Impact of coronavirus disease (COVID-19) on home dialysis: Experiences of home dialysis nurses in Australia and Canada

2021 ◽  
Vol 17 (2) ◽  
Author(s):  
Josephine Chow ◽  
Allyson Calvin ◽  
Angelina Villarba ◽  
Carol Armstrong ◽  
Dana Windebank ◽  
...  
Keyword(s):  
Home Dialysis ◽  
Dialysis Nurses

scholarly journals Perceptions of multidisciplinary renal team members towards home dialysis therapies

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0006222020
Author(s):  
Krishna Poinen ◽  
Mary Van Der Hoek ◽  
Michael A. Copland ◽  
Karthik Tennankore ◽  
Mark Canney
Keyword(s):  
Quality Of Life ◽  
Multidisciplinary Team ◽  
Allied Health ◽  
Further Education ◽  
System Level ◽  
Health Staff ◽  
Home Dialysis ◽  
Team Members ◽  
Dialysis Nurses

Background: Patients with end stage kidney disease are encouraged to pursue home dialysis therapy with the aims of improving quality of life, increasing patient autonomy and reducing cost to health care systems. In a multidisciplinary team setting, patients interact with nephrologists, nurses and allied health staff, all of whom may influence a patient's modality choice. Our objective was to evaluate the perceptions of all renal team members towards home dialysis therapies. Methods: Cross-sectional survey of multidisciplinary renal team members across five renal programs in British Columbia, Canada. The survey contained questions regarding primary work area, modality preference, patient and system factors that may influence modality candidacy, perceived knowledge of home therapies and need for further education. Results: A total of 334 respondents (22 nephrologists, 172 hemodialysis nurses, 49 home nurses, 20 pre-dialysis nurses, and 71 allied health) were included (48% response rate). All respondents felt that home dialysis was beneficial for patients who work or study, improved patients' quality of life, and provided cost-savings to the system. Compared to in-center hemodialysis nurses, home therapies nurses were between 5 and 9 times more likely to favor a home therapy for patients of older age, lower socioeconomic status, lower educational level, higher burden of comorbidities and those lacking social supports. Nephrologists and patients were felt to have the most impact on modality choice, while dialysis nurses were seen as having the least impact on modality choice. Most respondents felt the need for further education in home therapies. Conclusions: The majority of multidisciplinary team members, including allied health staff, acknowledged the benefits of home therapies. There were significant discrepancies amongst team members regarding patient/system-level factors that may impact home therapies candidacy. Structured, focused and repeated education sessions for all renal team members may help to address misperceptions around factors that influence modality candidacy.

scholarly journals A Nurse mailing list serving the Dialysis at Home community

2019 ◽  
Vol 2 (3) ◽  
pp. 159-162
Author(s):  
Marie PADERNOZ
Keyword(s):  
Peritoneal Dialysis ◽  
Home Treatment ◽  
Mailing List ◽  
French Language ◽  
Outpatient Management ◽  
Dialysis Patients ◽  
Home Dialysis ◽  
Material Supply ◽  
Email Address ◽  
Dialysis Nurses

Aware of the difficulties encountered by the centers in the outpatient management of peritoneal dialysis patients, on March 21, 2016, the French Language Peritoneal Dialysis Registry (RDPLF) launched an «alloDP» nursing list for the benefit of Home Dialysis units active in the Registry. Difficulties in relation to the isolation of the teams, the size of the centers, the number of participants, the lack of knowledge in the technique are undeniably a hindrance to the development of home treatment. This mailing list is exclusively reserved for home dialysis nurses after registration by the RDPLF. They need an email address, if possible, personal. Nephrologists and nurses at the material supply commercial providers may have access to alloDP, upon request, but only as «readers». To break her isolation, or sense of isolation, the nurse simply sends her question, request, or need to the nursing community to the address [email protected]. The wealth of sharing does the rest. To illustrate the content of the exchanges, we have chosen to summarize six of them in this article.

scholarly journals Telehealth for Home Dialysis in COVID-19 and Beyond: A Perspective From the American Society of Nephrology COVID-19 Home Dialysis Subcommittee

2021 ◽  
Vol 77 (1) ◽  
pp. 142-148 ◽  
Author(s):  
Susie Q. Lew ◽  
Eric L. Wallace ◽  
Vesh Srivatana ◽  
Bradley A. Warady ◽  
Suzanne Watnick ◽  
...  
Keyword(s):  
Home Dialysis ◽  
American Society

scholarly journals Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Annabel Boyer ◽  
Yannick Begin ◽  
Julie Dupont ◽  
Mathieu Rousseau-Gagnon ◽  
Nicolas Fernandez ◽  
...  
Keyword(s):  
Health Literacy ◽  
Observational Study ◽  
Health Information ◽  
Healthcare Providers ◽  
Significant Proportion ◽  
Good Health ◽  
Sufficient Information ◽  
Home Dialysis ◽  
Limited Health Literacy ◽  
Limited Health

Abstract Background Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). Methods This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. Results Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). Conclusion In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.

scholarly journals Current role of ultrasound in hemodialysis access evaluation

2021 ◽  
pp. 112972982110346
Author(s):  
Meola Mario ◽  
Jose Ibeas ◽  
Jan Malik
Keyword(s):  
Turning Point ◽  
Point Of Care ◽  
Low Cost ◽  
Wireless Systems ◽  
Future Perspectives ◽  
Maturation Period ◽  
Surveillance Programs ◽  
Dialysis Nurses

Physical examination (PE) is considered the backbone before vascular access (VA) placement, during maturation period and for follow-up. However, it may be inadequate in identifying suitable vasculature, mainly in comorbid patients, or in detecting complications. This review highlights the advantages of ultrasound imaging to manage VA before placement, during maturation and follow-up. Furthermore, it analyses the future perspectives in evaluating early and late VA complications thank to the availability of multiparametric platforms, point of care of ultrasound, and portable/wireless systems. Technical improvements and low-cost systems should favor the widespread ultrasound-based VA surveillance programs. This significant turning point needs an adequate training of nephrologists and dialysis nurses and the standardization of exams, parameters, and procedures.

scholarly journals Covid-19 Pandemic Era: Is It Time To Promote Home Dialysis And Peritoneal Dialysis?

2021 ◽  
Author(s):  
Mario Cozzolino ◽  
Ferruccio Conte ◽  
Fulvia Zappulo ◽  
Paola Ciceri ◽  
Andrea Galassi ◽  
...  
Keyword(s):  
Severe Infection ◽  
Human Interaction ◽  
World Health ◽  
Older Individuals ◽  
Home Dialysis ◽  
Renal Replacement Therapies ◽  
Home Based ◽  
Immunologic Diseases ◽  
Novel Coronavirus ◽  
Health Organization

ABSTRACT The novel coronavirus, called SARS-CoV-2 has been declared a pandemic on March 2020, by the World Health Organization. Older individuals and patients with comorbid conditions such as hypertension, heart disease, diabetes, lung disease, chronic kidney disease (CKD), and immunologic diseases are at higher risk of contracting this severe infection. In particular, patients with advanced CKD constitute a vulnerable population and a challenge in the prevention and control of the disease. Home-based renal replacement therapies offer opportunity to manage patients remotely, thus reducing the likelihood of infection due to direct human interaction. Patients are seen less frequently, limiting the close interaction between patients and healthcare workers who may contract and spread the disease. On the other hand, while home dialysis is reasonable selection at his time due to the advantage of isolation of patients, measures must be assured to implement the program. Despite its logistical benefits, outpatient hemodialysis also presents certain challenges during times of crises such as COVID 19 pandemic and potentially future ones.

scholarly journals Quantifying Missed Opportunities for Recruitment to Home Dialysis Therapies

2021 ◽  
Vol 8 ◽  
pp. 205435812199325
Author(s):  
Krishna Poinen ◽  
Lee Er ◽  
Michael A. Copland ◽  
Rajinder S. Singh ◽  
Mark Canney
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Health Care System ◽  
Selection Process ◽  
Chronic Dialysis ◽  
Home Therapy ◽  
Missed Opportunities ◽  
Home Dialysis ◽  
Missed Opportunity ◽  
Care System

Background: Despite the recognized benefits of home therapies for patients and the health care system, most individuals with kidney failure in Canada continue to be initiated on in-center hemodialysis. To optimize recruitment to home therapies, there is a need for programs to better understand the extent to which potential candidates are not successfully initiated on these therapies. Objective: We aimed to quantify missed opportunities to recruit patients to home therapies and explore where in the modality selection process this occurs. Design: Retrospective observational study. Setting: British Columbia, Canada. Patients: All patients aged >18 years who started chronic dialysis in British Columbia between January 01, 2015, and December 31, 2017. The sample was further restricted to include patients who received at least 3 months of predialysis care. All patients were followed for a minimum of 12 months from the start of dialysis to capture any transition to home therapies. Methods: Cases were defined as a “missed opportunity” if a patient had chosen a home therapy, or remained undecided about their preferred modality, and ultimately received in-center hemodialysis as their destination therapy. These cases were assessed for: (1) documentation of a contraindication to home therapies; and (2) the type of dialysis education received. Differences in characteristics among patients classified as an appropriate outcome or a missed opportunity were examined using Wilcoxon rank-sum test or χ2 test, as appropriate. Results: Of the 1845 patients who started chronic dialysis during the study period, 635 (34%) were initiated on a home therapy. A total of 320 (17.3%) missed opportunities were identified, with 165 (8.9%) having initially chosen a home therapy and 155 (8.4%) being undecided about their preferred modality. Compared with patients who chose and initiated or transitioned to a home therapy, those identified as a missed opportunity tended to be older with a higher prevalence of cardiovascular disease. A contraindication to both peritoneal dialysis and home hemodialysis was documented in 8 “missed opportunity” patients. General modality orientation was provided to most (71%) patients who had initially chosen a home therapy but who ultimately received in-center hemodialysis. These patients received less home therapy–specific education compared with patients who chose and subsequently started a home therapy (20% vs 35%, P < .001). Limitations: Contraindications to home therapies were potentially under-ascertained, and the nature of contraindications was not systematically captured. Conclusions: Even within a mature home therapy program, we discovered a substantial number of missed opportunities to recruit patients to home therapies. Better characterization of modality contraindications and enhanced education that is specific to home therapies may be of benefit. Mapping the recruitment pathway in this way can define the magnitude of missed opportunities and identify areas that could be optimized. This is to be encouraged, as even small incremental improvements in the uptake of home therapies could lead to better patient outcomes and contribute to significant cost savings for the health care system. Trial Registration: Not applicable as this was a qualitative study.

Sign in / Sign up

Export Citation Format

Share Document