Minimum of 10 to 12 clinics needed for fellows to give home dialysis without supervision
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ORLANDO — Attending at least 10 to 12 home dialysis clinics provides fellows with the needed training to provide home dialysis independently, according to results of a study of program directors and division chiefs presented, here.
“Right now, it is just check a box – ‘Do you have home dialysis training or not?’ We want to move toward. If they could attend at least 10 to12 clinics, that provides a sense of competency. But we do need to couch this because we are not confident that 10 to 12 home dialysis clinics is the right number to help you get what you need to get. There are also core competencies in home dialysis that we need to develop,” Yuvaram N. Reddy, MBBS, MPH, FASN, of University of Pennsylvania Perelman School of Medicine, told Healio.
In the study conducted as part of the ASN Home Dialysis Task Force, Reddy and colleagues anonymously surveyed 158 program directors and 170 division chiefs of U.S. adult nephrology fellowship programs. They asked about the minimum training fellows should receive before providing home dialysis without supervision and the needed home dialysis training resources.
Overall, 43 program directors and 31 division chiefs responded. Reddy said 72% of programs responded that all their fellows could provide peritoneal dialysis upon graduation, while only 30% of the programs said all their fellows could provide home hemodialysis upon graduation.
As to the question of the minimum training that fellows should have before providing peritoneal dialysis without supervision, 53% of program directors and 35% of division chiefs said between 10 and 12 clinics. As to the question of the minimum training that fellows should have before providing home hemodialysis dialysis without supervision, 56% of program directors and 23% of division chiefs said between 10 and 12 clinics.
Researchers found 33% of program directors and 29% of division chiefs said a minimum of 11 to 15 patients should be seen before a fellow could provide peritoneal dialysis independently. Additionally, 30% of program directors and 26% of program directors said a minimum of three to five patients should be seen before providing home hemodialysis independently.
Reddy said 74% of program directors wanted the ASN to create a virtual case-based home dialysis mentorship program.
“We are not providing the fellowship training that we ought to provide. That is a gap to home dialysis use. We think that increasing the amount of training for fellows would be a great first step in building a pipeline of home dialysis leaders,” Reddy said.
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Reddy YN, et al. FR-517. Presented at: ASN Kidney Week; Nov. 3-6, 2022; Orlando (hybrid meeting).
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