IMPROVING THE REUSE RATE OF DIALYZER FOR PATIENTS ON HEMODIALYSIS AT THE OUT- PATIENT UNIT OF THE NATIONAL KIDNEY AND TRANSPLANT INSTITUTE: A 2016 QUALITY IMPROVEMENT STUDY (2017)

Ruffa C. De Paz, RN; Daryl Cynthia R. Villanueva, RN; Lorraine Pinzon, RN;
Renniell Gamboa, RN; Shyree Sarmiento, RN; Nerissa M. Gerial, Ph.D., RN, CESE
(National Kidney and Transplant Institute)

 

BACKGROUND:

The Hemodialysis Center is a facility that works to perform dialysis treatment by utilizing a dialyzer or an “artificial kidney”. The average reuse rate of the dialyzer is 7 times. Previous data identified the failure to reach the average reuse that affects productivity and the quality of health care delivery.  

 

OBJECTIVE:

The study aimed to identify and study corrective measures that can be applied to address patient wellbeing thru safe and cost-effective health care delivery system and performance improvement of the unit by identifying and studying the causes of dialyzer failure. 

 

METHODOLOGY:

Continuous Quality Improvement approach was used. After determination of the root causes, best alternative solutions were identified and implemented such as installation of a temporary rinsing station at the temporary HD unit, adding a step in reprocessing a dialyzer with renalin dwell time for 10 minutes, installation of transducers for PBE port, strict implementation with the use of Pre-Blood Entry and strict compliance in monitoring, and creating a control group for evaluation of dialyzer.  

 

RESULTS:

There was a significant reduction of dialyzer failure rate to less than 2% (institutional margin) and that with the use of PBE monitor, warnings for impending dialyzer header clotting were flashed in the machine monitors.  Through this project, a patient on 3x a week hemodialysis can save up to P218, 400.00 equivalent to 78 hemodialysis sessions (P2,800.00/session). Also, our institution can save approximately P396, 025.00 from the dialyzer waste reduction alone.

 

CONCLUSION:

It was challenging to ensure the compliance of all the involved staff but through effective communication among hemodialysis nurses, the team exceeded the targets set, enabling the institute to provide patient satisfaction with the services. 

 

KEY WORDS:

kidney, artificial, continuous quality improvement, reuse, dialyzer