Helen Jefferies
Cardiff and Vale University Health Board
Shared Care Haemodialysis supports patients receiving haemodialysis in dialysis units to participate in aspects of their dialysis care, from measuring weight and blood pressure, to full independence in performing their own dialysis treatment. Shared Care can be a springboard to encourage patients to consider dialysing at home. There is a UK-wide drive to increase rates of Home Haemodialysis, which offers patients the opportunity to perform more frequent, individualised dialysis compared to standardised dialysis regimes in a dialysis unit, associated with better quality of life and patient-reported outcomes.
Currently, Shared Care delivery rate is low and highly variable between dialysis units. Units are run by independent dialysis companies contracted by the Health Board. There is organisational and geographical separation between the NHS and dialysis unit staff, which presents challenges to embedding a South-Wales wide initiative.
The Project:
The project idea is to create an active South Wales Shared Haemodialysis Care Collaborative Network of NHS medical, nursing and administrative staff, dialysis unit staff, patients, and kidney charities. The aim is to make Shared Haemodialysis Care a cultural norm along the entire patient journey, from first receiving education to beginning haemodialysis treatment, progressing if desired to dialysis at home.
How this will be achieved:
All staff involved in the patient pathway will be trained to understand Shared Care, so they can confidently explain the process and benefits to patients and carers. Shared Care will be offered and promoted to all patients who currently dialyse in a unit or may start haemodialysis treatment in the future. NHS and dialysis company staff will collaborate to develop individualised care plans to support patients to achieve their goals.
Anticipated benefits:
Shared Care improves patient experience, generates confidence and motivation to self-manage, and self-needling of fistulas reduces reported pain. Staff benefits include better job satisfaction, improved relationships with patients and improved job opportunities.