Improving Quality of Care in Hemodialysis: a Content Analysis

Abstract

Introduction: Hemodialysis is currently the most common alternative treatment in patients with renal failure in the world. Today, despite the support provided by healthcare providers for these patients, they still express dissatisfaction with the quality of care and find it inadequate. However, there have been few studies investigating the needs of in-patients receiving hemodialysis care in Iran. Thus this research was undertaken to study the needs and demands of such patients. Methods: This qualitative research was conducted from June to November 2016 to investigate the view points of the patients, their families and health care providers about improving quality of care in dialysis unit. At first, the sampling was based on a purposeful sampling method. A total of 35 participants (patients, their families and health care providers) were interviewed. The interviews were analyzed via Graneheim & Lundman qualitative content analysis. Results: Data analyses led to the production of 700 primary codes, 54 subcategories and 27 secondary categories out which 4 main categories of modification of physical stressors, requirement of support and the requirement of improved quality of Health Care service and improved facilities and equipment requirement. Conclusion: Planning for modification of physical stressors, improved support of patients, enhancing the quality of care services provided by the treatment team, upgrading the facilities and equipment and the adoption of an interdisciplinary approach are all believed to improve the care services among in-patients receiving hemodialysis treatment.

Patient perceived quality of nursing care in hemodialysis: A meta-synthesis

“…Sufficient Human resource means appropriate number of nurse, kidney specialist, nutritionist, social Human resource means professional human power behavior (being accessible and on time). 18,[22][23][24][25] "The nurse should have enough information about kidney and electrolytes, because a small error in the selection of filter, blood flow, and UF could lead to the worst electrolytic problem." (Study 4) 23…”

“…that are new and have a correct performance. 18,22,24,25 "Whenever a new dialysis machine is brought in, another one breaks down, and who knows when this other one is going to be repaired? There is always a shortage of machines in the department."…”

“…Various studies have shown that patients undergoing dialysis are financially troubled with respect to poor economic backgrounds, losing job in most of the time du to provide medicines, physician visits to control long-term complications of dialysis, and following from diet. [22][23][24] "Whenever I visit a physician's office, I have to pay a sum of money. Visits, tests and medicines must be paid for after all.…”

“…But how can you afford the medication and in-dwelling catheters when you are out of a good job". (Study 6) 22…”

“…Therefore, continuous attention to these patients is needed. 18,22 "I spend four hours under this dialysis machine, and every second of it is still part of my life. The nurses should be in of everything.…”