ESPN 50th Annual Meeting

ESPN 2017


 
Creating A Safe Environment for Young Adults to Achieve Independent Home Haemodialysis
DALJIT HOTHI 1 KATE SINNOTT 1

1- GREAT ORMOND STREET HOSPITAL FOR CHILDREN
 
Introduction:

 Objective

Some young adults may be suitable for home haemodialysis (HD) but lack of supervision or support may prevent this becoming a reality. 

Material and methods:

 Method

We describe our enhanced safety approach which enabled a 17 year old with a arterio-venous fistula to transition from in-centre HD to home HD, independently.

Results:

 Results

When planning the possibility of a young adult dialysing independently at home a number of unique safety issues need to be considered and mitigated against in addition to addressing common concerns such as non-adherence to treatment.  We individualised the training programme, modifying the standard teaching to incorporate additional safety measures focusing on a heightened awareness and earlier recognition of potential complications.  Technology such as medical alarm necklaces and watches, alarm amplifiers and blood leak detectors alerted the young adult or the local medical emergency teams of impending risks or complications. The speed and clarity by which the young adult communicated with the community medical support teams was improved utilising WhatsApp® and smart phones.

 

After a stable and adverse incident free six months of treatment the young adult transitioned to a nocturnal home programme.  

Conclusions:

Conclusion 

A young adult can haemodialyse at home, independently provided strategies are put in place to ensure the safety of the patient in the community.