You are tasked to provide a case study that details the most important considerations in taking a patient on their journey from the “Advanced Kidney Care Clinic” to being treated on home haemodialysis.
John is 52 years old and has diabetic kidney disease. He has been under the care of the hospital renal team who regularly monitor his kidney function. He spent several years in the “General nephrology” clinic, before moving to the “Advanced Kidney Care Clinic” which is focused on preparing patients for when their kidney function reduces so much that Renal Replacement Therapy is needed.
John is still working, tries to stay active and enjoys spending time with his children and grandchildren. He has high blood pressure, despite efforts to control it with medication. His biochemistry shows consistently high potassium levels, even though he has received dietetic advice to try and reduce his potassium intake.
John’s kidney Consultant has indicated that his kidney function has dropped to a level where they need to start talking about Renal Replacement Therapy. We would like you to describe the important things that should be considered as John transitions from a patient in the Advanced Kidney Care clinic to being an independent home haemodialysis patient. Things you should include are:
1. Creation of appropriate vascular access
2. What should be discussed when talking to John about the benefits to choosing home HD over in-centre HD
3. What should be discussed when talking to John about the potential issues when choosing home HD over in-centre HD
4. Decisions around the frequency and length of dialysis
5. The dialysis prescription (think about what level of solutes to add to the dialysis fluid)
6. Dialysis equipment required
7. Possible complications with haemodialysis and Safety systems of equipment
8. Commissioning of dialysis equipment
9. Water testing/Good practice
10. Maintaining high quality after installation, equipment, safety, testing, water.
– You can assume that the audience who the presentation is aimed at has a good understanding of renal failure and haemodialysis.
– You can get a significant proportion of marks simply for making sure your presentation is easy to read, formatted well, has appropriate references and has a logical flow and structure.
– The rest of the marks will be divided between each of the ten sections outlined above, with higher marks for more comprehensive and relevant information (i.e. things that are particularly important to think about for home haemodialysis rather than just for dialysis in general)
2000-3000 words. Relevant images, tables or graphs can be included to help illustrate the points you are making. (renal technology)
The Learning Objectives to be assessed in this assignment are as follows:-
1. Knowledge & Understanding
Understand the biology of the kidney and its pathology.
Understand the principles of renal replacement therapy
Critically evaluate healthcare technologies for renal dialysis systems.
Understand the principles of infection control in the dialysis unit
2. Discipline Skills
Exercise significant judgement in the context of integrated and multidisciplinary healthcare technology
3. Personal Transferable Skills
Apply scientific method; solve problems systematically