LAS VEGAS–Having a dialysis patient hospitalized can disrupt their routine and their dialysis prescription. So it is important that both dialysis staff – and the patient – understand how the experience impacts overall patient health.
That was the message heard at a well-attended session at the American Nephrology Nurses’ Association annual conference this week on improving communication between hospital acute dialysis staff and outpatient staff when a patient needs care. It is just as important for the patient to keep track of the care they received—the medications, the procedures, tests, etc.—as it is for the outpatient staff once the patient returns to the clinic.
Debra Castner, MSN, APN, CNN, the facilitator for the session, entitled “Care coordination: Improving clinical outcomes in patients with AKI and CKD,” encouraged attendees to look at communications tools offered by the Society of Hospital Medicine. The toolkit, called the Better Outcomes by Optimizing Safe Transitions, or BOOST (www.hospitalmedicine.org) is a national initiative aimed at the care of dialysis patients as they transition from hospital to home, but Castner told the audience that many of the communication tools and check lists can be adopted to dialysis care.
This week, The Renal Network Inc. also released a toolkit to help outpatient staff track information about dialysis patients during a hospital stay. More information on that program can be found here.
Follow the trail
Developing a paper (or a virtual) trail of patient/staff interactions requires knowledgeable nurses on the hospital acute dialysis staff side and the outpatient dialysis staff side, said Castner. Effective communications is also important in resolving problems between nursing homes and outpatient clinics. Patients may not always be compliant between dialysis sessions, and it can be challenging to get nursing home staff to take on the responsibility of following a patient’s dietetic regimen.
Some important tips:
- Getting a discharge summary is helpful. Sometimes nephrologists can do a hospital consult but don’t follow the dialysis patient through discharge.
- There may be different data collection software used by the hospital and the outpatient dialysis facility. HIPPA can also sometimes make it difficult to get an assessment. Make sure the patient walks out with a copy of his/her discharge summary.
- Dialysis patients, in fact, can be a source of information and an information gatherer. “We have the ability to empower patients who can be the squeaky wheel,” noted one nurse. “Give patients with some experience to take charge of their own dialysis. Give them something to do. Have your dialysis patients ask their floor nurses, ‘What is my hemoglobin? What is my hemoglobin?’ Let them advocate for themselves.”