Retention seen as equally important as enrollment to expand home dialysis
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Key takeaways:
- Building enthusiasm about the benefits of home dialysis is key to getting patients interested.
- Retention is just as important as recruiting new patients to home dialysis.
PALM SPRINGS, Calif. — Home dialysis provides a host of benefits for patients, a speaker said here, but enthusiasm and effective education are key in building a successful program.
“Home dialysis offers better outcomes; the psychosocial outcomes are huge,” Marijo Johnson, MSN, RN, CNN, said during a presentation at the American Nephrology Nurses Association National Symposium. “You don’t have to deal with transportation costs, so it is cost-effective for them,” Johnson said. “Patients also use fewer medications.”
All those benefits can lead to an improved quality of life, empowerment and pride in self-care, Johnson said.
After hearing from attendees about their successful home programs, Johnson, a home dialysis nurse at Fresenius Medical Care North America in Grand Rapids, Michigan, offered details on the key components to a successful home dialysis program: education, assessment, training and retention.
“We don’t want to ‘push’ patients to go home,” Johnson. “It should not be about that. We want to make sure that people have the education and the information to be empowered to make an informed choice about their dialysis.”
What helps to empower patients is motivation, Johnson said. “It should be their motivation, not ours” to make the decision to do dialysis at home, she said.
Johnson said there were three components of a good education program. Staff education is key. “We have to make sure we are knowledgeable enough to educate our patients,” Johnson said. “Facility education is equally important. We have to make sure our providers understand home dialysis. That includes the ancillary staff.”
Home dialysis also requires a detailed assessment, Johnson said. “We have to assess the patient; we have to assess the home environment. It is not a small assessment.”
There are a number of perceived barriers for patients who might be candidates for home dialysis, such as financial and social barriers, as well as a lack of pre-dialysis education and care. “Language barriers, the burden of self-care, a lack of trust in the health system and health literacy can also deter patients from taking on the responsibility of home dialysis,” Johnson said.
Those barriers can be managed by providing support for patients, tailoring the educational approach to the literacy level of the patient and provide medical care for patients with chronic kidney disease, Johnson said.
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