Looking for info for research project

nutella, MSN, RN · Jun 17, 2016

I'm a current nursing student who has an assignment to research standards of care for inpatient hemodialysis, particularly pre-dialysis protocols (i.e., what floor nurses should be doing or not doing before sending patients to dialysis).
This is a group project, and I'm in charge of researching professional standards for this particular area. What I'd LOVE some help with would be any links to standards of care published either in professional journals or a professional organization website. Also, if you know of research articles in this area, I'd really like to hear about those as well.
Thanks so much in advance for any help in this area.

The problem is that there are not many standards for acute dialysis patients and what nurses should or should not do is based on a couple of things. I can give you some ideas to start you off but you have to do research in the online/school library.

Acute dialysis is different from chronic dialysis because patients are usually acutely ill on top of what else is going on or they get started on dialysis.

What to consider:

Safety Concerns:

1.Handoff if the patient leaves to an acute dialysis room and is not getting HD in the room :

How is the handoff(verbal/ticket to ride/ per computer). Is there a hospital or dialysis policy that requires verbal report from nurse to nurse before the patient can travel?

2. Is the patient on telemetry? if yes - can the pat travel off tele ? or does tele mean the pat can not leave the floor (some acute rooms have tele).

3. Does the patient need medications while in dialysis?

Other concerns:

New dialysis patients are usually not allowed to eat on dialysis and should only have a small snack before to avoid N/V - if they are diabetics and got long acting insuline - the nurse needs to make sure blood sugar is checked . If patient is not eating may not get sliding scale insulin or modified dose.

Medications: Some medications get dialysed out - there is an app and there is a booklet that tells which meds get HD out. Is there an order to hold meds before HD?

Blood draws: If a pat goes to HD in am - they can draw the blood especially if the patient is a difficult stick - it needs to be clear what the protocol is in the hospital (commonly I received pat with a bag of tubes to draw...).

Transfusion: if a patient is planned to have a transfusion with HD it is good to check if there is a consent.

Antibiotics: some hospitals have to send antibiotics with the patient when order to get with HD for example vanco or similar.

Floor nurses usually do a quick assessment before sending off the patient...

I am not sure this is helpful ...

Twinmom06, ASN, APN · Jun 21, 2016

The problem is that there are not many standards for acute dialysis patients and what nurses should or should not do is based on a couple of things. I can give you some ideas to start you off but you have to do research in the online/school library.
Acute dialysis is different from chronic dialysis because patients are usually acutely ill on top of what else is going on or they get started on dialysis.
What to consider:
Safety Concerns:
1.Handoff if the patient leaves to an acute dialysis room and is not getting HD in the room :
How is the handoff(verbal/ticket to ride/ per computer). Is there a hospital or dialysis policy that requires verbal report from nurse to nurse before the patient can travel?
2. Is the patient on telemetry? if yes - can the pat travel off tele ? or does tele mean the pat can not leave the floor (some acute rooms have tele).
3. Does the patient need medications while in dialysis?
Other concerns:
New dialysis patients are usually not allowed to eat on dialysis and should only have a small snack before to avoid N/V - if they are diabetics and got long acting insuline - the nurse needs to make sure blood sugar is checked . If patient is not eating may not get sliding scale insulin or modified dose.
Medications: Some medications get dialysed out - there is an app and there is a booklet that tells which meds get HD out. Is there an order to hold meds before HD?
Blood draws: If a pat goes to HD in am - they can draw the blood especially if the patient is a difficult stick - it needs to be clear what the protocol is in the hospital (commonly I received pat with a bag of tubes to draw...).
Transfusion: if a patient is planned to have a transfusion with HD it is good to check if there is a consent.
Antibiotics: some hospitals have to send antibiotics with the patient when order to get with HD for example vanco or similar.
Floor nurses usually do a quick assessment before sending off the patient...
I am not sure this is helpful ...

this is a great synopsis