Coordinated hospital-home care for kidney patients on hemodialysis from the perspective of nursing personnel

Abstract

OBJECTIVE: To examine, from the nursing perspective, the needs and challenges of coordinated hospital-home care for renal patients on hemodialysis. METHODS: A qualitative analysis was conducted with an ethnographic approach in a hemodialysis unit in San Luis Potosi, Mexico. Semistructured interviews were conducted with nine nurses, selected by purposeful sampling. Structured content analysis was used. RESULTS: Nurses recounted the needs and challenges involved in caring for renal patients. They also identified barriers that limit coordinated patient care in the hospital and the home, mainly the work overload at the hemodialysis unit and the lack of a systematic strategy for education and lifelong guidance to patients, their families and caregivers. CONCLUSIONS: This study shows the importance and necessity of establishing a strategy that goes beyond conventional guidance provided to caregivers of renal patients, integrating them into the multidisciplinary group of health professionals that provide care for these patients in the hospital to establish coordinated hospital-home care that increases therapeutic adherence, treatment substitution effectiveness and patient quality of life.

The continuity of hospital nursing care for Primary Health Care in Spain

“…In addition to including education and training of family members which are sufficient to care for the patient at home, this strategy should also offer alternative support and coping for the disease, obtaining the most effective and personalized care. Coordinated hospital-home care would increase the patient's quality of life and provide caregiver support (5) . A study conducted in Norway with older patients pointed out that identifying patients who are clinically fit for discharge by informing the patient and their immediate family members about discharge, providing written information on post-discharge care transfer and arranging patient transport activities lead to successful discharge (6) .…”

Exploring experiences of the quality of nursing care among patients, nurses, caregivers and physicians in a haemodialysis department

“…They also reported a heavy workload at the HD Department. The absence of a systematic approach towards the education and lifelong guidance of patients and their families and caregivers was one of the main barriers to comprehensive care provision for patients (Tejada-Tayabas et al 2015).…”

Hemodialysis Patient Care in Renal Dialysis Unit among Selected Hospitals in the Sultanate of Oman

“…The delivery of continuous and coordinated care lessens the demand for hospital services, waiting times for other services in different parts of the hospital, and the threat of complications [33][34]. That is why patients treated with hemodialysis not only have a low health related quality of life as [35] as well as eexperienced mortality rates of 15%-20% each year [36].…”