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The Home Care Dialysis Patient

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Hello! I am a dialysis nurse turned Home care nurse with a question for all you home care nurses concerning dialysis...a little background, the community I live in had a dialysis center open in the past year thus an influx of dialysis patients that need home care...this is very new for the experienced home care nurses as they rarely have had the opportunity to care for this patient population so my question to is...What do you wish you knew about dialysis/dialysis patients? For example do you feel the need for more end stage renal diet education, fistula care, or info on the treatment process??

Thanks!

KateRN1

Specializes in COS-C, Risk Management. Has 20 years experience.

I am also a former dialysis nurse now in home care, not a combination I see very often--welcome! Because dialysis is a Medicare covered benefit, home care nurses generally do not address dialysis issues on the plan of care as those services are not billable for us. Of course, ESRD issues are very important for us to know so as to understand our patient population, but (Medicare) home care nurses generally are not able to do much in terms of teaching of the disease process, dressing changes, assessment of the fistula/graft/catheter, diet teaching, etc. We can mention it and certainly do, but those items are not skillable and billable for us, so cannot be the focus of the plan of care.

Kate said it all. There's not much we can do for these patients.

We are currently in the process of starting home dialysis setup to cater to the patients in India. Any advice regarding the setup would be greatly appreciated

thanks

I have recently admitted two patients with ESRD. I have NO IDEA what to do for them. Any advise would be extremely welcomed.

KateRN1

Specializes in COS-C, Risk Management. Has 20 years experience.

Concentrate on the disease processes that led to the renal disease--diabetes, HTN, etc. Management of those disease processes and all that goes along is probably your best bet.

Hello! I am a LNA for a home healthcare company. I recently started caring for a man in his early 60s with end stage renal failure and diabetes who lives at home and does home dialysis. I know as a LNA we are limited as to what we can do in situations like this but I am just curious as to any imput the LPNs or RNs have. I am 23 years old but have been fascinated with the medical field since I was very young so I well educated when it comes to matters regarding the patients I see in their homes. I would love ANY advice on caring for a patient on home dialysis!! This man has paralysis from the waist down and is a one person hoyer lift. What should I be keeping an eye out for regarding his access site, vitals, etc. Also best ways to make him comfortable, foods he should be eating, etc.

I am a bit of an overachiever but I feel it makes me one step above a normal LNA and my patients feel more at ease. So please tell me ANYTHING and EVERYTHING! Even if it something an LNA doesnt have to be concerned about Id like to still know, its helpful since this man is in his home if I have the best understanding as possible and can catch any issues immediately and inform the appropriate person!

Thanks everyone!