Management of hemodialysis unit sudan

1. MANAGEMENT OF HEMODIALYSIS UNIT
DR. AHMED AKL, MD,FACP
ISN EDUCATION AMBASSADOR,
Consultant of Nephrology & Transplantation,
Urology & Nephrology center,
Mansoura, Egypt

2. FIRST HUMAN DATABASE

3. EBERS PAPYRUS
First to describe peritoneal dialysis 1550
B.C.

4. OPTIMAL DIALYSIS
Anemia
management
Good nutritionBP control
Fluid and
electrolytes
hemostasis
BMD
management
Dialysis
Adequacy
Kt/v

5. • In 1913 three medical scientists working in the Department of
Pharmacology at Johns Hopkins Medical School devised equipment and
methods for vividiffusion in animals; haemodialysis was invented.
• Thirty years elapsed before a clinically effective system was designed, by
Willem Kolff working in the Municipal Hospital at Kampen.

6. Gordon Murray (1963) Murray’s first dialyser

7. Infection
Control
Dialysate
Delivery
Water
Quality
Patient
Satisfaction
Anemia
Transplant & Modality
Education
Quality of
life
Nutrition
Vascular
Access
Mineral Bone
Disease
Dialysis
Adequacy
Patient

9. INTERDISCIPLINARY TEAM
Physician
Social
WorkerDietitian
RN

10. INTERDISCIPLINARY CORE TEAM
Physician
Social
Worker
Dietitian
RN Patient

11. Medical
Director Social
WorkerDietitian
RN Admin
CEO
Anemia
RN Access
Adequacy
RN
Infection
RN
Biomed.
Tech
QAPI TEAM

12. STANDARDS
COLLECT DATA
IDENTIFY PROBLEMS
RE-ASSESS
ANALYZE PROBLEMS
AND GENERATE
SOLUTIONS
CHOOSE AND
IMPLEMENT SOLUTION
COLLECT DATA
IDENTIFY PROBLEMS
ANALYZE PROBLEMS
AND GENERATE
SOLUTIONS
CHOOSE AND
IMPLEMENT SOLUTION
RE-ASSESS

13. DATA SOURCES
• Electrical safety testing reports.
• Reuse master file.
• Patient satisfaction surveys.
• State and federal survey reports.
• Medical device alerts.
• Manufacturers recalls.
• Performance appraisals.
• Utilization review reports.
• Medical record.
• Dialysis record/Log sheets.
• Patient care plans.
• Hospitalization record.
• Laboratory and other diagnostic records.
• Incident reports.
• Equipment maintenance reports.
• Water Quality monitoring reports.
• Culture reports: Water, reused dialyzers,
Dialysate, Environmental.
• Hepatitis surveillance reports.
Patient
Equipment
Environment

14. RESPONSE TO UNDERPERFORMANCE

15. INTERDISCIPLINARY CORE TEAM

16. Medical Director Oversight Of Facility Staff

17. QAPI IDENTIFIES KTV PROBLEMS

18. Quality Metrics in ESRD

19. Continuous Quality Improvement In Dialysis Units

20. CHECK SHEET

21. In Conclusion
Medical
Director
Social
Worker
Dietitian
RN
Admin
CEO
Anemia
RN
Access
Adequacy
RN
Infection
RN
Biomed.
Tech
QAPI TEAM

22. THANK YOU