Dialysis Clinical Paper

Ms. Mancinho continues to strive for excellence and patient care improvements in her position as staff nurse in the hemodialysis unit. She is currently the primary nurse for five of our chronic dialysis patients. All of her primary patients exceed recommended adequacy guidelines and maintain patent, infection free arterial venous fistulas/grafts. While participating in monthly interdisciplinary care plan meetings, she makes suggestions that have led to positive outcomes such as: changes in dry weights, reviews of patients medications with the nephrologist to facilitate warranted medication adjustments as needed, referrals/close coordination with other disciplines such as podiatry and wound care to prevent infection/amputation in patients with advanced vascular disease, and endocrinology for educational purposes for well controlled blood sugars. She is able to quickly assess subtle changes in her patients to then notify the charge nurse and physician for appropriate guidance in facilitating positive patient care outcomes. Through her acute assessment skills she prevented an access from clotting. Prevention of clotting leads to extended longevity of the access. She applies the nursing process to systems or processes at the team/unit/work group level to improve Veteran care. She worked with flow in the new unit which led to better patient care and staff satisfaction. She developed the time out policy: a requirement for

My job has double check for all iv medication that is given. There are no verbal orders the team must place the order while rounding or within 10 mins of the conversation. We encourage family and patient to ask questions. Doing the right thing even if it’s not your patients. In a case where a RN was applying cream to a sacral wound that had eschar. It was encouraged to do a wet to dry and call for consult with wound team. It is never easy to give advice to a coworker that is season; however, it is never easy to watch a person perish due to staffing errors. Huddles are great way to get information across without placing blame. Giving advice in a non-judgmental way to coworkers. Continues education and begin a resource are a few ways to ensure patient

When I arrive to the facility this morning I was informed that one of the patients had passed away during the night, which was quite sad. Today I was in the acute ward all day and was able to watch the RN perform an ECG on a man that was bought in via ambulance who was complaining of chest pain. I watched as she placed the ECG leads on different positions of the chest. The RN showed me what a normal heart rate should look like. I also went around the ward taking OBS and notice that one of the patient's O2 levels were very low at 73%, the RN then gave the patient some ventolin through a mask to increase oxygen levels and they rose to 95%. The RN also showed me the medication charts and how they are to be read. I went around with her watching

During the transitioning process to the new hemodialysis unit, Ms. Conlon anticipated the challenges acquired by learning to set up and use new water equipment in an acute situation. In response to this, Ms. Conlon created and implemented a reverse osmosis flow sheet to assist her colleagues with the quick set-up of the portable RO in the ICU care setting. This tool resulted in a smoother transition for her colleagues, improvement in the delivery of care to the acute dialysis patient, and a decrease in the possibility of staffing overtime.

Cetiner is the primary nurse for four dialysis patients. She tends to all of their complex needs as she strives to improve their outcomes. She delivers care in a manner that preserves patient autonomy, dignity and rights. This is evidenced by all four patients exceeding unit/network benchmarks in adequacy, access and anemia management. She became an advocate for a Veteran who lives in a nursing home and has no family, resulting in improvement of care. She diligently worked with one Veteran to avoid multiple hospital admission for fluid overload. She developed a treatment program along with the Medical Director to manage the patient’s fluid both during and after the hemodialysis treatment. She has provided much support to one of the Veterans with many socioeconomic issues ultimately affecting his treatment. Because of her due diligence with his non- compliance he now stays for his entire treatment on a regular basis

Patients who use peritoneal dialysis change their own cleansing solutions at home, usually about six times per day. This procedure can be done manually when active or automatically by machine when sleeping. However, the patient’s overall condition, as well as the positioning of the catheter, must be monitored regularly by nurses and technicians at the Dialysis Center (Gapenski, pg. 27-28). The Outpatient Clinic currently takes up 80 percent of the space it shares with the Dialysis Center. The recent growth in volume has created a need of 25 percent more space for the Clinic. Its large size compared to the Dialysis Center and its patients frequent use of other departments in the hospital are justifications as to why it was decided to move the Dialysis Center to another building. Big Bend Medical Center currently doesn’t have adequate space to house the Dialysis Center, so it was also decided to build a new 20,000-square-foot building. This expansion and move were went to benefit both departments and help increase patient volume. The goal of increased patient volume is expected, but the directors and other department heads did not agree with the new allocation of indirect costs. In the past, facilities costs were aggregated, so all departments were charged cost based on the average embedded cost regardless of actual age of the space occupied. Since many department heads considered this

You, as a staff member have to realize that each patient is an individual. Each patient has unique healthcare needs. There are

Patients require continuous treatments up to 3 times a week as they wait for a kidney transplant, while others are reliant on lifelong dialysis treatments due to their ineligibility of being a transplant recipient. Since wait times for kidney transplants can extend into several months and years, the cost incurred for these patients in relatively high. With the incidence of ESRD on the rise, there is a continuing need to provide services to address it. Healthcare organizations are expected to adapt their healthcare delivery models to address this increase of ESRD pertaining to kidney failure while staying financially viable.

The dialysis bag is comparable to a cell membrane. They are similar in the sense they are both semi-permeable. Smaller molecules can pas through the tubing however larger ones cannot. An obvious difference would be the composition of the tubing compared to the membrane. Another difference is that although they both are semi-permeable, the tubing simply works depending on the size of the molecules, while a cell membrane depends on a multitude of things such as ions and receptors, etc.

Delegated tasks, and monitoring all direct-patient staff, including LPNs and Dialysis Assistants, assessed care needs and developed

The usual way was to log onto a computer (if not in use); look for the patient and quickly skim the patient’s history, resulting in wasted time. The result was a flow sheet that was easily accessible, located in front of the patient's bedside chart. The flow sheet included pertinent information from the patient’s last two hemodialysis treatments. We received positive feedback from the staff, and the flow sheet was adopted in the unit. After one year, the project was reviewed and continued to receive positive

The option that is most frequently used to treat the disease is dialysis. Dialysis takes a person blood and passes it through an artificial dialyzer which removes toxins and extra fluids from the patient’s blood. In addition to the “Core curriculum for the dialysis technician: a comprehensive review of hemodialysis” dialysis can be done in centers or at the patient’s own home, most of the time it’s done in centers three times a week for four hours.

As a dialysis nurse I am tasked with providing pre and post treatment assessments for each patient and through these assessments I identify if there are any patient problems that must be managed. These problems can include access issues, such as clotting or infection, fluid related problems and many others. If a patient is short of breath or complains of chest pain prior to

In Kidney failure cases urea, creatine, uric acids and electrolytes move from the blood to the dialysate with the net effect of lowering their concentration in the blood. RBC s WBC s and plasma proteins are too large to diffuse through the pores of the membrane. Hemodialysis patient are exposed to 120 to 130 L of water during each dialysis treatment. Small molecular weight substances can pass from the dialysate in to patient’s blood. So the purity of water used for dialysis is monitored and controlled.

Kidney failure is a public health problem, which has dramatic effects on patients' health. In some