Patient and Facility Safety in Hemodialysis

Abstract

SummaryPatient safety is the foundation of high-quality health care. More than 350,000 patients receive dialysis in the United States, and the safety of their care is ultimately the responsibility of the facility medical director. The medical director must establish a culture of safety in the dialysis unit and lead the quality assessment and performance improvement process. Several lines of investigation, including surveys of patients and dialysis professionals, have helped to identify important areas of safety risk in dialysis facilities. Among these are lapses in communication, medication errors, patient falls, errors in machine and membrane preparation, failure to follow established policies, and lapses in infection control. The quality assessment and performance improvement process should include a dedicated safety team to focus on specifically identified areas of risk and to establish outcome goals guided by best practices and agreed-upon measures of success. A safety questionnaire can be given to patients and staff and the responses evaluated to improve understanding of the prevailing attitudes and concerns about safety. By sharing these results, openly acknowledging the challenges, and using a blame-free root cause process to identify action plans, the facility can begin to establish a culture of safety.

Patient Safety: What Is It All about?

“…2 ). Garrick et al [23] report about the results from a survey among ESRD patients and professionals commissioned by the US Renal Physicians Association. In this survey study, 49% of patients reported to be worried about safety at least sometimes.…”

“…(3) The specific device should be called out when delivered onto the operative field. Based on adverse event studies and reports, a number of specific risk reduction strategies for dialysis units have been recommended recently [17,23] . These include for example: -Independent double checks of i.v.…”

The Evolving Role of the Medical Director of a Dialysis Facility

“…Finally, true population management requires the medical director to work with the interdisciplinary team, attending nephrologists, and patients to engage patients in their own care, which is essential for driving the best outcomes. The need for discreet population management skills is consistent with the requirement for medical directors to provide a patientcentered safe environment of quality care as articulated by Medicare in its Quality Strategy Document 2014 (14).…”

Enfermagem E Metas Internacionais De Segurança: Avaliação Em Hemodiálise

“…Estudos internacionais mostram que os principais problemas relacionados à segurança do paciente em hemodiálise envolvem quedas, erros de medicação, eventos relacionados a acesso venoso, erros de dialisador e sangramento prolongado (16) .…”