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Dialysis Event - NHSN Mobile App

Each month, facilities use a Dialysis Event form to report the details of each dialysis event that occurred among patients. One form should be completed per event for all patients who received hemodialysis at the facility during that month.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Dialysis Event - NHSN Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Facility ID

  • Ico textbox

    Event #

  • Ico textbox

    Patient ID

  • Ico textbox

    Social Security #

  • Ico textbox

    Secondary ID

  • Ico textbox

    Medicare #

  • Ico textbox

    Patient Last Name

  • Ico textbox

    Patient First Name

  • Ico textbox

    Patient Middle Name

  • Ico dropdown

    Gender

  • Ico textbox

    Date of Birth

  • Ico textbox

    Ethnicity (specify)

  • Ico textbox

    Race (specify)

  • Ico textbox

    Event Type

  • Ico date

    Date of Event

  • Ico textbox

    NHSN Procedure Code

  • Ico textbox

    Location

  • Ico statictext

    Vascular accesses: (check all that apply)

  • Ico checkbox

    Fistula

  • Ico dropdown

    Buttonhole?

  • Ico textbox

    Access placement date (mm/yyyy) (if unknown, enter unknown)

  • Ico checkbox

    Graft

  • Ico textbox

    Access placement date (mm/yyyy) (if unknown, enter unknown)

  • Ico checkbox

    Tunneled central line

  • Ico textbox

    Access placement date (mm/yyyy) (if unknown, enter unknown)

  • Ico checkbox

    Nontunneled central line

  • Ico textbox

    Access placement date (mm/yyyy) (if unknown, enter unknown)

  • Ico checkbox

    Other access device (e.

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