Abstract: SA-PO916
The Effect of Interim Assessment on Home Hemodialysis Patient Readiness
Session Information
- Dialysis: Home Hemodialysis
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Hemodialysis
Authors
- Saiprasertkit, Nalinee, University Health Network, Toronto, Ontario, Canada
- Chan, Christopher T., Toronto General Hospital, Toronto, Ontario, Canada
Background
Studies have demonstrated the favorable clinical outcomes and better quality of life of home hemodialysis (HHD) compared with conventional hemodialysis. Teaching strategies to ensure the patients’ ability to administer their own therapies safely without supervision at home is fundamental to the success of home hemodialysis. Several studies showed mid-training assessments followed by final assessment at completion of training improved learning outcomes. The purpose of this study is to determine the impact of interim assessments on the readiness of HHD before transitioning home.
Methods
This is a prospective feasibility study examining consecutive end stage renal disease (ESRD) patient and caregiver who were undergoing HHD training between September 1, 2017 to May 31, 2018. Every potential home hemodialysis candidate was observed for their hemodialysis performance skills and asked basic knowledge questions regarding hemodialysis by an independent HHD nurse after 16 sessions of HHD training and at the end of training. HHD candidates and training nurse were provided feedback for observed errors. The confidence in performing dialysis at home was assessed by global rating scale (GRS) in every HHD patient and their primary nurse before and after every interim assessment.
Results
Of 11 candidates; 9 candidates were ESRD patients, 2 candidates were ESRD patients’ caregivers. Mean age was 47.3 ± 14.3 years, 63.6 % was male, 54% was Asian, 81.8% graduated from college or higher education, 54% used central venous catheter for vascular access.The confidence level scores in performing HHD in both candidates and primary nurses before the 2nd interim exam was significantly higher than the 1st interim exam (57.6 vs 64.4 (p 0.014); 53.1 vs 60.3 (p 0.026). The confidence level scores in performing HHD in both candidates and primary nurses before the 2nd interim exam was significantly higher than the 1st interim exam (57.6 vs 64.4 (p 0.014); 53.1 vs 60.3 (p 0.026).
Conclusion
Interim observed evaluation is a feasible strategy to enhance patients and nurses' ability to train a complex medical procedure. Prospective evaluation of the clinical impact of interim training evaluation on adverse outcomes warrant further evaluation.