Authors (including presenting author) :
Hui YH (1), Lee KFM (2), Law MC (3), CHEUNG SCA (4) Lai WS (5)
Affiliation :
(1) Nursing Services Division, United Christian Hospital; (2) Department of Medicine & Geriatrics, Tuen Mun Hospital; (3) Department of Medicine & Therapeutic, Prince of Wales Hospital; (4) Department of Medicine, Queen Elizabeth Hospital; (5) Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Engaging to evidence-based practice (EBP) has been recognized as an important move in contemporary nursing practice. The application of EBP redesigned practice will transform existing practice into a more effective, efficient and safer care. Timely initiation of dialysis serves as a vital management to end stage renal disease patients. Unplanned urgent initiation of dialysis is associated with poorer outcomes then planned initiation. Literatures reviewed that early education and pre- dialysis clinic attendance were associated with greater likelihood of elective dialysis initiation. In local practice, pre-dialysis education is carried out in renal nurse clinic. First renal nursing assessment appointment is referred and booked by renal physician when chronic kidney disease (CKD) patients are approaching stage 5. However, the average non-attendance rate of first renal nursing assessment in five local renal nurse clinics was undesirable. It was 15.28% (n=288) recorded from May 2017 to July 2017.
Objectives :
To decrease the non-attendance rate of first renal nurse assessment in five renal nurse clinics under the Hospital Authority (HA).
Methodology :
By applying the John Hopkins Nursing Evidence-based Practice Model, a new phone reminder service was implemented from July 2018 to September 2018 in five renal nurse clinics under the HA. The clerks of the involved clinics delivered phone calls to remind patients to attend the first renal nursing assessment one week before their appointments. Maximum three phone 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.
Result & Outcome :
Total number of patients booked for first renal nursing assessment during the intervention period was 267 in five renal nurse clinics. 24 patients requested to change the appointment while receiving the phone calls. 15 patients defaulted the scheduled appointments, the overall average non-attendance rate of first renal nursing assessment 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 renal nursing assessment in out-patient setting may be effective to reduce the possible risk of unplanned urgent initiation of dialysis to safeguard our patients.
Co-location with:
