Feasibility of a hemodialysis safety checklist for nurses and patients: a quality improvement study

Abstract

BackgroundPatients with end-stage renal disease are at high risk for medical errors given their comorbidities, polypharmacy and coordination of care with other hospital departments. We previously developed a hemodialysis safety checklist (Hemo Pause) to be jointly completed by nurses and patients. Our objective was to determine the feasibility of using this checklist during every hemodialysis session for 3 months.MethodsWe conducted a single-center, prospective time series study. A convenience sample of 14 nurses and 22 prevalent in-center hemodialysis patients volunteered to participate. All participants were trained in the administration of the Hemo Pause checklist. The primary outcome was completion of the Hemo Pause checklist, which was assessed at weekly intervals. We also measured the acceptability of the Hemo Pause checklist using a local patient safety survey.ResultsThere were 799 hemodialysis treatments pre-intervention (13 January–5 April 2014) and 757 post-intervention (5 May–26 July 2014). The checklist was completed for 556 of the 757 (73%) treatments. Among the hemodialysis nurses, 93% (13/14) agreed that the checklist was easy to use and 79% (11/14) agreed it should be expanded to other patients. Among the hemodialysis patients, 73% (16/22) agreed that the checklist made them feel safer and should be expanded to other patients.ConclusionsThe Hemo Pause safety checklist was acceptable to both nurses and patients over 3 months. Our next step is to spread this checklist locally and conduct a mixed methods study to determine mechanisms by which its use may improve safety culture and reduce adverse events.

The Effect of Nursing Instructions on Nurses’ Knowledge, Practice and Suggestions Regarding Adverse Events in Hemodialysis

“…On the other hand, these results correspond with many studies [18,19], who stressed that hemodialysis nurse, should have knowledge of types and causes of adverse events to identify related risks and situations that affected the patient safety and led to prevent patient harm and ensure the quality of care. Also, [20], stressed in his report that providing safe care to the patient that depends on nurses' qualifications to detect factors which contributed to adverse events occurrence.…”

Dynamic risk assessment in healthcare based on Bayesian approach

“…The process of hemodialysis is illustrated in Fig. 2 [19,20]. Specifically, nurses cannulate the vascular access, and connect them to electronically controlled dialysis machines.…”

Protocol on: Evaluate the Effectiveness of Nursing Protocol on Knowledge and Practices Regarding Hemodialysis Care among Professional Staff

“…Chronic renal failure is medically managed with fluid adjustments, correction of electrolyte imbalances, proper low protein diet, and drug. dialysis and renal replacement are the ultimate renal replacement therapy [11,12].…”