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Implementation of a new pathway supporting vulnerable patients on haemodialysis
Dodds, Annette
Dodds, Annette
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Affiliation
University Hospitals Birmingham NHS Foundation Trust
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Publication date
2024-06-17
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Abstract
It is recognised that the patients attending for dialysis are increasingly co-morbid and complex, however little has been discussed about the increasing numbers of vulnerable patients. This abstract, outlines the implementation of a pathway to support these vulnerable dialysis patients.
In June 2018, NHS improvement produced Learning Disability Improvement Standards to improve access to services. Further documents were also published including,
• Improvements in care of patients with a Learning Disability recognised in the NHS Long Term Plan (Jan 2019)
• ‘Right to be heard’: The Government’s response to the consultation on learning disability and autism training for health and care staff (Mandated - Nov 2019)
In July 2020, the Vulnerabilities team within this NHS Trust, launched the Trust Learning Disability and Autism strategy. The strategy incorporated training, raising awareness and development of standards and implementation of an in-patient pathway. Due to the significant numbers of vulnerable patients being identified amongst the dialysis population, this author decided to adapt this inpatient pathway for the chronic outpatient haemodialysis programme. This process was completed with the support of the vulnerabilities team and launched in the dialysis units in July 2021.
The pathway involved all patients with a diagnosis of LD being identified, passports being completed and uploaded to the main Trust IT system so available if these patients were admitted to hospital. A monthly risk assessment form was also completed to ensure patients were receiving the care they required and were fully supported, carers identified, adaptations made as required, mental capacity assessments completed and best interest meetings arranged.
Quarterly meetings were initiated across the HD service with the link nurses on each unit attending to feedback on progress and to seek advice from the vulnerabilities team. In these meetings it was identified that there were other vulnerable patients suffering with dementia, mental health problems and young adults between the ages of 16 and 25 who also required support. As the Trust developed inpatient pathways for these other vulnerable patients, the pathways were again adapted for dialysis. Staff have received education and training and feel much more confident in raising concerns and supporting their vulnerable patient population.
1500 patients attend regular Haemodialysis sessions within this author’s NHS Trust, across 15 dialysis centres (2 being in acute Hospital settings). A recent audit has identified 31 patients with LD and Autism, 16 patients with dementia, 33 with diagnosed mental health problems and 10 young adults. 75% of our vulnerable patients are cared for within the 13 satellite units utilising the vulnerabilities pathway.
Implementation of this pathway has enabled the dialysis nursing teams to be able to identify vulnerable patients and confidently ensure that they are supported and cared for appropriately as outpatients.
Citation
Dodds, A. (2024) 'Implementation of a new pathway supporting vulnerable patients on haemodialysis'. UK Kidney Week 2024. Edinburgh International Conference Centre: 11-13 June.
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Conference Output