Intradialytic hypotension alert system: A quality improvement perspective
Jandryle U Trondillo
Caring Homes Group, UK
: J Nurs Patient Care
Abstract
Measures in dealing with Intra-Dialytic Hypotension (IDH) at the home level rely solely in the assessment of the competent individual performing the procedure as hypotension tolerance varies among patients and is attributed to multiple factors such as length of the dialysis treatment, individual’s normal range, or UF goals. Unsuccessful management of IDH leads to termination events. In the hospital environment, there is a wide array of management for IDH, for instance they can extend the management to administration of hypertonic solutions or administering medications. However, there is no universal protocol and the literature suggests that in UK alone, there is disparity of the approach from one centre to the other. Much more is in a home or nursing home environment wherein this management is very limited. Locally, home hemodialysis adopts the local NHS guideline, which is a home hemodialysis guideline to manage IDH. This guideline was developed for patients to manage IDH as they dialyzed themselves, not in a nursing home environment wherein there are qualified professionals that can extend such management within the limits of the institution’s mandate. The rationale for this initiative is to establish a baseline care process model that will shift the framework of home hemodialysis management from symptoms based to trigger based system through adding an alert system following the treatment that promotes a culture of detection and prompt management. As such, a newer sensibility was developed to address such gap wherein nursing homes can extend the IDH management to better enhance the efficacy of the hemodialysis treatment. The fundamental concept of this initiative are integrating the latest evidence and modify it to a nursing home environment that suits existing legislation, regulations and company procedures.
Biography
Jandryle U Trondillo is a Development Research Scholar who just ventured a new nursing role in UK after serving as Consultant in a multinational in vitro diagnostics company and faculty in a university in his hometown. He is currently in the Roster of Harvard Medical School’s Southeast Asia Healthcare Leadership Program (HMS-SEAL). He contributed a few papers in the academic community and has been actively involved in improving the quality of research output as Journal Referee in multiple international journals. Currently, he serves as Director-International of Sigma’s Phi Gamma Chapter. Moreover, he is also a Member and Fellow of the International Society for Quality in Health Care. He is a qualified Nurse in the Philippines and UK with specialty accreditation as Nephrology Nurse awarded by the Board of Renal Nurses in the Philippines.
E-mail: jandryle@gmail.com
