An Introduction to <i>dialysis education: Issues, innovations and impact</i>

Jaar, Bernard G.; Choi, Michael

doi:10.1111/sdi.12680

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…In‐center haemodialysis remains the leading form of renal replacement therapy in most countries. This is despite the fact that home therapies result in improved biochemical parameters, clinical endpoints, quality of life and mortality reduction 7 . Given the anticipated increase in need for renal replacement therapies, programs will benefit financially and patients clinically if greater attention is directed toward uptake of home modalities and quality improvement initiatives directed toward program improvement.…”

Section: Current Status Of Home Therapiesmentioning

confidence: 99%

The need for individualizing teaching and assurance of knowledge transmission to patients training for home dialysis

2022

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Patients have varied learning styles and this has implications for home haemodialysis (HHD). Assessment tools directed toward understanding these styles remains understudied. As a consequence, this may lead to substandard retention rates or adverse events in HHD programs. As part of a continuous quality improvement initiative we have aimed to improve our understanding of patient learning styles and consequently tailor home dialysis training to individuals. To objectively determine knowledge translation and comprehension, irrespective of learning styles, we have introduced an objective structured clinical examination (OSCE). This assessment tool allows for further refinement of educational priorities by highlighting both deficiencies and strengths.Thereafter, an exit OSCE ensures patients attain an acceptable standard to complete home haemodialysis independently. We hope this tool will help shape future training criteria for HHD programs and consequently reduce adverse event rates. K E Y W O R D S home dialysis training, individualized education, patient OSCE SUMMARY AT A GLANCE • Patients have individualized learning styles and home dialysis training should be personalized.• Home modalities improve clinical endpoints and are more cost effective than incenter treatment.

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Section: Current Status Of Home Therapiesmentioning

confidence: 99%

The need for individualizing teaching and assurance of knowledge transmission to patients training for home dialysis

2022

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“…Education and care programs provided before patients initiate KRT have long been associated with improved patient outcomes, reduced medical expenditures, and greater rates of home KRT 5–9 . However, as a result of numerous barriers, including limited resources, patient aversion/hesitancy, and provider training, many patients do not receive such education 10–12 . Moreover, it is estimated that between one‐third and two‐thirds of dialysis starts occur with inadequate, if any, predialysis nephrology care (i.e., “crash” starts) or are unplanned in nature, 12,13 all but eliminating the potential for adequate predialysis education and preparation.…”

Section: Introductionmentioning

confidence: 99%

Assessing the impact of transitional care units on dialysis patient outcomes: A multicenter, propensity score‐matched analysis

Blankenship

Usvyat

Kraus

et al. 2023

Hemodialysis International

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Introduction Inadequate predialysis care and education impacts the selection of a dialysis modality and is associated with adverse clinical outcomes. Transitional care units (TCUs) aim to meet the unmet educational needs of incident dialysis patients, but their impact beyond increasing home dialysis utilization has been incompletely characterized. Methods This retrospective study included adults initiating in‐center hemodialysis at a TCU, matched to controls (1:4) with no TCU history initiating in‐center hemodialysis. Patients were followed for up to 14 months. TCUs are dedicated spaces where staff provide personalized education and as‐needed adjustments to dialysis prescriptions. For many patients, therapy was initiated with four to five weekly dialysis sessions, with at least some sessions delivered by home dialysis machines. Outcomes included survival, first hospitalization, transplant waiting‐list status, post‐TCU dialysis modality, and vascular access type. Findings The study included 724 patients initiating dialysis across 48 TCUs, with 2892 well‐matched controls. At the end of 14 months, patients initiating dialysis in a TCU were significantly more likely to be referred and/or wait‐listed for a kidney transplant than controls (57% vs. 42%; p < 0.0001). Initiation of dialysis at a TCU was also associated with significantly lower rates of receiving in‐center hemodialysis at 14 months (74% vs. 90%; p < 0.0001) and higher rates of arteriovenous access (70% vs. 63%; p = 0.003). Although not statistically significant, TCU patients were more likely to survive and less likely to be hospitalized during follow‐up than controls. Discussion Although TCUs are sometimes viewed as only a means for enhancing utilization of home dialysis, patients attending TCUs exhibited more favorable outcomes across all endpoints. In addition to being 2.5‐fold more likely to receive home dialysis, TCU patients were 42% more likely to be referred for transplantation. Our results support expanding utilization of TCUs for patients with inadequate predialysis support.

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An Introduction to dialysis education: Issues, innovations and impact

Cited by 2 publications

References 24 publications

The need for individualizing teaching and assurance of knowledge transmission to patients training for home dialysis

The need for individualizing teaching and assurance of knowledge transmission to patients training for home dialysis

Assessing the impact of transitional care units on dialysis patient outcomes: A multicenter, propensity score‐matched analysis

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