6 Month Experience with 1 Nurse Training 2 Patients Together for Nightly Home Hemodialysis
To have 1 nurse successfully train 2 patients at a time for nightly home hemodialysis (NHHD) within a 7–10 week time period. Methods:
Over the past 6 years, Lynchburg Nephrology Dialysis Inc. has evolved its NHHD program from 1 nurse training 1 patient during an average 6 week period to training 2 patients in a 7–10 week period. Patients came either from our in-center population or directly from internal medicine. Our pre-evaluation procedures and manual were revised. Patients were pre-evaluated for literacy, manual dexterity, strength, hearing and visual deficits, substance abuse, psychiatric disorders, and compliance before being accepted into the program. A home visit was made to evaluate their environment, family interactions, and water source. Our training manual was rewritten to fifth grade level. Every patient was given index cards printed in 20 size font with step-by-step procedures for machine setup, put-on and takeoff, re-circulation, and power failure. Patients were dialyzed 4 days/week to improve cognitive function and ‘dialyzed the bucket’ 1 day, thus training 5 days/week. One nurse trained 2 patients, staggering their start dates 2 weeks apart to allow for both individual and group teaching. Fistula or IJ catheter was used for access. Patients were trained alone or with a partner. In the last week of training, patients were dialyzed for 7 h and were expected to complete all procedures independently. Results:
From March 2003 to August 2003, 6 patients were trained for NHHD. 2 patients finished training in 7 weeks, 2 in 9 weeks, and 2 in 10 weeks. Conclusion:
One nurse can successfully train 2 patients at a time for NHHD in a 7–10 week time period at a decreased cost to dialysis provider.
Document Type: Research Article
Affiliations: Lynchburg Nephrology Dialysis Inc., Lynchburg, VA, U.S.A.
Publication date: 2004-01-01