Improvement in care: A collaborative approach to rehabilitation

Abstract

Examination of the patient experience within our unit, from pre dialysis through to establishment of dialysis in the community identified that the care was fragmented. To improve patient care, a change process was initiated. Four home care teams comprising three qualified nurses and one renal care assistant were established with each team responsible for a caseload of patients within a specified geographical location. To measure the impact on the patient, 100 questionnaires were circulated after twelve months. Results from 60 patients showed 76% of pre dialysis patients and 80% of dialysis patients were very satisfied with the change process. The main advantage of this change for the patient is that they are in a continuous supportive cycle for all their non-inpatient care throughout their replacement therapy. We conclude that patient focused care is essential and should be a transition catalyst in a change resistant environment.

Chronic kidney disease and support provided by home care services: a systematic review

“…In contrast to the general trend of studies included in this SR where the focus was exclusively on the dialysis phase of care for patients, one study [64] included information from both the dialysis and pre-dialysis phases of care for PD and HD patients. This study explored the impact HC has on patients in one hospital in the United Kingdom.…”

“…The two studies that examined HC interventions for HD patients [62,63] and most of the HC assisted PD studies [48,50-53,55,56,58,60] focused on assistance dialysis patients received from a nurse. Two of the remaining studies [61,64] considered the effects of HC teams and the rest focused on assistance received from either a home-assistant where a background in healthcare was not necessary [49,57], a nurse assistant [59] or a nurse or a healthcare aid [54]. …”

“…Based on survey results, more than three-fourths of PD and HD patients were very satisfied with the pre-dialysis and dialysis phase of their care after the implementation of HC program [64]. The HC team consisting of three nurses and one renal care assistant provided continuous social support to patients.…”

“…Apart from one study [64] that incorporated information about patient experiences with the implementation of a HC program that affected both the dialysis and pre-dialysis phases of their care, there were no studies that explored the impact HC has on non-ESRD CKD populations. It is well known that CKD is often accompanied by several comorbid conditions, is common among older people and its prevalence increases with age.…”