Timely initiation of dialysis is vital to chronic kidney disease stage 5 (CKD5) patients. Literatures reviewed that unplanned urgent initiation of dialysis was associated with poorer outcomes and early pre-dialysis education enhanced greater likelihood of elective dialysis. Pre-dialysis education is referred by renal physician when patients are approaching CKD5 and carried out in renal nurse clinic in Hong Kong. However, the average non-attendance rate of the new appointment in five renal nurse clinics under Hospital Authority (HA) was undesirable with 15.28% (n=288) from May 2017 to July 2017. Therefore, evidence-based practice (EBP) was applied to decrease the non-attendance of new appointment in these clinics. Method: Applying the John Hopkins Nursing Evidence-based Practice (Practice question, Evidence, Translation) Model, a new phone reminder service was implemented from July 2018 to September 2018 in these five renal nurse clinics. The clerks of the involved clinics called patients attending the first pre-dialysis education one week before appointment. Maximum three calls within two days were delivered. If the patients could not be contacted, voice messages were left to their message boxes if available. Changing of appointment was allowed upon patient??s request. The content of the reminder was standardized by a script and the compliance of the clerk was audited by a renal nurse with a standard audit tool. Results: Collectively 267 patients were booked for first pre-dialysis education during the intervention period in five renal nurse clinics. 24 patients requested changing appointment. 15 patients defaulted, the average non-attendance decreased from baseline 15.28% to 5.29% which was statistically significant (p=0.001). Conclusion: The judicious use of current best evidence to reduce the non-attendance rate of first pre-dialysis education in out-patient setting may be effective to reduce the possible risk of unplanned urgent initiation of dialysis to safeguard our patients.
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