We have recently started sending our VAD patients (both LVAD and biVAD) to outpatient dialysis. We chose one center and provided them with training and equipment. I know some VAD centers do not even provide monitors but just have the patients on battery during dialysis.
VADs are intended to permit people with heart failure to live as near a "normal" life as possible. That includes going to wherever. As the technology has improved, the restrictions on patients requiring 24/7 caregivers etc have been lifted. However; most patients, even those going to outpatient dialysis, have spouses that will accompany them. It's a win-win; the dialysis center gets a steady flow of VAD patients (well only <10% of ours need ongoing dialysis after discharge), and the VAD patients get to live at home and attend outpt HD.
As mentioned by someone else, your patient's VAD center is going to be your best friend. They can coordinate with the device manufacturer to provide literature and education if you want it before accepting the patient.
Assuming the patient has a Heartmate II rotary pump - the main issues we had in setting up were:
1. Regular automated blood pressure cuffs generally don't work because the patients have minimal pulsatility. We send out patients home with handheld dopplers to measure their BP so we considered having them take it to dialysis but ended up getting the automated Terumo blood pressure cuff that has a "low pulsatility" mode.
2. Fluid management - this is where we decided to give the dialyis center a monitor for the pt to hook up to. They can read the flows constantly and very easily tell by either the flow or another parameter (PI, or pulsatility index) if the pt is getting hypovolemic. Honestly though clinical signs are your best sign - if they are lightheaded, get palpitations (low volume can irritate the ventricle and give you PVCs), back off on the fluid removal.
The things I can tell you as reassurance - the patients know how they usually feel. They are very used to being overloaded and then "underloaded".. and they can tell the difference. If they are sitting talking to you and warm and perfused, they're ok. Our dialysis staff were clear that they were not responsible for the VAD, and the patient was clear on that too -they were responsible for their device. One of our VAD coordinators went down for the first treatment as reassurance for both the dialysis staff and the patient. We're lucky that the center is down the road from our hospital, but if there was a patient we were worried about, we'd be doing the outpatient dialysis in our hospital facility and not sending them off campus.
Thoratec's website has an "eUniversity" that allows you to sign up, get manuals, watch presentation, watch videos, do learning modules and quizzes etc if interested.
Again, though, use the patient's VAD coordinator - that's what they are there for. We do community/EMS/PCP/dialysis education all the time. I'm actually very surprised this is a potential plan and you haven't yet been contacted by the VAD coord.
If you need anything, or don't know who the VAD coordinator is to contact, send me a PM with the hospital name and I can probably tell you.