September 2010
What You Should Know If You Are Receiving Dialysis
 
Yes

About 367,000 Americans underwent dialysis to treat their kidney failure in 2007. While the technology for hemodialysis is well established and the treatment is a routine part of healthcare delivery, risks are ever-present since hemodialysis patients undergo three treatments each week, take multiple medications and often have multiple comorbidities. In a three-year period, Pennsylvania healthcare facilities submitted 526 reports involving hemodialysis administration to the Pennsylvania Patient Safety Authority. Medication errors were the most common type of hemodialysis event submitted representing 29% (150 reports) of all hemodialysis events. Other hemodialysis administration events involved failure to follow policy or protocol such as treatment set-up procedures (12.9%), needle disconnection and needle infiltration (6.1% for each category), and falls (5.9%). Events related to hemodialysis administration may lead to serious patient harm. One Serious Event reported to the Authority involved a needle disconnection during hemodialysis that resulted in significant blood loss. Know what you can do to help prevent an error from occurring while you are receiving dialysis treatment. 

What You Can Do:
  • Keep a list of all your medications and share it with your providers in the dialysis clinic and other care areas where you are treated.
  • Make sure you know what medications you are taking and why. Stay alert for any medications that may be missed or given in error.
  • Make sure you are involved in every aspect of your hemodialysis care so that you will know if something is not right and you can tell someone right away. For example, if the label on the dialyzing solution does not match your prescription or the dialyzer is not labeled with your name be sure to tell someone.
  • Make sure your healthcare provider knows your name and birth date. There could be mix ups if there are two people receiving dialysis with similar names.
  • Since dialysis treatment can make patients dizzy and more likely to fall, make sure you take every precaution. For example, make sure you tell staff if you are feeling dizzy or unstable after treatment. Request a blood pressure check if necessary.
  • Consider a treatment facility that also has physical therapists or exercise physiologists available for strength training.
  • Make sure you tell staff about any falls you may have experienced since your last treatment to determine whether any adjustments to the hemodialysis treatment or doctor notification is necessary.
  • Look around at the dialysis center you attend and tell staff about any potential tripping hazards you notice.
  • Make sure staff knows if you need a cane or other assistance to walk.
  • Make sure to wear shoes when you are being weighed to avoid slipping and falling.
  • Make sure you have a call bell easily accessible if you need assistance going to the bathroom.
  • Know the importance of fluid and weight management in between treatments to avoid blood clots.
  • Make sure your hemodialysis access has adequate flow. Avoid tight clothing or jewelry on the arm you receive treatment to prevent clotting and allow adequate flow.

If you are a candidate, consider an arteriovenous fistula for your hemodialysis vascular access because it lasts longer than other access methods and is associated with fewer complications.

For more information on hemodialysis administration data, go to the 2010 September Pennsylvania Patient Safety Advisory article, “Hemodialysis Administration: Strategies to Ensure Safe Patient Care” at www.patientsafetyauthority.org or click here.

©2018 Pennsylvania Patient Safety Authority