For years, evidence proved that the adequate dialysis treatment, proper nutrition, and use of arterial venous fistula (AVF) in place of HD catheters are associated with patients’ decreased mortality rate among end stage renal disease (ESRD) patients on hemodialysis (HD). Improving overall health of ESRD patients is largely dependent on individual patients themselves, but as nurses it is our responsibility to promote and educate patients to take charge of their own life.
In the acute setting, the large populations of dialysis patients are unaware of the risk when treatments are missed. Educating patients is an ongoing process and can be very challenging. Currently both doctors and nurses are working on how to educate them in a better way for them to understand. Nutritionists are present in every acute setting to help regulate diet that is designed for renal patients but the real challenge is often that dietary services overlook types of food that must be avoided by renal patients.
We had frequent cases where we were called to the facility to dialyze a patient with high K level and the cause was a patient consuming an orange juice due to a low blood sugar. Cases like these call for education being necessary for any party involved with patients’ care. Nowadays we put more focus on educating all personnel including patients’ family regarding diets and the risk when not followed. Nephrologists and renal nurses encourage patients to receive AVF.
Many studies show that there is a high mortality rate associated with HD catheters mainly due to high infection rate. Although we do see failed cases of AVF due to clotting and severe circulation blockage, the benefits outweigh the negatives. For cases where a patient is not able to have AVF, we educate how to care for catheters to reduce infection. Unfortunately, many HD catheters in general often do not provide adequate clearance as shown by the recirculation studies and results that prove it to be true.
The renal function test also shows that in general patients with AVF have a better clearance compared to the patients with HD catheters. Currently, our focus is educating ESRD patients and all who are involved in care of patients to promote health and longevity. We also educate them to realize that optimum health is achievable if they put their best efforts into taking care of their own health by following guidelines that are available to them. By providing more education, we hope for decreased cases of hospitalization that are simply due to lack of understanding and education.