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NHSN Dialysis Event Surveillance – NHSN Enrollment for Outpatient Dialysis

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Available for download Enrollment for Outpatient Dialysis Facilities slide set [PDF - 2.01 MB]


Slide 1. Welcome to NHSN Dialysis Event Surveillance training for NHSN Enrollment. This presentation will explain all of the steps necessary to enroll your outpatient dialysis facility in NHSN.

Slide 2. The audience for this presentation is any person enrolling a dialysis clinic or center in NHSN. A person who enrolls a facility in NHSN is known as the NHSN Facility Administrator. This presentation is also for NHSN group users who want to understand the facility enrollment process. Please note that groups enroll in NHSN differently than facilities, please see Guides for the Group Function in the NHSN Resource Library for additional information.

Slide 3. The learning objectives for this presentation include where to find resources for NHSN enrollment, definitions of NHSN user roles, and instructions on completing NHSN Enrollment Steps 1 – 5.

Slide 4. There are many resources for enrollment and reporting. In addition to the NHSN Helpdesk, there are general enrollment resources available under the Enrollment Requirements on the NHSN menu. Visit the NHSN Dialysis Event website for dialysis-specific resources.

Slide 5. There is a dialysis facility enrollment checklist which is a helpful tool for dialysis facilities to complete enrollment efficiently. Complete the steps in order. The time required for each step is estimated on the checklist.

Slide 6. In addition to the checklist, there is a “NHSN Facility Administrator Enrollment Guide” which is a general resource for all types of facilities enrolling in NHSN. In contains instructions and tips that may be helpful.

Slide 7. If you have multiple dialysis clinics to enroll, start by enrolling one clinic completely first. Once you have completed the enrollment of the first facility, you can go to the dialysis event website for instructions on how to enroll the additional clinics. Enrolling additional facilities is much simpler after the first one has completed enrollment and has been activated.

Slide 8. First, let’s review the key personnel roles in NHSN. The person who enrolls a facility in NHSN is called the NHSN Facility Administrator. Across components, the Facility Administrator manages users and user rights, manages locations and patients, can add, edit & delete facility data, and has the authority to nominate groups (for data sharing between facilities). Only the Facility Administrator can reassign their role to another user.

Slide 9. In addition to the Facility Administrator, there is the NHSN Patient Safety Primary Contact Person. This is the person who interacts most closely with CDC regarding the Patient Safety Component. Other users’ roles vary depending on which rights the facility administrator chooses for them. They may have one or more rights to view data, to do data entry and analysis. There is only one Facility Administrator, but a user can be given administrative rights and then do many of the same things that the Facility Administrator can. One person may hold multiple roles. For example, you may be both the Facility Administrator and the NHSN Patient Safety Primary Contact Person.

Slide 10. Here is a overview of the NHSN enrollment process: As you can see, there are 5 steps. First step is training and preparation. Following that, you will read and agree to the rules of behavior and register your facility with NHSN. The third step has two parts: request and then install a digital certificate onto your computer. Fourth, you’ll access the NHSN Enrollment webpage to submit the two required forms electronically and finally, you’ll print the consent form, get the appropriate signatures, and then return the signed form to NHSN. [MOUSE CLICK] So let’s begin with Enrollment step 1 training and preparation.

Slide 11. It is important to review all training materials before beginning enrollment. Dialysis training requirements are listed on the Dialysis Event website. Please note that any person collecting data, regardless of whether or not they have access to NHSN for data entry, must be familiar with the Dialysis Event Protocol. This is important for data quality.

Slide 12. There are some technical steps to complete before beginning enrollment, which may require assistance from your IT department, depending on your local network settings. First, change email spam-blocker settings to allow all email from both and This is essential for completing enrollment successfully. Add both https://* and https://* to the trusted sites list and allow pop-ups for these sites. This is done in Internet Explorer, by opening the “Tools” menu, and selecting “Internet Options”. Trusted sites are added under the “Security” tab and pop-ups settings are managed on the “Privacy” tab.

Slide 13. Once training and preparation is complete, you proceed to register your facility [MOUSE CLICK].

Slide 14. The Facility Administrator goes to the NHSN web address shown here, reads the rules of behavior, and then selects “agree”. You can print a copy of the rules of behavior for your records if you would like. The rules pertain to things like securing sensitive information, preventing unauthorized access to the system, and so on. Each user is responsible for helping to prevent unauthorized use of, and access to, NHSN.

Slide 15. When you click “Accept” to the rules of behavior, you will proceed to this Registration page. Here the Facility Administrator fills out his or her name and email address. It is very important to enter your email address correctly. You will need to enter a facility identifier. CCN stands for “CMS Certification Number”, which is a 6 digit number for dialysis facilities. If your number is not accepted, email the NHSN helpdesk for assistance. At the bottom of the screen it says “I certify that I have completed all of the appropriate, required NHSN trainings” and asks for a date. Enter the date that you finished all required training, as listed on the Dialysis Event website, to certify training completion. Then click “Save”.

Slide 16. When you complete enrollment step 2 and successfully register your facility, you immediately receive a Welcome email from NHSN. If you do not immediately receive a Welcome email, contact the NHSN helpdesk. The Welcome email contains a web link, password and instructions on how to request a digital certificate.

Slide 17. Now that you have registered your facility, the next step is to acquire a digital certificate. [MOUSE CLICK] This is a two part process; first you request a digital certificate from SDN. The request takes 1-3 business days to be processed. Once it is approved, you will receive a second email with instructions on how to install it.

Slide 18. So what is a digital certificate and what is SDN? SDN is the secure data network. SDN provides secure online access to and exchange of information between CDC & public health partners. Users enroll in SDN and obtain a digital certificate to get access to CDC applications. A digital certificate is an electronic document installed on a user’s computer to certify the user’s identity and their authorization to exchange information on the network. CDC uses SDN so that users transfer information privately and securely to NHSN. There are specific IT requirements for installation, which are included in the email with installation instructions.

Slide 19. When you click on the link in the Welcome email, you’ll come to this webpage. Here enter the password provided in the Welcome Email and then press “Accept”.

Slide 20. Once you press “Accept”, you will proceed to the SDN Enrollment Form. Here you will enter your information, such as your name, employer and contact information. It is very important that the email address you enter is correct, is the same email address used for registration, and is an email address that you check often. Once all the data have been entered, click “Next”.

Slide 21. You will proceed to the next page where you will be prompted to select the SDN program and the program activities that you want to join. The program whose activities you want to join is National Healthcare Safety Network (NHSN). Select “NHSN Enrollment” from the activities list. Then click “Next”.

Slide 22. On the next page, you will create an SDN challenge phrase. Your challenge phrase is your password that you will provide each time to access NHSN. Because your challenge phrase is used to log in to SDN to access NHSN in the future, it is important to make a copy of it for reference later. Enter and confirm your SDN challenge phrase, then choose “Next”.

Slide 23. This is what the webpage looks like for you to create your challenge phrase. As you can see, there are certain requirements for your challenge phrase: for example, it must be at least 8 characters long and is case sensitive.

Slide 24. Once you have confirmed your challenge phrase, you will see a confirmation message that your “Digital Certificate Request has been received”. You will also get an email confirming your certificate has been requested. If you do not receive this confirmation, contact SDN.

Slide 25. Now your digital certificate is requested. [MOUSE CLICK] Once approved, you will receive an email for the next step, installation of the digital certificate.

Slide 26. After your request for a digital certificate is approved, it will take 1 to 3 business days for you to receive an email with instructions for installation. The email comes from PHINTech and has the subject line “Action-Required – Your digital Certificate is Ready to Install”. If you do not receive the email after 4 or more business days, or have any problems with installing your digital certificate, contact SDN.

Slide 27. Once your request is approved, the email that is sent from PHINTech with the subject line “Action-Required – Your digital Certificate is Ready to Install” has 2 links. One link opens instructions on how to install the digital certificate. Follow these instructions carefully. The second link opens a window where you download the digital certificate itself.

Slide 28. Use the same computer to download the digital certificate that you will use to access NHSN in the future. Follow the instructions provided in the email carefully. We strongly recommend involving your IT department, if you have one. You must use Internet Explorer to download the digital certificate. Have the “” and “” websites added to your trusted sites list for successful installation. Click the link in the “Digital Certificate Request Approved” email. You will be prompted to enter your SDN challenge phrase, this is the same challenge phrase you choose when you requested your digital certificate. Enter your challenge phrase & click “submit”.

Slide 29. After you have confirmed your information, you will be brought to this screen. Read the IT requirements and be sure your computer is ready to download the certificate. Then click the “Download” button to begin installation.

Slide 30. Once you have clicked the “Download” button, downloading should begin automatically if all of your system settings are correct. If you run into problems, contact your IT department for assistance. Your IT department can also contact SDN. If everything went smoothly, after a few moments you should see the confirmation page, that says “Your digital certificate is installed”. Verify installation in Internet Explorer by clicking on Tools, then Internet Options. Select the Content Tab, and click on “certificates”. You should see a certificate with your name issued by CDC. While you are here, it is recommended to save a backup copy of the digital certificate. To do that, click on the certificate, then choose “Export” to save it to an external device, such as a flash drive or CD.

Slide 31. To save a copy of your digital certificate, in Internet Explorer, click the “Tools” menu. Under “Tools”, select “Internet Options”. When the “Internet Options” window opens, click on the “Content” tab. Then pick “Certificates”. Highlight your certificate. And then you can choose “Export” to save it to an external device. You will be prompted for a “key” to export your digital certificate. This is your challenge phrase (password).

Slide 32. If your certificate is properly installed, you will immediately be able to access SDN’s secure Public Health Partner’s site. If you cannot access this site after installing your digital certificate, contact SDN.

Slide 33. Digital certificates are user specific: Do not share your digital certificate with others. Install it on the computer you will use for NHSN reporting. You can install your digital certificate on additional computers if necessary (for example, your work desktop & work laptop). And if different users share a computer for accessing NHSN, multiple certificates (one/user) can be installed on same computer. Be sure to make a copy of it as soon as it is installed. CDC pays for digital certificates. They are renewed annually, a warning email is sent 30 days before it expires with renewal instructions.

Slide 34. Now that the digital certificate is installed, we have completed Enrollment Step 3. [MOUSE CLICK] Next step is to submit the required forms electronically.

Slide 35. To get to the “NHSN Enrollment” page, log on via SDN’s Public Health Partner’s page. On this site, you’ll enter your challenge phrase. This is the same challenge phrase or password that you created when you requested your digital certificate. Click ‘Submit’.

Slide 36. If your challenge phrase is accepted, you’ll be directed to the SDN homepage. Select ‘NHSN Enrollment’.

Slide 37. The ‘NHSN Enrollment’ link will bring you to this ‘Enroll Facility’ page. First, access and print the required enrollment forms.

Slide 38. Under the Patient Safety Component, there are 2 forms required for Outpatient Dialysis Centers: Facility Contact Information form and the Outpatient Dialysis Center Practices Survey If you haven’t already, print and complete these forms before moving on to the next step.

Slide 39. This is the first page of the Facility Contact Information form. It asks for a facility identifier, such as the American Hospital Association ID# or CMS Certification Number # [MOUSE CLICK]. The CMS Certification Number is 6 digits long, but may begin with a zero. Enter in the numbers that your facility has. If your facility does not have the number, that’s fine just check “Not applicable” [MOUSE CLICK]. If you treat outpatients, [MOUSE CLICK] your Facility Type is “Hemodialysis Center”, even if you are affiliated with a hospital.

Slide 40. Select the Patient Safety Component. [MOUSE CLICK] The NHSN Facility Administrator is the person who is enrolling the facility in NHSN, be sure to use the same email address as in steps 2 and 3.

Slide 41. On the facility Contact information form, indicate the person who will be most involved with Patient Safety surveillance activities [MOUSE CLICK]. This may be the Facility Administrator or someone else.

Slide 42. Since you are only enrolling in Patient Safety, [MOUSE CLICK] you can skip the Healthcare Personnel Safety Primary Contact Person. [MOUSE CLICK] The Microbiology Lab Director or Supervisor is required, add a contact from the lab you use most often if you have one, if you do not have a Lab contact, use the Facility Administrator. [MOUSE CLICK] You can also skip the Biovigilance Primary Contact

Slide 43. The second piece of required enrollment paperwork is the Outpatient Dialysis Center Practices Survey. You can get a copy of the survey from the NHSN Dialysis Event website ahead of time. That way when you do get to this point in enrollment, you will have all the information ready.

Slide 44. This is the first page of the Outpatient Dialysis Center Practices Survey. The practices survey is completed during enrollment and then once a year thereafter. The survey is based upon the annual survey that CDC used to do, so it may look familiar to some of you. There are several sections including Facility Information, Patient and Staff Census, Vaccines, Hepatitis B and C, Policies and Practices and Vascular Accesses.

Slide 45. There are several questions that ask about patients from the first week of January. The first time these questions are completed, it may take a little time to retrieve the necessary information. In the future, it can be completed at the beginning of the year and may be easier since the information can be collected prospectively.

Slide 46. Once you have accessed, printed, and completed the required forms on paper, click on Enroll a facility. From this point, you’ll need to complete the rest of enrollment step 4 in one sitting. You will not be able to save your work in progress. Once you begin submitting the required form information don’t stop until you get an on-screen confirmation message that enrollment has been submitted.

Slide 47. Here you are going to be prompted to enter your required form information, beginning with the Facility Contact Information. Add this, then choose “verify data”. If your information is entered correctly, but you get an error message that your information cannot be verified, contact the NHSN Helpdesk.

Slide 48. Once your contact information is verified, it will ask about the facility type, which for dialysis clinics is AMB-HEMO-Hemodialysis Center. And the component you are enrolling in, which for dialysis reporting is Patient Safety. When you choose these two things, the required dialysis survey appears.

Slide 49. Complete the dialysis survey online, using your completed paper version as a guide. You need to enter all of the information in one session. Don’t leave your computer idle for too long, because the secure website may time-out and you’ll need to start over.

Slide 50. Once you have entered and saved all of your survey information, you’ll see a green checkmark next to it. You can print a completed survey for your records. Once all of the required form information is entered and saved, click the ‘Submit’ button to finish enrollment step 4.

Slide 51. Once the required forms are saved and submitted, a confirmation message displays. You are not finished with enrollment step 4 until you see this confirmation message on the screen. You will immediately receive an NHSN email with a link to your consent form if everything was submitted properly. If you do not receive immediately this email, contact the NHSN Helpdesk.

Slide 52. You have now completed enrollment step 4. [MOUSE CLICK] The last step is to print your consent form, get the appropriate signatures, and return the signed form to NHSN.

Slide 53. When you successfully submit required forms, you will immediately receive an NHSN email which contains a link to your consent form. The consent forms are facility-specific, you must print the consent form that is provided in the email link. You have 30 days to open the link and print the form. So it’s important that you are checking your email. Once printed, CDC must receive the signed form within 60 days.

Slide 54. When you click on the link, you may need to login to SDN’s Public Health Partners page and then copy the link and paste into the browser to open the consent form.

Slide 55. The Agreement to Participate and Consent covers the NHSN Purposes, facility eligibility and data collection and reporting requirements. It also includes an assurance of confidentiality.

Slide 56. The consent form needs to be signed by the Patient Safety Primary Contact Person and your Facility Leadership. NHSN requires the highest level administrator at your facility to sign. In hospital-type settings, this is usually a C-level executive (such as the CEO or COO). In outpatient settings, the highest level administrator may be the medical director. You can either mail or fax your signed consent form to NHSN. Keep a copy for your records.

Slide 57. Within 3 business days following NHSN’s receipt of a properly signed consent form, NHSN will activate your facility and notify you via email. The email comes from NHSN and has the subject “NHSN enrollment approved”. Once you’ve received this email, you’ll immediately be able to login to NHSN Reporting.

Slide 58. This concludes the last step of NHSN Enrollment.

Slide 59. Now that enrollment is complete, the next step is set-up which only takes a few minutes. Training on NHSN Set-up is available on the Dialysis Event homepage. Set up includes adding users & assign user rights, if you want; adding ‘Outpatient Hemodialysis Clinic’ Location and creating Monthly Reporting Plans. These steps must be completed before you can begin reporting data.

Slide 60. If you plan to enroll in NHSN, this is the proposed timeline, although some facilities may need more or less time than this estimate. By the end of the first week, complete training and preparation, agree to the rules of behavior, register your facility with NHSN, and request your digital certificate. Install your digital certificate sometime in week 3. Submit your required enrollment forms online during week 4. Send your signed consent form to NHSN by the end of the 4th week. And then set-up NHSN and begin reporting data by the end of the 5th week.

Slide 61. Remember, email is our only way to communicate with you! Please send us any changes in your email address, and make certain that your Information Systems will allow bulk email from CDC.

Slide 62. If you are planning on enrolling your facility, register today. Print and begin working on the outpatient dialysis center practices survey. Also, print the checklist. If applicable, let your ESRD Network or other organization know that you’re enrolling in NHSN.

Slide 63. Thank you for completing enrollment training for dialysis facilities. Questions about this presentation can be directed to the NHSN Helpdesk at

Contact NHSN:
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    Atlanta, GA 30333
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