¶ … Education of Hemodialysis-Dependent Patients Concerning the Use of Phosphorus Binder in Lieu of Dialysis during Emergencies
Clinical Leadership Theme:
The clinical leadership competency/role and/or magnetism thread that is the framework for this project requires effective transformational leadership practices that can motivate all stakeholders to become educated concerning the use of phosphorus binders in lieu of dialysis (Cook, 2004).
Patient: Hemodialysis-dependent patients
Intervention: EDUCATE and train to use phosphorus binder
Comparison: in lieu of no hemodialysis treatment during power outage or emergency
successful return demonstration of how and when to use phosphorus binders
Time: 80% of 99 patients educated by August 30, 2015.
Project overview:
This project involves training selected clinical staff members to provide educational support services to hemodialysis-dependent patients concerning the use of a phosphorus binding drug, Renagel to prepare them for the event of an emergency situation when dialysis services are unavailable.
AIM statement: The AIM statement that will guide this initiative is as follows: By August 15, 2015, 80% of hemodialysis dependent patients will be educated and prepared/trained to use phosphorus binder in lieu of hemodialysis treatment during power outages or other emergency situations.
Rationale:
The use of phosphorus binders for hemodialysis patients is not new, and the original binders were aluminum-containing phosphorus that were shown to be highly effective in lowering phosphorous levels; however, these original phosphorus binders resulted in multisystem toxicity and their use was therefore discontinued for the most part (Beyzarov, 2009). An alternative was found in calcium-containing binders which were regarded as safer but this intervention was found to cause accumulation of calcifications in multiple tissues that resulted in increased patient mortality, especially among patients with advanced stage chronic kidney disease and their use was largely discontinued as well (Beyzarov, 2009).
Since its approval, the use of non-calcium-, non-aluminum-containing phosphorus binders gained increased acceptance by the healthcare community following the publication of the results of a study in Kidney International that showed patients who were treated with sevelamer experienced significantly lower mortality rates related to the control of coronary artery calcifications vs. patients who were treated with calcium-based phosphate binders (Beyzarov, 2009). These drugs represent potentially life-saving alternative treatments for hemodialysis-dependent patients during emergency situations when power is lost or dialysis equipment is otherwise inoperable (Lemieux & Chamberlinon, 2015).
Methodology:
a. Kotter's Eight-Step Model (change theory) applies perfectly to the development of my educational project on phosphorus binder for dependent hemodialysis patient. Kotter's model is best viewed as a vision for the change process and for avoiding major errors in the change process (Mento, Jones & Dirndorfer, 2002). The model calls attention to the key phases in change process. The Kotter's eight-phase model proposed as follows below.
1. Establish a sense of urgency because opportunities or crisis demand a change now. The development of this project was based on urgent need for change. After national earthquakes, hurricane and general power outages, it was found that hemodialysis-dependent patients did not have an alternate solution available during emergency situations.
2. Create a guiding team to form change agents with credibility, authority and skill to assist in the change process -- We have established a core team of educators that go from patient to education and answer questions.
3. Develop a change's vision and strategy -- Part of the education process is making sure that each patient understands the need for phosphorus binders when an emergency hits and they cannot get to dialysis treatments.
4. Clearly communicate the change vision -- This is done both in group as well as one-on-one with patients. All well trained team of educators that have the same vision so that the same education is provided to each and every patient.
5. Empower the individuals involved in the change process by removing obstacles, changing structure, rewarding new ideas. This is the main goal of my project, to empower patient with the knowledge they need when my nurse team and myself cannot be there. Giving each individual the booklets and medication is not enough to ensure their survival during a power outage or earthquake when they cannot get needed dialysis treatments.
6. Generate short-term success, celebrate and reward early success -- This step is not yet developed, but there is talk for creating a plan to celebrate patient successes.
7. Consolidate gains and continue change -- This is part of the long-term plan to including phosphorus binder in all education for all future patients.
8. Make change stick to anchor new behavior into the culture.
Hemodialysis on End Stage Renal Disease Patients and the Increasing Role for the Nurse It is a difficult condition of a kidney failure when one's kidney could no longer carry out the proper metabolism system to eliminate waste products. Kidney is the essential organ that is responsible in waste elimination, including others like detoxification process of drugs and toxic materials, also in controlling water balance, salt balance, blood pressures and
Introduction, Analysis of Existing Evidence, and Quality Improvement Process Hemodialysis patients are at high risks of infection due to their impaired immune defenses and repetitive access of the bloodstream via vascular access types. The treatment process of hemodialysis involves using different processes and equipment that sometimes worsen the patients’ conditions. For example, frequent antibiotics administration to these patients generates antimicrobial resistance and multidrug-resistant organisms. Central venous catheters (CVCs) are among the
The client has had major feelings of not being able to cope with what is happening to him. He has "forgotten" about dialysis appointments and has even avoided doctors' phone calls. I have told him that they way he behaves will have a direct impact on his physical condition. When a kidney patient becomes ambivalent about his diet, forgets to take his medication, or abandons fluid restrictions, all of these
Thirdly they used member checks in which participants were asked to comment on the data themes and the researcher's interpretations in a follow-up telephone call. Lastly an extensive literature review was conducted prior to the start of the research (Landreneau and Ward-Smith, 2007). Philosophical and Theoretical Connectedness The researchers stated that in reviewing the literature, there was only one study found that addressed patients' perceptions concerning their choices, and this choice
Physicians, however, prefer hemodialysis because of reimbursement trends (Wellbery). Dietary Changes - Many patients also prefer peritoneal dialysis to hemodialysis because the latter restricts the diet (NKUDICC 2000). Peritoneal dialysis removes body wastes slowly but it always does. In hemodialysis, on the other hand, wastes can build up for two or three days between treatments. In addition, a patient on hemodialysis must observe a restrictive diet. Some clinics help plan
In an acute care setting, such Veterans Affairs, this objective is executed by educating patients about how to maintain a healthy diet and lifestyle after the leave the facility, while in a long-term care setting-such as Cobble Hill-this objective is executed on a daily basis by providing nutritious meals for elderly residents. And finally, in an ambulatory, out-patient care setting-such as Atlantic -- the clinical nutritionist works to support
Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.
Get Started Now