Teach aides about dialysis with Q&A session
Home care aides often are on the front lines of making sure dialysis patients maintain their health through adhering to their special diets.
Whether the patient follows the diet could mean the difference between life and death. So it’s especially important to make sure aides understand why this is so important and what they can do about it.
The Visiting Nurse Association Montgomery County Combined Health District in Dayton, OH, provided aides with a voluntary inservice on dialysis patients and found that aides were very concerned about patients’ compliance with their diets.
"They were interested in talking about the diet because they see patients cheating," says Janine Howard, RN, nursing coordinator for the nonprofit agency that serves the Dayton area.
"A lot of patients are on fluid restrictions, and one patient told an aide, I know I’m allowed to have eight glasses of water a day, but coffee doesn’t count,’" Howard recalls.
So the aide asked Howard whether coffee counts toward the fluid restriction, and Howard assured her it does. (See dialysis patients’ diet, fruit exchanges, vegetable exchanges, and menu pattern, pp. 13-15.)
Preparing for the inservice
Howard collected information about hemodialysis, peritoneal dialysis, kidney function, and acute and chronic renal failure before creating the one-hour inservice.
She found some of the information, including a video on dialysis, at a local hospital medical library and conducted a computer search to find more details on the subject.
"I also went to our own files at work and made copies for everyone on the proper diet," she adds.
The aides gave Howard’s inservice excellent ratings on the feedback forms she handed out. "The comments said the inservice was very helpful and was good knowledge for taking care of their patients," Howard says.
After distributing the hand-outs, Howard opened up the inservice to a question-and-answer period. She started it by asking the aides how many of them have patients with renal failure and how many have patients on dialysis.
In response to their questions, Howard covered these areas:
• Aides should report to nurses immediately if they see that the patient’s shunt site is swelling or is tender.
• Some patients on dialysis will urinate minimally, and their urine will be dark, tea-colored, and foul smelling.
• Dialysis patients may be depressed or anxious. "I told them that if the patient seems worse or wasn’t coping very well, then the aide needs to let the primary nurse or supervisor know right away," Howard says. "A dialysis patient is more likely to commit suicide than the normal patient, so I tried to drive it home that if they see these patients and something doesn’t seem right, they need to tell the nurse."
• Aides should look for signs of depression such as a normally talkative patient who no longer is talking or a patient who says, "I’m just useless, and I’m not good for anyone anymore."
JANUARY
1-31: National Glaucoma Awareness Month: Nearly half of the 2 to 3 million people who suffer from glaucoma do not realize they have the disease because it causes no early symptoms. For information about glaucoma, contact Prevent Blindness America, 500 East Remington Road, Schaumburg, IL 60173. Telephone: (800) 331-2020.
1-31: National Volunteer Blood Donor Month. This month honors regular blood donors and encourages others to become donors. Contact American Association of Blood Banks, 8101 Glenbrook Road, Bethesda, MD 20814-2749. Telephone: (301) 907-6977. Fax: (301) 907-6895. E-mail: Christine@aabb-org.
18-24: Healthy Weight Week. This week was established to celebrate healthy lifestyle habits. Contact: Frances Berg, Healthy Weight Journal, 402 South 14th St., Hettinger, ND 58639. Telephone: (701) 567-2646. Fax: (701) 567-2602.
25: National IV Nurse Day. This event honors intravenous nurses in hospitals and home care facilities. Contact: Education Department, Intravenous Nurses Society, Fresh Pond Square, 10 Fawcett St., Cambridge, MA 02138. Telephone: (617) 441-3008. Fax: (617) 441-3009.
FEBRUARY
1-7: National Patient Recognition Week. All health care providers are encouraged to reflect on their dedication to patient care and satisfaction. February 3 is designated as Patient Recognition Day. Contact: John O’Malley, president, Strategic Visions Inc., 337 Turnberry Road, Birmingham, AL 35244. Telephone: (205) 995-8495.
1-28: American Heart Month. The American Heart Association will celebrate its 50th anniversary this year and focus its attention on cardiovascular disease and women. National Women’s Heart Health Day is on Feb. 1. More women than men have died of cardiovascular disease in recent years, and with 240,000 American women dying of heart disease each year, it’s the leading cause of death for U.S. women. Contact: American Heart Association, 7272 Greenville Ave., Dallas, TX 75231. Telephone: (800) AHA-USA1; Fax: (214) 369-3685. Web site: www.americanheart.org.
1-28: Wise Health Consumer Month. Companies, hospitals, and HMOs are offering more self-care programs. Contact: The American Institute for Preventive Medicine, 30445 Northwestern Hwy., Suite 350, Farmington Hills, MI 48334. Telephone: (248) 539-1800, ext. 247. Fax: (248) 539-1808.
The calendar listing is provided courtesy of the Society for Healthcare Strategy and Market Development of the American Hospital Association. The organization, located at One North Franklin, 31st Floor, Chicago, IL 60606, sells an 89 page, "Health Observances & Recognition Days" calendar (Catalog No. C-166858) for $15 for AHA members and $20 for nonmembers. Call (800) 242-2626 for more information.
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