels in dialysis patients

Time of registration of hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Data from medical institution LIS

[ analytical advice ]

None.

Blood phosphorus control rate for hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index number ] IIHAD-52

[ DEFINITIONS ]

The proportion of maintenance hemodialysis patients with blood phosphorus levels of 1.13-1.78mmol/L to the total number of maintenance hemodialysis patients in the same period.

The proportion of the cases with blood phosphorus level of 1.13-1.78mmol/L in the maintenance hemodialysis patients accounts for the total times of blood phosphorus level tests of the maintenance hemodialysis patients actually recorded in the same period

[ MEANS FOR solving PROBLEMS ]

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Hemodialysis patients' blood phosphorus control rate-blood phosphorus level is 1.13-1.78mmol/L maintenance hemodialysis patients number/same period maintenance hemodialysis patients number x 100%

Blood phosphorus control rate of hemodialysis patients, namely the blood phosphorus level test times of example/contemporary maintenance hemodialysis patients with blood phosphorus level of 1.13-1.78mmol/L according to actual record of patient schedule, multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis Chamber (Central) maintenance hemodialysis patients have blood phosphorus levels of 1.13-1.78 mmol/L.

Denominator: and (4) checking the blood phosphorus level of the patient according to the actual record of the patient schedule of the patient during the period of the maintenance hemodialysis patient.

In the region

Molecule (a): regional hemodialysis chamber (central) maintenance hemodialysis patients have blood phosphorus levels of 1.13-1.78 mmol/L.

Denominator: and (4) actually recording the blood phosphorus test times of the patient according to the patient schedule for the patient with the concurrent maintenance hemodialysis.

[ molecular description ]

Statistics of blood phosphorus control rates for hemodialysis patients are calculated as the value of blood phosphorus in a blood electrolyte test in mmol/L.

Blood phosphorus levels that were included in the statistics can be custom-ranged statistics.

Maintenance hemodialysis patients require an assessment of blood phosphorus levels every 3 months.

And counting the control rate of the patient undergoing maintenance hemodialysis, and counting the results of the patient undergoing dialysis in a certain institution within the range of the progress inquiry counted by the day of counting.

[ Inclusion in groups ]

All patients on maintenance hemodialysis were counted for the last blood phosphorus level within each patient's schedule. The specific conditions and ranges of inclusion are selected by user.

The patient is returned to the original dialysis unit for dialysis in the maintenance hemodialysis in less than 3 months after leaving the hemodialysis room (center), and the control rate of the blood phosphorus level is continuously calculated.

[ exclude population ]

[ Specification of the denominator ]

If 1 patient is treated in several dialysis institutions in the area, the test result is recorded once according to the rule after the duplication checking of the identity card. [ Inclusion in groups ]

[ exclude population ]

[ data elements ]

Maintenance hemodialysis patient

Registered hemodialysis patients

Blood phosphorus levels in dialysis patients

Time of registration of hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

The data come from the medical institution Lis.

[ analytical advice ]

None.

Control rate of blood iPTH of hemodialysis patient

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-53

[ DEFINITIONS ]

The proportion of patients on maintenance hemodialysis with IPTH levels 2-9 times the upper limit of normal is the number of patients on total maintenance hemodialysis at the same time.

The proportion of the cases that the iPTH level of the maintenance hemodialysis patient is 2-9 times of the upper limit of the normal value accounts for the total number of blood iPTH level tests of the maintenance hemodialysis patient, which are actually recorded in the same period.

[ MEANS FOR solving PROBLEMS ]

Reflecting the quality of treatment of secondary hyperparathyroidism in hemodialysis centers.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The IPTH control rate of hemodialysis patients is 2-9 times of the number of patients with maintenance hemodialysis with iPTH level at the upper limit of the normal value/the number of patients with synchronous maintenance hemodialysis is multiplied by 100 percent

The control rate of blood IPTH of hemodialysis patients is 2-9 times of the upper limit of normal value of blood IPTH level of maintenance hemodialysis patients/the test frequency of actually recorded blood IPTH level of the maintenance hemodialysis patients at the same period is multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis chamber (central) maintenance hemodialysis patients had 2-9 times higher upper limit of normal blood IPTH levels.

Denominator: the patient with the concurrent maintenance hemodialysis tests according to the actually recorded IPTH level of the blood of the patient.

In the region

Molecule (a): regional hemodialysis chamber (central) maintenance hemodialysis patients have 2-9 times higher normal blood IPTH levels.

Denominator: and (4) carrying out IPTH test on patients with synchronous maintenance hemodialysis according to the actual recorded patient blood IPTH test times.

[ molecular description ]

The blood iPTH value of a hemodialysis patient is in pg/ml or other units.

The blood iPTH level including the statistics was calculated from 2 to 9 times (2 to 9 times) of the local monitoring method.

[ Inclusion in groups ]

All patients on maintenance hemodialysis were included in the statistics for the last blood iPTH level within each 1 statistical schedule. The specific conditions and ranges of inclusion are selected by user.

The patient is returned to the original dialysis unit dialysis maintenance hemodialysis patient in less than 3 months after leaving the hemodialysis room (center), and the control rate of the blood iPTH level is continuously calculated.

[ exclude population ]

Patients leaving a hemodialysis room (center) for 3 months or more and returning to the unit again are counted as new patients. The test results of the leave phase were not included in the statistics.

[ Specification of the denominator ]

The system schedule was done for 1 month in 31 days, with 6 months as the check deadline. The statistics are according to the month, so that the statistics actually count as incomplete only if the statistics are not reported after the natural month exceeds about 1 week of inspection. However, each patient should be tested no less than 2 times per year, and due to the difference between the 31-day per month schedule and the natural month, if only 1 test is required for this year, the 2 nd test is completed by default 12 and 31 days before this year. Progress on the local system should be prompted.

Since maintenance hemodialysis patients evaluate the blood iPTH condition every 6 months, the schedule needs to be readjusted if there are multiple tests to be repeated within the prescribed schedule. The last recording result is the beginning, and the last inspection in the progress is used as the inspection result of the next recording.

The number of blood iPTH level tests actually recorded by hemodialysis room (center) maintenance hemodialysis patients within the year is equal to the number of patients continuously dialyzed in a dialysis room (center) for 12 months multiplied by 2+ the number of patients newly introduced into the maintenance hemodialysis treatment within the year, wherein the maintenance hemodialysis treatment is more than or equal to 6 months < 12 months multiplied by 2-the patient newly introduced into the maintenance hemodialysis treatment within the year, wherein the number of the patients is more than or equal to 6 months < 12 months, only 1 test result is recorded, and the patient is more than or equal to 6 months and less than 6 months and 1 test result is recorded.

Newly entered patients include patients who are newly entered in the present year or who have been under 6 months from the last half year of the previous year after the introduction of dialysis treatment. Newly entered patients with maintenance hemodialysis are subjected to statistics after 3 months of continuous dialysis, and the starting time of the statistics is calculated according to the introduction time point.

In the next half year of the previous year or the next half year of the current year, if the test result is recorded for 1 time in the progress, the test is finished in the progress, but if the next check is carried out in the current progress of the next year, the calculation is still carried out for 1 time, and if the control rate of the timing test is counted, the actually recorded result is counted according to the result of the check. Therefore, the inspection result of the next half year judges whether the result should be recorded again in the next year, and if the result needs to be recorded, the last result of the previous year is used as the result which should be recorded in the schedule.

Counting all the patients with the maintenance hemodialysis in the time period in real time, wherein if the patients who enter the new 6 months are not considered as unfinished patients if the tests are not finished, the statistics are not temporarily included; but incorporate the statistics of the denominator if the test has been completed.

If the time between 2 tests is > 6 months, the patient leaves the hemodialysis room (center) after the in-progress incomplete test, then the patient still receives statistics and counts 1 incomplete statistical denominator.

If 1 patient is treated in several dialysis institutions in the region, the value of the blood iPTH is recorded according to the above rule after the duplication checking according to the identity card.

The test times recorded by all the maintenance hemodialysis patients in a certain period are summed to obtain the test times actually recorded by the same-period maintenance hemodialysis patient in the dialysis room (center).

[ Inclusion in groups ]

[ exclude population ]

Repeat tests more than 1 within 2 patient schedules are no longer included repeatedly, only 1.

[ data elements ]

Maintenance hemodialysis patient

Registered hemodialysis patients

iPTH level in blood of dialysis patient

Time of registration of hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Data from medical institution LIS

[ analytical advice ]

None.

Hemodialysis patient serum albumin control rate

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-54

[ DEFINITIONS ]

The proportion of maintenance hemodialysis patients with serum albumin > 35g/L to the total number of maintenance hemodialysis patients in the same period.

The ratio of the serum albumin level of the maintenance hemodialysis patient of more than 35g/L to the total number of serum albumin level tests of the maintenance hemodialysis patient actually recorded in the same period

[ MEANS FOR solving PROBLEMS ]

Reflecting the quality of nutrition treatment of the hemodialysis center.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Hemodialysis patients serum albumin control rate-maintenance hemodialysis patients number with serum albumin > 35 g/L/maintenance hemodialysis patients number in the same period x 100%

Hemodialysis patients serum albumin control rate-example/same-period maintenance hemodialysis patients with serum albumin level > 35g/L test times of serum albumin level according to actual record of patients x 100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis chamber (central) maintenance hemodialysis patients serum albumin > 35 g/L.

Denominator: the patients with concurrent maintenance hemodialysis are tested according to the serum albumin level of the patients actually recorded by the patients.

In the region

Molecule (a): regional hemodialysis chamber (central) maintenance hemodialysis patients serum albumin > 35 g/L.

[ molecular description ]

The unit of serum albumin level for the serum albumin control rate of hemodialysis patients is g/L.

Maintenance hemodialysis patients require an assessment of serum albumin status every 6 months.

And counting the control rate of the patient undergoing maintenance hemodialysis, and counting the results within the range of progress inquiry of the day included by the patient undergoing dialysis in a certain institution.

[ Inclusion in groups ]

All patients on maintenance hemodialysis were included in the statistics for the last serum albumin level within the schedule. The specific conditions and ranges of inclusion are selected by user.

Leave the hemodialysis chamber (center) for < 3 months and return to the maintenance hemodialysis patient dialyzed by the original dialysis unit, the serum albumin level control rate is still continuously calculated.

[ exclude population ]

[ Specification of the denominator ]

The system schedule was done for 1 month in 31 days, with 6 months as the check deadline. The statistics are according to the month, so that the statistics are actually counted as incomplete only if the natural month exceeds about 1 week of inspection without returning. However, each patient should be tested no less than 2 times per year, and due to the difference between the 31-day per month schedule and the natural month, if only 1 test is required for this year, the 2 nd test is completed by default 12 and 31 days before this year. Progress on the local system should be prompted.

Since maintenance hemodialysis patients assess serum albumin levels every 6 months, the schedule needs to be readjusted if there are multiple tests repeated within the prescribed schedule. The last recording result is the beginning, and the last inspection in the progress is used as the inspection result of the next recording.

The number of serum albumin level tests actually recorded by hemodialysis room (center) maintenance hemodialysis patients within the year is equal to the number of patients continuously dialyzing for 12 months in a dialysis room (center), the number of newly-entered patients with maintenance hemodialysis treatment more than or equal to 6 months < 12 months in the year is equal to 2, and the number of newly-entered patients with maintenance hemodialysis treatment more than or equal to 6 months < 12 months in the year is equal to or greater than 6 months < 12 months, only 1 test result is recorded, and the patients with maintenance hemodialysis patient 6 in the year are less than 6 months and record 1 test result.

If the time between 2 tests is > 6 months, the patient leaves the hemodialysis room (center) after the in-progress incomplete test, then the patient still incorporates the statistics and counts 1 incomplete statistic numerator and denominator.

Continuous calculation is possible if the patient is withdrawn after 1 test but resumes dialysis within 3 months. And recalculating for more than 3 months. .

If 1 patient is treated in several dialysis facilities in the area, the value of serum albumin is recorded according to the above-mentioned rule after the duplication of the identification card.

[ Inclusion in groups ]

[ exclude population ]

[ data elements ]

Maintenance hemodialysis patient

Registered hemodialysis patients

Serum albumin levels in dialysis patients

Time of registration of hemodialysis patients

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Data from medical institution LIS

[ analytical advice ]

Is free of

Kt/V and URR control rates for hemodialysis patients

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-55

[ DEFINITIONS ]

The proportion of maintenance hemodialysis patients with a single chamber Kt/V (spKt/V) of greater than 1.2 and a URR of greater than 65% of the total number of maintenance hemodialysis patients in the same period.

The ratio of the number of single-chamber Kt/V (spKt/V) of the maintenance hemodialysis patient greater than 1.2 and URR greater than 65% of the total number of serum albumin level tests of the maintenance hemodialysis patient actually recorded at the same time

[ MEANS FOR solving PROBLEMS ]

Reflecting the quality of adequacy of the dialysis treatment of the hemodialysis center.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

Kt/V and URR control rates for hemodialysis patients SPKt/V greater than 1.2 and URR greater than 65% of maintenance hemodialysis patient population/number of contemporaneous maintenance hemodialysis patients × 100%

Kt/V and URR control rates for hemodialysis patients-spKt/V and URR test times recorded by patients in actual spKt/V and URR test times X100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis Chamber (Central) maintenance hemodialysis patients with spKt/V greater than 1.2 and URR greater than 65% of cases.

Denominator: the number of spKt/V and URR tests of the patient is recorded according to the actual record of the patient in the patient during the period of the maintenance hemodialysis patient.

In the region

Molecule (a): regional hemodialysis compartment (central) maintenance hemodialysis patients have cases where spKt/V is greater than 1.2 and URR is greater than 65%.

Denominator: the number of spKt/V and URR tests of the patient actually recorded by the patient is recorded by the patient with the concurrent maintenance hemodialysis.

[ molecular description ]

Maintenance hemodialysis patients require assessment of spKt/V and URR status every 6 months.

The newly entered maintenance hemodialysis patient should have 1 test result within a real 6 month schedule starting at the time entered, the test results of ≥ 1 being counted up by the last 1 test result according to the schedule of the day of registration. The actual schedule is readjusted 1 time per 1 test because the completion rate is counted.

And recalculating the last test result inclusion statistics of the progress in the progress at the time point of the result of the inclusion statistics.

And counting the control rate of the patient undergoing maintenance hemodialysis, and counting the result of the patient undergoing dialysis at a certain institution within the inquiry range of the current progress from the day of counting.

[ Inclusion in groups ]

All patients on maintenance hemodialysis were counted for the last spKt/V and URR values within the 6 month test schedule. The specific conditions and ranges of inclusion are selected by user.

Leaving the hemodialysis room (center) for less than 3 months and returning to the maintenance hemodialysis patient dialyzed by the original dialysis unit, the spKt/V and URR level control rates are still continuously calculated.

[ exclude population ]

Leave a hemodialysis room (center) for 3 months or more and return to the unit again, calculated for newly entered patients. The test results of the leave phase were not included in the statistics.

[ Specification of the denominator ]

The system schedule was done for 1 month in 31 days, with 6 months as the check deadline. The statistics are according to the month, so that the statistics are actually counted as incomplete only if the natural month exceeds about 1 week of inspection without returning. However, the number of tests that should be performed per patient per year cannot be less than 2, and if the difference between the 31-day monthly schedule and the natural month results in only 1 test in this year, the 2 nd test is completed by default 12 and 31 days in this year. Progress on the local system should be prompted.

Since maintenance hemodialysis patients assess Kt/V and URR control rate status of hemodialysis patients every 6 months, the schedule needs to be readjusted if there are multiple tests to be repeated within the prescribed schedule. The last recording result is the beginning, and the last inspection in the progress is used as the inspection result of the next recording.

The number of Kt/V and URR control rate tests of hemodialysis patients actually recorded by hemodialysis room (center) maintenance hemodialysis patients within the year is equal to the number of patients continuously dialyzing in a dialysis room (center) for 12 months multiplied by 2+ the number of patients newly entering the annual accumulated maintenance hemodialysis treatment for more than or equal to 6 months and less than 12 months multiplied by 2-the patients newly entering the annual accumulated maintenance hemodialysis treatment for more than or equal to 6 months and less than 12 months, and only the patients recorded with 1 test result, the patients recorded with 1 test result and the hemodialysis patients recorded with 6 test results.

If 1 patient is treated in several dialysis institutions in the area, the values of Kt/V and URR control rate of serum hemodialysis patients are recorded according to the above rules after checking for duplication of identity cards.

[ Inclusion in groups ]

[ exclude population ]

Repeat tests more than 1 within 1 patient schedule are no longer included repeatedly, only counted as 1.

[ data elements ]

Quality control of dialysis

[ basic data set ]

Hemodialysis patient dialysis patient serum spKt/V and URR for maintenance hemodialysis patient registration

[ data Collection method ]

And (3) calculating blood BUN levels before and after dialysis from a local hemodialysis management system and a Lis system or acquiring results obtained by an OCM (optical coherence module) on the hemodialysis machine, synchronizing the results to the management system and then acquiring the results or acquiring the results after manual filling.

[ analytical advice ]

None.

Inter-dialysis weight gain control rate

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-56

[ DEFINITIONS ]

The proportion of hemodialysis patients with an inter-dialysis weight gain of less than 5% to the total number of hemodialysis patients in the same period.

The weight gain during dialysis was less than 5% of the dialysis sessions in all the same sessions.

[ MEANS FOR solving PROBLEMS ]

Reflecting the quality of patient volume management of the hemodialysis center.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The control rate of weight gain during dialysis is equal to the number of hemodialysis patients with weight gain less than 5% during dialysis/the number of hemodialysis patients in the same period multiplied by 100%

Control of inter-dialysis weight gain-inter-dialysis weight gain less than 5% dialysis cases/cases of all hemodialysis in the same phase x 100%

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis compartment (central) maintenance hemodialysis patients had an inter-dialysis weight gain of less than 5% dialysis sessions.

Denominator: dialysis cases of contemporary hemodialysis patients.

In the region

Molecule (a): hemodialysis room (central) hemodialysis patients in the area had less than 5% dialysis sessions for inter-dialysis weight gain.

Denominator: dialysis cases of contemporary hemodialysis patients.

[ molecular description ]

Hemodialysis patients can follow a period of time or make statistics of the rate of weight gain control of the patient undergoing dialysis.

(pre-dialysis weight-weight after last dialysis)/pre-dialysis weight value less than 0.05.

The pre-and post-dialysis weights should be subtracted from the patient's appendages such as thicker clothing, shoes, wheelchairs, etc.

[ Inclusion in groups ]

All hemodialysis patients were included in the statistics after completion of one treatment.

[ exclude population ]

Is free of

[ Specification of the denominator ]

The statistics of a period are self-defined. Default is according to 3 months statistics.

[ Inclusion in groups ]

The hemodialysis room (center) was counted for all dialysis sessions completed.

[ exclude population ]

If the patient was treated with CRRT, the weight gain calculation for this time was not included in the statistics. Statistics can be included if the local system can uniformly include CRRT patients into management.

[ data elements ]

Quality control of dialysis

[ basic data set ]

Registered hemodialysis patients

Body weight before and after dialysis

[ data Collection method ]

Calculated from data automatically entered on the local system.

[ analytical advice ]

Is free of

Index control rate of chronic kidney disease-mineral metabolism bone abnormality (CKD-MBD) of maintenance hemodialysis patient

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-57

[ DEFINITIONS ]

In unit time, the CKD-MBD index controls the proportion of maintenance hemodialysis patients that reach standards.

[ MEANS FOR solving PROBLEMS ]

Reflecting the management of CKD-MBD of the patient by the medical institution.

[ INDICATOR SOURCE/DOCUMENT ] NEW-UP

[ equation ]

The control rate of CKD-MBD index of the maintenance hemodialysis patients is equal to the number of the maintenance hemodialysis patients reaching the standard controlled by the CKD-MBD index/the total number of the maintenance hemodialysis patients at the same period is multiplied by 100 percent

The CKD-MBD index control rate of the maintenance hemodialysis patient is equal to the times of CKD-MBD index control reaching the standard/the times of KD-MBD index test of the maintenance hemodialysis patient at the same period according to the actual record of the patient is multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis room (central CKD-MBD index controls the number of times to reach standard.

Denominator: and controlling the number of reaching the standard of the patient with the synchronous maintenance hemodialysis according to the KD-MBD index actually recorded by the patient.

[ molecular description ]

Definition of CKD-MBD index control standard: blood calcium levels of 2.1 to 2.5mmol/L and blood phosphorus levels of 1.13 to 1.78mmol/L, iPTH are 2 to 9 times the upper limit of normal. 3 indexes are required to reach the standard at the same time.

According to the requirements of medical quality control indexes of professional health committee for nephropathy, the blood calcium and blood phosphorus of a maintenance blood patient are tested 1 time every 3 months, the blood iPTH level is tested 1 time every 6 months, whether 3 test results reach the standard at least 2 times every year or not simultaneously, and the time for completing 2 tests is less than 6 months. The time interval between the blood iPTH test and the blood calcium and blood phosphorus test is less than 3 months.

[ Inclusion in groups ]

[ exclude population ]

The maintenance hemodialysis patient has more than 2 tests in one year, and can only count to complete 1 test if the time of 2 tests is more than or equal to 6 months.

[ Specification of the denominator ]

The number of CKD-MBD index tests actually recorded by hemodialysis room (center) maintenance hemodialysis patients within the year is equal to the number of patients continuously dialyzing and treating in a dialysis room (center) for 12 months multiplied by 2 + the number of patients newly entering the maintenance hemodialysis treatment accumulated in the year which is more than or equal to 6 months and less than 12 months multiplied by 2-only 1 test result is recorded in the maintenance hemodialysis treatment accumulated in the year which is more than or equal to 6 months and less than 12 months multiplied by 2 + the patient recorded with the maintenance hemodialysis treatment of the maintenance 6 maintenance hemodialysis patient in the year which is less than 6 months and recorded with 1 test result.

The system schedule was done for 1 month in 31 days, with 6 months as the check deadline. The statistics are monthly, so that the statistics actually exceed about 1 week without any return and are counted as incomplete. However, each patient should complete the test no less than 2 times per year, and the test of the current year is only required 1 time due to the difference between the 31-day per month schedule and the natural month, and the test of the 2 nd time is completed by default 12 and 31 days before the current year.

The statistical time period is generally one natural year, and if the newly entered patient is less than one natural year, the statistics is carried out according to the actual natural month of the natural year.

If 1 maintenance hemodialysis patient is dialyzed in other hemodialysis rooms (centers) within a period of time after the dialysis is terminated in one hemodialysis room, the interruption time is continuously calculated within 3 months when the previous hemodialysis unit treatment is returned again at present, and if the interruption time is more than or equal to 3 months, the statistics is carried out again according to the newly entered patient.

Since there are situations where a patient resumes dialysis again after a dialysis unit exits dialysis, applying formula 1 to a cross-sectional survey may involve a greater number of patients who may be undergoing maintenance dialysis. If the second formula is used for counting, the patient may have a failure to count as done in the year due to the patient's interruption of the hemodialysis treatment in one facility.

[ Inclusion in groups ]

All maintenance hemodialysis patients who had been continuously dialyzed in one dialysis room (center) for 3 months were included.

[ exclude population ]

If a patient leaves the dialysis facility during the year and the first time schedule has not expired for the year, the patient is no longer enrolled in the year. Statistics for the year should be included if the test period has been exceeded before leaving.

[ data elements ] of the data structure,

Maintenance hemodialysis patient registration hemodialysis patient hemocalphos whole-stage thyroxine

[ basic data set ]

Quality control of dialysis

[ data Collection method ]

Obtained from Lis of medical institutions

[ analytical advice ]

Current studies show that the prognosis for patients who meet the standard with 3 indexes is better than that for 2 patients who meet the standard, and so on. If there is a significant difference between the statistics and the mean, the cause should be looked up or a grouping study should be performed.

Long-term usage rate of arteriovenous internal fistula of maintenance hemodialysis patient

[ quality control index set ] hemodialysis quality control index set

[ quality control index No. ] IIHAD-58(NEP-D-10)

[ DEFINITIONS ]

The continuous service time of the same arteriovenous internal fistula is more than 2 years of the proportion of patients with maintenance hemodialysis in unit time.

[ MEANS FOR solving PROBLEMS ]

Reflecting the management condition of a medical institution on the arteriovenous internal fistula of a patient.

[ INDICATOR SOURCE/DOCUMENT ] MEDICAL QUALITY CONTROL INDICATOR FOR NATIONAL HYGIENIC DEFENCE AND HEALTH DEFENCE

[ equation ]

The long-term usage rate of the internal arteriovenous fistula of the maintenance hemodialysis patients is that the continuous usage time of the same internal arteriovenous fistula is more than 2 years of the number of the maintenance hemodialysis patients/the total number of the maintenance hemodialysis patients at the same period is multiplied by 100 percent

[ rules of calculation ]

Blood permeable room (center)

Molecule (a): hemodialysis room (number of patients on maintenance hemodialysis with the same central arteriovenous internal fistula lasting more than 2 years.

Denominator: total number of concurrent maintenance hemodialysis patients.

Region(s)

Denominator: total number of concurrent maintenance hemodialysis patients.

[ molecular description ]

The same arteriovenous internal fistula means that the blood vessel access continuously used at present in hemodialysis is the autologous arteriovenous internal fistula, and the puncture point is the same fistula vein.

The long-term utilization rates of the arteriovenous graft blood vessel and the autologous arteriovenous internal fistula are respectively counted.

It is possible that a patient may have had a thrombolytic, interventional, or open procedure within 2 years of internal fistula use, but the patient's internal fistula is considered to be in continuous use if the puncture is still on the same fistula vein, but specific details of the invasive treatment regimen within 2 years should be able to be continuously queried or counted.

The patient uses the same internal fistula for 2 years, and the starting time is the time when the patient applies the internal fistula for the first time to perform regular hemodialysis treatment, but does not start the dialysis treatment in the dialysis room (center).

When the annual statistics shows that one internal fistula of one patient is used for more than 2 years, complications occur and the use is stopped, at the moment, the situation that 2 internal fistulas are used successively occurs, and in the annual statistics, the situation is that the same internal fistula of the patient is used for more than 2 years, and a new internal fistula is included in the statistics of the next year.

[ Inclusion in groups ]

Hemodialysis compartment (center) all patients used for more than 2 years calculated as the time at which an arteriovenous internal fistula started to deploy.

If the patient uses 2 internal fistulas in the same time period, if the first internal fistula is more than or equal to 2 years, the second internal fistula is not included in the statistics of the time period within the year.

[ exclude population ]

Patients using a tunneled, dacron jacketed hemodialysis catheter did not receive statistics.

If the patient has 2 vascular accesses at the same time, if one internal fistula has poor flow and is difficult to continue to be used as a dialysis vascular access, and another internal fistula is used although the internal fistula is not occluded, the original fistula of the patient is considered to be terminated and is not included in statistics.

[ Specification of the denominator ]

Maintenance hemodialysis patients who are dialyzing for more than 3 months in the hemodialysis room (center) in the present year, regardless of whether the patient is currently undergoing dialysis treatment at the hemodialysis facility.

[ Inclusion in groups ]

All maintenance hemodialysis patients who continuously dialyzed for 3 months in one dialysis room (center) were included as long as the patient appeared for a statistical period regardless of whether they currently continued dialysis treatment in the dialysis room (center).

[ exclude population ]

Patients who died and were kidney transplanted were not included in the statistics if the same fistula was not used for more than 2 years within the statistical period.

[ data elements ]

Vascular access type internal fistula enabling time for maintenance hemodialysis patients

Reason for withdrawal from maintenance hemodialysis

[ data Collection method ]

Data is entered by a physician from a hemodialysis management system.

If the 2-year usage rate of the arteriovenous internal fistula of a maintenance hemodialysis patient is obviously higher or lower than the average level, the situations that whether a unit without a vascular access operation is not recorded in time after the internal fistula of the patient loses work, the 2-year usage rate of a hemodialysis room (center) with more newly introduced patients is low, the 2-year usage rate of a unit with more vascular access operations is low and the like need to be particularly noticed.

Through the specific index statistical method and the collection mode, the whole blood quality control system is maintained and updated, and intelligent quality evaluation of the system is realized by data access with each medical institution.

The above-mentioned embodiments are only preferred embodiments of the present invention, and all equivalent changes and modifications made within the scope of the claims of the present invention should be covered by the claims of the present invention.

Claims

1. A hemodialysis quality control system, the system comprising:

2. The hemodialysis quality control system of claim 1, wherein the data collection module comprises a cache database for collecting collected information and outputting the collected information to the data preprocessing module, and the data collection module collects the collected information and classifies the collected information into the patient basic statistical data module, the infrastructure management index module, the quality control process management index module and the quality control result management index module according to the collected objects;

3. The hemodialysis quality control system of claim 2, wherein the patient basis statistics module comprises:

c type of payment for the hemodialysis patient.

4. The hemodialysis quality control system of claim 2, wherein the infrastructure management index module comprises:

5. The hemodialysis quality control system of claim 2, wherein the quality control process management index module comprises:

i record completion rate: urea removal index, urea reduction rate;

the incidence of hepatitis K and hepatitis c;

6. The hemodialysis quality control system of claim 2, wherein the quality control result management index module comprises:

7. The hemodialysis quality control system of claim 1, wherein the data pre-processing module comprises a data analysis module, a data processing module, and a standardized database;

8. The hemodialysis quality control system of claim 1, wherein the index quality control module comprises a description index module, a quality control process control index calculation module and a quality control structure control index calculation module, and the description index module, the quality control process control index calculation module and the quality control structure control index calculation module respectively calculate the ratio of each index in the jurisdiction according to a preset formula, then compare the ratio with a preset standard ratio, and output the score of each index.

9. The hemodialysis quality control system of claim 1, wherein the evaluation module comprises a qualification rate statistic module for calculating the qualification rate of the collection mechanism according to the score output by the index quality control module, and an index comprehensive analysis module for analyzing according to the scores and the qualification rate of the index quality control output module.

10. A control method of a hemodialysis quality control system, comprising the steps of:

the stranded evaluation module evaluates the following equation: