Vascular Access Awareness Week - Activity Reporting

Please select the activities your facility has completed during Vascular Access Awareness Week for a chance to win a catered lunch from the Network!

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* 1. Facility Information

Facility Name

CCN (6-digit Medicare certification number)

Person Completing Form

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* 2. Please select all activities your facility completed during Vascular Access Awareness Week. You may be contacted by a Network employee for additional information.

Designate one day during the week for staff to wear RED. This serves as a conversation starter with patients who will be curious why everyone is wearing the same color. Use this as an opportunity to spread awareness about vascular access health.

Hold an in-service with staff members about access management – feel the thrill and listen for a bruit!

Provide patient education on access care and management. Consider having a vascular surgeon or an access center provide education.

Recognize a patient or patients who have taken good care of their access. Provide them with a prize, patient spotlight board, certificate, etc.

Distribute “celebration kits” or certificates for patients who have successfully converted from a CVC to a permanent access OR who have attended appointments to initiate permanent access.

Create a tri-fold board or bulletin board about access care and management for display.

Perform a Root Cause Analysis on any access-related hospital visits.

Have staff and/or patients review pictures of “good” and “bad” access management and access sites

Distribute QIRN5 Patient Wallet Cards to patients and discuss the importance of using if hospitalized to help ensure proper care of HD or PD accesses during their stay.

Get CREATIVE – perform an activity of your choosing to promote a healthy access!

If you completed a different activity, please describe

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* 3. Upload image of activity (optional). You can email multiple pictures to Katelynn Booth at kbooth@qualityinsights.org

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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