Anaemia management protocols in the care of haemodialysis patients: examining patient outcomes

Abstract

Using a nurse-driven protocol in practice supports the independent nursing role while contributing to safe patient outcomes.

Nurse Staffing and Renal Anaemia Outcomes in Haemodialysis Care

“…), it is challenging for the renal care team to achieve and maintain target levels (Saunders et al . ; Trowbridge et al . ).…”

“…The monitoring of haemoglobin levels, plus ESA and iron dosing has traditionally been within the physician's role but current trends place greater emphasis on the decision‐making role of the nurse in renal anaemia management (Macdonald ; Saunders et al . ). According to Macdonald (), renal nurses have a central and wide‐ranging role in optimising the renal anaemia management, although the use of nursing time for these tasks is suboptimal.…”

“…However, the challenge to achieve and maintain target levels with current treatment options involves frequent review of patient blood work and adjustment of ESA and/or intravenous iron doses and consequently compounds a significant workload for the renal care team (Saunders et al . ; Trowbridge et al . ).…”

A nurse prescriber‐led protocol for anaemia management in established haemodialysis patients: A retrospective study

“…Renal nurses are in an ideal position to identify, assess and manage anaemia and well placed to implement and audit new approaches to improving anaemia‐related outcomes. Traditionally, management of anaemia was physician led with minimal input or action from nurses (Saunders, MacLeod, Salyers, MacMillan, & Ogborn, 2013). The emergence of erythropoietin therapy, however, saw renal anaemia advance as a renal nursing speciality including the development of the anaemia co‐ordinator role.…”

“…Protocol‐based anaemia management using algorithms provides a method of focusing attention on the importance of maintaining haemoglobin levels within target range. Using such protocols is another advance in nurse‐led renal anaemia management (Chan, Moran, Hlatky, & Lafayette, 2009; Kotwal et al., 2013; Nhan, Jensen, & McMahon, 2007; Patterson & Allon, 1998; Perkins et al., 2007; Rogers et al., 2011; Saunders et al., 2013; Yong & Kairaitis, 2010). Nurse‐led protocol‐based anaemia management results in greater consistency in care and improves outcomes including achieving targeted haemoglobin levels and less haemoglobin variability particularly above the target level (Chan et al., 2009; Kotwal et al., 2013; Patterson & Allon, 1998; Perkins et al., 2007; Yong & Kairaitis, 2010).…”