Implementing Change to Improve the Paediatric Haemodialysis Experience
- Slides: 12
Implementing Change to Improve the Paediatric Haemodialysis Experience Rachel Yeomans 25 February 2016
Contents Background and Context Unit Composition Initial Changes and Progression Weekly Meetings and Guidelines Staff Roles Aspirations Questions Implementing Change to Improve the Paediatric Haemodialysis Experience 2 January 2022
Context Over the past 18 months the unit has undergone significant changes A team of core staff has been developed, consisting of: Implementing Change to Improve the Paediatric Haemodialysis Experience 3 Four staff nurses Two sisters One clinical support worker One renal consultant January 2022
Unit Composition The unit currently has 13 patients, is open six days a week, and runs a 24 hour on-call service This service supports patients in all areas, who may require haemodialysis, plasma exchange or peritoneal dialysis Implementing Change to Improve the Paediatric Haemodialysis Experience 4 January 2022
Initial Changes Introduced monthly reviews with the consultant and senior nurse of all patients Developed a pro forma for reviews that ensures all appropriate bloods, heights and screens are carried out in a timely manner Implementing Change to Improve the Paediatric Haemodialysis Experience 5 January 2022
Implementing Change to Improve the Paediatric Haemodialysis Experience 6 January 2022
Progression Rearranged notes and introduced dividers Nursing documentation Medication check with families MDT results ward round, dietician, nurse and doctor Feed on unit, binders given on HD if they eat Manual BPs on all patients, equipment purchased and staff trained One Alfacalcidol given on the unit to improve adherence and reduce meds at home Implementing Change to Improve the Paediatric Haemodialysis Experience 7 January 2022
Weekly Meetings Weekly meetings with nursing staff One transplant work-up update Two results meetings Implementing Change to Improve the Paediatric Haemodialysis Experience 8 One service improvement January 2022
Guidelines Structured approach to line locks Tinzaparin anticoagulation Implementing Change to Improve the Paediatric Haemodialysis Experience Line sepsis and first line antibiotics 9 Equipment review Protocol in place, devised by the pharmacist and renal consultant for the use of Tinzaparin January 2022
Staff Roles ● Aiming for each nurse to acquire additional roles: – Unit leads – Transplant work-up – Infection control and dressings – Student supervision – Family liaison and charities – IQP, administration and unit decoration Implementing Change to Improve the Paediatric Haemodialysis Experience 10 January 2022
Aspirations Improve position in Renal Registry league tables Electronic monthly reviews, ICE panel Pharmacy input to monthly reviews Costing of service – currently in progress Senior nurses to complete prescribing course HDF and home haemodialysis and consideration that the unit could become a regional training centre Implementing Change to Improve the Paediatric Haemodialysis Experience 11 January 2022
Questions? Implementing Change to Improve the Paediatric Haemodialysis Experience 12 January 2022