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Discharge Planning: Patients With Haemodialysis Essay

1832 words - 7 pages

The local renal satellite services offer patients treatment of haemodialysis 3 times a week. This is a treatment for patients whose kidneys have failed and it is to remove toxins and waste from the blood (Levy et al 2009). Patients are often unwell when they attend the unit and also have other issues that affect their health. These are linked either to their kidney failure, or to other co-morbidities. Cardiac problems often become a major complication for dialysis patients (Harnett et al). This assignment will be discussing a patient who attended the dialysis unit feeling unwell on arrival. It will cover the initial assessment of the patient and the challenges faced in transferring them to the main renal unit inpatients ward. It will also look at assessing whether the renal ward or another specialist area would be the appropriate care environment. The discharge process should normally commence as soon as a patient is admitted. This to identify the different needs of the patient and to help make it a smooth transition (Corman 2005). Unlike wards, satellite renal units do out-patient haemodialysis only. Patients are admitted to the unit on their arrival that day for dialysis and also discharged the same day. However when a patient presents a serious medical problem, they will not be discharged home as normal unless it is medically safe to do so. Transferring a patient or discharging is a very complex issue and involves a multidisciplinary team (MDT) (Department of Health 2010) to work as one unit, to achieve a safe outcome for the patient. The scenario chosen is of Lewis Whittle as he will be known to protect his identity (NHS Code of Practice 2010). Lewis’ case is being used because of the complex nature that he presented with at the time and one where he was transferred and then discharged back into the care of the renal unit at a later date. This is when the renal staff have to be involved in the discharge planning for the patient as he is a regular service user with the renal unit. Lewis is a 76-year-old man that has been on dialysis for just over one year and also suffers from a congestive cardiac failure (CCF). The scenario was one that did not go as smoothly as normal because of the two different needs of the patient; his dialysis and his heart condition.

Lewis had arrived on the renal unit as normal for his dialysis, but on arrival had said that he was feeling unwell and had chest pains. He had stated he used his glyceryl trinitrate (GTN) spray 2 times for angina but this had had no effect (Nursing Times 2006). The Associate Practitioner that had admitted Lewis that morning felt that a senior member of staff was also required to help with the assessment of Lewis, to ensure he was given the best possible care as quickly as possible.
The ward manager and associate practitioner began the assessment, by taking all of Lewis’ vital signs following a systematic approach: Airway; Breathing; Circulation; Disability and Exposure (A.B.C.D.E)....

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