The Health Foundation is an independent charity working to continuously improve the quality of heatlhcare in the UK

Closing the Gap through Changing Relationships

Enabling self-management and shared haemodialysis care in hospital based dialysis

In brief

Every year, 20,000 people in the UK with kidney disease receive dialysis, which usually takes 3-4 hours at a time, 3 times a week.

Although a small proportion of people in the UK manage their own dialysis at home, for most people it requires many hours every week in hospital. Dialysis is therefore a life-saving but demanding routine.

There is evidence that it often leaves people feeling helpless and dependent on hospital staff, as well as having a huge impact on the lives of patients and their families. 

The aim of this project was to embed shared haemodialysis care across the six main renal units and 20 satellite haemodialysis units in Yorkshire and the Humber. Shared haemodialysis care is when patients at dialysis units are supported to undertake tasks involved in their own treatment to the extent that they wish to and are able to do.

The project team developed a three-day ‘train the trainer’ course to equip dialysis nurses with the skills to educate and support patients to take on greater responsibility for their own care.

Dialysis patients had the opportunity to learn a range of shared haemodialysis care skills, from weighing themselves and taking their own blood pressure, to operating the dialysis machine and administering injections. Each patient recorded their progress in a competency handbook.

The project found that shared haemodialysis care can have a significant impact on the lives of people undergoing dialysis, giving them greater control of their condition and making them feel more confident and able to ask questions about their treatment. It also encourages nurses to see patients as part of the team, supports closer engagement between patients and nurses, and helps to raise job satisfaction levels among nursing staff.

Why is this project needed?

Kidney dialysis is an essential but demanding procedure for thousands of people across the country. Because of the nature of the treatment it can disrupt every aspect of a person’s life, and have a major impact on their emotional and economic well being.

There is often little opportunity for indivduals to play an active role in their care, leading to an experience of treatment as inflexible, demotivating and disempowering. Evidence shows that many people enjoy taking an active role in their treatment, and that doing so can lead to better outcomes and improved quality of life.

Self-dialysis has been available to people with kidney disease for many years, in the shape of home haemodialysis, but this is not widespread in the UK, and is unavailable to many whose accommodation is not suitable, who live alone or who lack the confidence to tackle it.

The option of self-dialysis on a medical unit provides a ‘half-way house’ between traditional hospital dialysis and home haemodialysis – offering patients the opportunity to manage their treatment for themselves, with the support of clinical staff where they need it. Some may later choose to move on to home dialysis.

our unit is in the process of setting up a self care project. So far there are 6 off us self cannulating and feeding information e.g. weight blood pressure tempreture etc. We are only waiting on (proceedures) being set up.
I wonder what advice do you give to your patients on how to dispose the dialysis tubings and bags?
Thankyou for your question regarding dialysis tubing and bags. As these patients are being dialysed in centre these materials go into the clinical waste in the usual way.
In Shropshire in the community the council picks up all blood contaminated consumables and dispose of it as clinical waste - so it gets incinerated.
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