Download - Assisted Automated Peritoneal Dialysis(aAPD)
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NIPEC Annual ConferenceProfessional Standards Enhancing Person-Centred Care
Assisted Automated Peritoneal Dialysis(aAPD)
Susie MawhinneyPD Nurse BCH
A new treatment choice for patients with End Stage Kidney Disease in Northern Ireland
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Presentation Outline• Understand treatment choices for patients
with End stage kidney disease• Why an Assisted Automated Peritoneal dialysis
service was needed• How we started it• What is happening now
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Transplantation• No dialysis needed• Close to normal kidney function• Fewer restrictions• Risk of rejection• Medication• Reduced immunity• A transplanted kidney has a finite
lifespan
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Haemodialysis• In-centre (mostly) or rarely at home• 3+ sessions a week• Fistula required – Needles• Travel to unit x 3 weekly• In centre HD - Nurses carry out
treatment for patient
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Peritoneal Dialysis APD• Home dialysis• Night time treatment• Simple machine• Permanent catheter• Storage required• Fluid heavy to lift
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Statistics• Number of patients receiving Renal Replacement
Therapy(RRT) in UK is growing by 5-8% pa
• Older people are the largest and fastest growing group of dialysis patients.
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PD: a suitable treatment for the elderly?
Pros• Less travelling involved• Minimises risks of hospital
based infections• Benefits of a home based
therapy• A more gentle form of dialysis
treatment. • More cost effective
Cons• Physically unable • No back up / support
available.
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Definition of aAPD• “Assisted Automated Peritoneal Dialysis is a service whereby a
paid carer performs all or part of the dialysis treatment for a PD patient, thereby enabling more patients to receive their treatment in the community” (2)
• The paid carer can be provided directly by the Health Authority, through the network of community nurses, or indirectly by arrangement with a contracted service provider such as Baxter Healthcare (2)
2 Specification for commissioning of the PD pathway NHS Kidney Care 2009
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Getting Started• Business plan developed• Recruitment of Health care company to provide Health Care
Assistants( HCAs)• Service level agreement• Training plan devised for HCAs• 3 day training course delivered• 6 month pilot study commenced Dec 2011
• Rolled out to all N.I May 2012.
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The aAPD Service
Healthcare Assistant to visit patient daily to:• Remove used bags & empty drain bags• Check drained fluid• Connect new bags & set up machine• Check BP & weight• Carry out exit site care• Record all information• Review stocks• Contact patients PD unit if problems arise.
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The service now• 50 patient have availed of service
• Used for – struggling PD patients, new starts, respite and paediatrics
• 22 patients presently using service
• Over 35 Health care assistants trained to cover NI
• BCH PD nurses provide an out of hours on call service for all PD patients
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Conclusion• No rise in peritonitis rates
• Pt Satisfaction survey showed all aApd patients would recommend service.
• aAPD now offered as a treatment modality in NI.
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Patient CommentsPatient Comments
“ “ I would have to travel to hospital 3 times a week – I would have no life”
“It is a great help – I could not manage on my own”
“ Great service – takes the pressure off the carer”
“HCAs provide moral support for carer and brighten patient’s day”
“Very happy with service”
“HCAs very good at their job and very friendly”
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Any questions?