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S 13 Parallel Session
Programme of the Session
Title: Education
GS: Ann Bonner (Australia)
Health literacy and renal healthcare: Why does it matter?
O 17
Introduction of basic life support simulation training into satellite dialysis units
Cathy Poole (UK)
O 18
Patient empowerment – Training the person on dialysis
Helena Pereira (Portugal)
O 19
Review of educational tools and awareness of Venous Needle Dislodgement (VND)
Sophie Halldin (Sweden)
O 20
Can assistant practitioners be successfully integrated into the nursing skill mix of haemodialysis units?
Susie Mallinder (UK)
Abstracts
GUEST SPEAKER
Health literacy and renal healthcare – Why does it matter?
A. Bonner1, 2, 3
1School of Nursing, Queensland University of Technology, Brisbane, Australia; 2NHMRC Chronic Kidney Disease Centre of Research Excellence, Unviersity of Queensland, Brisbane, Australia; 3Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Australia
Background
Healthcare professionals largely believe that if people have adequate knowledge about what to do they will engage in self-management behaviours. However, this presupposes that people have sufficient health literacy skills as well as sufficient understanding of their health problem. There is an assumption that health literacy is a generic set of competencies and skills. Health literacy is more than having the necessary functional skills (e.g. reading information); rather it is a broader practice which entails having the knowledge, motivation and competence to make decisions in everyday life concerning healthcare needs.
During this presentation, I will explain that health literacy skills must adapt to varying disease contexts and settings and people’s experience of and within these contexts. This means that living with a complex disease such as chronic kidney disease (CKD) requires that effective health literacy must be formed and then practised in that context which changes during the trajectory of CKD. Health literacy is both a cognitive ability and a social skill. All of this matters for renal health professionals because our current focus on non-adherence and low self-management behaviours needs to be redirected towards putting the individual’s information experience of CKD and its self-management at the centre of health literacy to better inform consumers of health education.
BIOGRAPHY OF THE GUEST SPEAKER
O 17
Introduction of basic life support simulation training into satellite dialysis units
C. Poole1, P. Burdis1
1Training & Education, Fresenius Medical Care, Birmingham, United Kingdom
Background
Research identifies that simulatated healthcare training has a beneficial impact on learners’ self-confidence and self-efficacy. Cardiac arrests in patients receiving long term chronic haemodialysis in satellite haemodialysis units is not commonplace. As an adjunct to annual basic life support (BLS) training via e-learning BLS simulation was introduced into the satellite dialysis units.
Objectives
1. enable staff to practice BLS skills in a familiar clinical environment
2. provide a more realistic approach than classroom
3. familiarise use of local resuscitation equipment
4. promote consideration for other patients.
Methods
Simulation equipment was purchased for eight Area Head Nurses and consisted of the following:
• Resuscitation manikin
• Floor mat
• BLS Algorithm from the Resuscitation Council (UK)
• Pocket mask
• Resuscitation bag valve mask to assist ventilation
• Carry case for all equipment
• Resuscitation face shields
• Universal wipes
Consistency of the simulation was ensured with a session plan to guide the instructor through the simulation.This was supported by a simulation quiz and evaluation form.
Results
30 simulations undertaken involving 123 staff members who include registered nurses and healthcare support staff. Participants per session ranged from 1 - 8 with a mean of 4. Ninety eight percent of participants were more confident in their BLS skills, 75% preferred this training approach and 100% of participants confirmed that all staff should have BLS simulation training.
Conclusion/Application to practice
BLS simulation has been well received. The simulation prompted discussion linked to the ethical and practical issues of cardio pulmonary resuscitation in dialysis units. We recommend BLS simulation as an effective training methodology.
O 18
Patient empowerment - Training the person on dialysis
H. Pereira1, A. Martins1, C.M. Cunha1, C. Matias1, V. Silva1, M. Cunha1, M. Fonseca1, J. Pinheiro1, 2, J. Fazendeiro Matos3, M.T. Parisotto4
1NephroCare Fafe, Fresenius Medical Care, Fafe, Portugal; 2Bioethics Institute, Portuguese Catholic University, Porto, Portugal; 3NephroCare Portugal, Fresenius Medical Care, Porto, Portugal; 4Care Value Management EMEA, Fresenius Medical Care, Bad Homburg, Portugal
Background
Patients on haemodialysis have to live daily with the conditions of their disease and with changes in their daily lives. The Declaration of Jakarta (1997) reinforced the importance of selecting health care professionals for the promotion of patients’ health. Therefore, the nurses when subscribing to the empowerment model for their care should consider patients as equitable partners in the health team, with a role to support and strengthen individual, family and community functioning.
Our clinic team plans to train the patient in order to improve their autonomy and their knowledge when it comes to decision-making.
Objectives
• To identify training needs and describe the implementation of an education programme
Methods
The survey of patient satisfaction from 2012 indicates that 8.8 % of our patients felt there was a lack of information. This made us aware that there was a need to make information available. To develop a training project, literature research was conducted in the EBSCO database, b-ON, Google scholar.
We identified training needs from our literature searches and also from the analyses of 50 people on haemodialysis treatment during the year 2014 through informal interviews. From the mentioned analysis, we developed individual training sessions.
Results
Throughout the year 2015, 14 training courses were held with the duration of approximately 30minutes for 84 people. Each person took part for a total of 7 hours spread over 12 months.
Conclusion/Application to practice
Nurses as important links in the care of the person in regular haemodialysis programme should promote patients’ autonomous decision making and adherence with the treatment regimes.
O 19
Review of educational tools and awareness of Venous Needle Dislodgement (VND)
S. Halldin1, P. Byhmer2, D. Keane3, J.P. Van Waeleghem4
1Nephrology, Heamodialysis, Danderyds Sjukhus, Stockholm, Sweden; 2RedsenseMedical, Halmstad, Sweden; 3Department of Renal Medical, Leeds Teaching Hospital trust, Leeds, United Kingdom; 4Nephrology, University Hospital Antwerp, Antwepen, Belgium
Background
Haemodialysis(HD) is a routine treatment, but life-threatening complications still happen, such as VND. In 2008, the EDTNA/ERCA launched a project "How to minimize the risks of VND" which produced some educational tools. We were interested in current awareness of VND and the value of the previous project.
Methods
This study was based on a survey undertaken at the EDTNA/ERCA congress 2015 in Dresden. The survey was introduced during a presentation and was handed out and collected in the Redsense booth in the exhibitor area.
Results
Survey respondents (n=81) were predominantly experienced nurses. Over half had experienced a VND at their own clinic. Two-thirds assessed the risk of VND at least every month, but only 60% of these are recording the assessment in the patient´s chart. Of the respondents who had experienced a VND, 26% still did not regularly do risk assessments.
Two-thirds of respondents were aware of the "12 steps to minimize the risks of VND" poster, whereas only 40% were aware of the Risk Assessment tool. A quarter had paper copies of the Risk Assessment Tool in their clinics, but almost 90% suggested that it would be helpful to have the tool in a digital format - preferably on a computer.
Conclusion/Application to practice
There remains a significant group who are not undertaking risk assessments for patients at risk of VND and who are not aware of the Risk Assessment Tool. There is a need for an educating tool to minimize the risks of VND.
O 20
Can assistant practitioners be successfully integrated into the nursing skill mix of haemodialysis units?
S. Mallinder1, J. Egbe1, J. Williams1
1Renal, Epsom and St Helier NHS Trust, South West London and Surrey, United Kingdom
Background
Shortages of Registered Nurses is widely acknowledged in the National Health Service. Different strategies are used to overcome this shortfall. The assistant practitioner (AP) is a relatively new development. The numbers of renal patients continues to grow and haemodialysis satellite units are being built. Ensuring appropriately educated staff are recruited to the renal workforce is challenging.
Objectives
To ensure a competent workforce is available to care for haemodialysis patients by supporting structured, tailored education to unregistered staff.
Methods
Following literature review, 4 healthcare assistants within the renal department commenced a foundation degree in healthcare. The 2-year programme has practice based competencies. Renal and Haemodialysis care competencies were developed with the university, to ensure the AP’s successfully completing their training are skilled to deliver high standards of care in the haemodialysis unit.
Results
The healthcare assistants successfully completed the 2-year programme, supported by the practice educator. They deliver care under supervision of a registered practitioner, with knowledge and skill beyond that of traditional healthcare support workers, taking some tasks from registered professionals, working across traditional boundaries. A medicines management competency document was developed to support the practitioners.
Conclusion/Application to practice
The AP's have a positive impact on service delivery, improved patient experience and optimal use of resources. The initiation and completion of out-patient haemodialysis is a continuous process, delivered by AP's. Integrating unregistered practitioners into the nursing workforce has challenged boundaries, however, to ensure a competent workforce is available in the future, innovation and change are required. This project has been positively evaluated by patients and renal unit staff including the AP’s.