how we started! - rjl.se · how we started! britt-mari banck [email protected] . he put...
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How we started! Britt-Mari Banck [email protected]
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He Put Demands on the Health Care Provider/System
• Learn to manage my own dialysis treatment
• Optimal individual dialysis treatment
• That the health care provider was listening to my needs
• Daily dialysis or at least 5-6 days a week
• To be fully involved and have influence over my dialysis regime and treatment
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We Started With the Hardware and Software…
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…and Then Proceeded
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Another Step Towards Independence…
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…and Then: Independent!!
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The Self-Hemodialysis Staircase©
Out-patient clinic Emergency care Peritoneal dialysis Assisted HD
Visitor at the Self-Dialysis unit, receiving information about self-dialysis.
”Dresses” and primes the machine at start-up, with some supervision. Write protocol.
Manages the machine at start-up and conclusion with supervision. Gets help with inserting needles or handling the CDK. Cleans up. Manages alarms.
Manages the machine independently. Inserts and withdraws needles/ manages CDK with some assistance. Cleans up.
Manages everything without supervision. Home-HD
The staircase is not static. Changes can go both upwards and downwards depending on the patient’s condition and motivation. Training and information is provided along the entire staircase.
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Patient participation! • Build trust • Structure • Be attentive – listen to others • A sense of security and comfort • Humor
”Should we call this unofficial labor….?”
Success Factors
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”This is my way!”
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”Do you know what’s best about this job? – You can be lazy without it being noticed!”
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Partnership
• Team in a honest and changing dialouge • Enable them to be an active partner in care • Competent staff – are crucial • Goals! need to be mutually agreed and realistic