Ms Dong Wang1, Mr Matthew Harvey1, Ms Rita Carmel O’Neill1, Ms Ellen Ramas1, Ms Kate O’Brian1
1Eastern Health Victoria, Melbourne, Australia
Home haemodialysis improves survival and quality of life compared with haemodialysis delivered in hospital-based units. Access damage caused by poor technique is the main reason that leads to a hospital stay, surgery, loss of lifelines. AVF plastic cannula was introduced to our unit to determine the reliability of using plastic cannula on home haemodialysis patients.
A literature review was conducted to evaluate and provide the rationale and justification for this project, followed by a plan including staff training, patient selection, and measuring instruments. Budget costs are itemised to compare the current programme with using plastic cannula. The patient training programme is tailored to meet the individual circumstances, ongoing evaluation and monitoring to ensure that patient safety is not compromised during project.
As of July 2019, a total of 8 patients were trained using plastic cannula successfully at home. Two patients were discharged as they had received kidney transplants and one patient was transferred to satellite units due to unresolved access issues. Two patients were discharged from home therapy as deterioration of medical and cognitive condition; three patients continued home haemodialysis using plastic cannula.
We found that using plastic cannula can reduce access-related issues, patients also reported significantly increased satisfaction with home therapy due to less fears and anxiety. As no sharps are produced, it is proven to be safer and more cost effective compared to existing programmes using metal AVF needles for home based haemodialysis patients.
I aspire to conduct myself in my chosen profession as an advanced level specialist renal nurse. I have been involved in the development of nursing evaluation tools and treatment planning skills for myself and fellow nursing professionals, and have expertise in haemodialysis (acute and chronic), peritoneal dialysis, nurse education, patient training and independent patient assessment. I also have participated in number of research projects pertaining to advancing renal health care.
As a nurse, I believe that we should be prepared to be challenged and keep current with new developments. I completed my Nephrology care certificate in 2007 and, in 2013, I completed a Master of Nursing degree specializing in renal care.