Kent Kidney Care Centre: welcome to the Haemodialysis Unit

Transcription

1 Kent Kidney Care Centre: welcome to the Haemodialysis Unit Information for patients Our dialysis unit is devoted to the care of people with kidney disease who require haemodialysis. We are an outpatient department, which means that people come in from home for their treatment, usually three times each week. Opening hours are 07:00 to Monday to Saturday. Our Canterbury and Medway Units also offer an evening (twilight) service Monday, Wednesday, and Friday until midnight. When is dialysis available? Dialysis sessions take place in the morning and afternoon, with the option of evening dialysis at Medway and Canterbury. The units may vary slightly in their opening hours, however normal opening hours are as follows: the morning session starts at 07:30 the afternoon session starts at 13:30 the evening session starts at 17:00 hours. You will be given a specific appointment time, and usually dialyse either on a Monday, Wednesday, and Friday, or Tuesday, Thursday, and Saturday. You may have a preferred day or time to dialyse, if this is not available when you need to start dialysis, we will ask you to attend on a day and time where we have a vacancy. We will endeavour to accommodate your preferred day and time as soon as possible. It is important to keep to the agreed appointment time. Occasionally we may ask you to change you appointment arrangements, if another patient urgently needs dialysis at a specific time. This will not happen frequently and we will give you as much notice as possible. If you work or have child care commitments everything possible will be done to ensure that your dialysis fits in with your personal needs. We care 1

2 Can I bring someone with me? If you are anxious about your first dialysis, then you are welcome to bring someone with you. However we do not encourage visitors on a daily basis due to space constraints. Who will be looking after me? The unit is staffed by a team of registered nurses and health care support workers who have all been trained to care for people receiving haemodialysis. Every patient receives care from a named medical consultant, who will see you once a month during your dialysis. Please contact your GP for any medical problems not related to your kidneys. Other health care professionals you will meet on the unit include: consultant nurse physiotherapist dialysis matron dietitians home dialysis nurse occupational therapist advanced kidney care nurses renal technicians transplant nurses renal counsellor assessment officer ward clerk pharmacist housekeepers How will I travel to dialysis? We try to provide dialysis at a unit close to your home, in order to keep travelling time to a minimum. However, if this is not possible when you start dialysis, we will contact the unit nearest to you and ask them to inform us when the next vacant space is available. Patients often drive or use public transport to travel to their unit. If you require patient transport to and from dialysis, please speak to a member of staff who will advise you. Please be aware that patient transport is in great demand and vehicles will be allocated with up to five people per journey. This means that journey times are likely to take much longer than alternatives, as other people will need to be picked up and dropped off. If you are going to be driving yourself, consider someone bringing you for the first week or so. It may be possible to claim costs back for mileage or public transport, depending on your circumstances. Ask the unit ward clerk for more information, including parking arrangements. What does access for dialysis mean? In order for you to have dialysis we will need to access your blood stream. This is done via something called a fistula or a temporary line inserted into your neck (a neck line). Fistula - this involves joining an artery to a vein in your arm. It is a simple operation performed in theatre. Ideally this will be done several weeks before you are due to start dialysis as it is usually six to eight weeks before a fistula can be used. When the fistula is mature enough to be used, two needles will be inserted into your arm using local anaesthetic. One needle will take the blood from you to the artificial kidney (dialyser) and the other needle will return the cleaned blood to you. Graft - this is an alternative to a fistula, which follows the same principles as above, using a synthetic material. 2

3 Neckline - a plastic line is inserted into a vein under your collarbone using a local anaesthetic. This procedure would be carried out in the procedure room on Marlowe Ward. Necklines are normally only used temporarily as they have a much higher risk of becoming infected or blocked. Caring for your dialysis access Further information about how to look after your dialysis access is available in separate information leaflets - Care of your arteriovenous fistula and Central venous catheter (line) for haemodialysis. Ask a member of staff if you would like more information. What will happen when I have dialysis? Your first impression of the dialysis unit may be overwhelming. There are a lot of machines with noisy alarms, and equipment may seem very complicated. Please try not to worry; the staff will do everything they can to make this time as stress-free as possible for you. You will meet many new people and hopefully it will not take long for you to settle in to the routine of dialysis. In order to safely carry out your dialysis treatment you will need to be weighed and have your lying and standing blood pressure and temperature taken and recorded. Your blood pressure will also be taken at intervals during dialysis. At the end of the treatment you will be weighed and your lying and standing blood pressure taken and recorded. The person caring for you will programme the machine with the individual requirements for your treatment. The length of time spent dialysing varies from person to person, but is usually between three and four hours each session. You will need to sit in a reclined position in a special dialysis chair or lie on a hospital bed for the duration of the dialysis. Whilst you are receiving dialysis you will be restricted to what you can physically do. However this time can be spent reading, watching television, chatting to fellow patients, or doing some gentle chair-based exercises. We advise you to wear loose comfortable clothing so we can easily see and access your fistula or neckline. Shortly after starting your dialysis treatment you will be offered a cup of tea and a biscuit. If you have a large amount of fluid to be removed during dialysis you may be advised by the nursing staff not to have more than one drink. It is not unusual to feel slightly dizzy when you start dialysis. If you feel unwell at any time, please call a member of staff. What is shared care? We believe that the most important person in managing your care is you. Therefore, we encourage you to become as involved in managing your treatment. We call this shared care. It means that with support and training you can be involved in managing your own dialysis, if you wish. This can range from basic tasks (such as weighing yourself on arrival) to being responsible for your whole dialysis session; or could lead you to deciding to dialyse at home, or just having more control over your own treatment within the dialysis unit. If sometimes you just do not feel up to managing your own care we are always there to help you. 3

4 Of course, if you feel that shared care is not for you we will be happy to fully manage your care. If you are interested in taking more control over your care please speak to a member of staff. Can I have my dialysis at home? If you are interested in having your dialysis in your own home, please speak to a member of staff at the unit and they can give you more information or contact the specialist home dialysis nurses on your behalf. The home dialysis nurses will contact you with more information. What happens if I am unable to attend for dialysis? Please telephone your unit directly and tell them that you are not attending for dialysis. This is important as we may have to cancel transport and need to know whether or not to prepare your dialysis machine. If you do not arrive for dialysis and you have not contacted us, we will be concerned about your wellbeing and try to telephone you. If we are unsuccessful in speaking to you or your designated contact person we will ask the police to go to your house to check if you are alright. This may result in the police gaining forced entry into your property (forcing the door open) to check on your safety. To avoid this happening please remember to let us know that you are alright and not coming for dialysis that day. If you do not attend for dialysis we will expect you when your next treatment is due. We are unable to offer you dialysis on another day or time outside of your planned sessions. What happens if I miss dialysis treatments? Your dialysis treatment is carefully calculated to remove adequate toxins (poisons) and fluid from your body. If you miss dialysis, fluid and toxins can rapidly build up and cause you harm. If you regularly miss dialysis treatments, this will damage your heart and lungs and can result in early death. If you are on the transplant list, we would usually suspend you from the list if you routinely do not attend for dialysis, because your chance of a safe and successful transplant would be reduced. If you are having problems balancing hemodialysis treatments with a busy lifestyle it is important that you let us know. We may be able to suggest alternative dialysis times or options. I m worried that I m not going to be able to cope We understand that starting haemodialysis can have a big impact on your day to day life. If you are worried about how you are coping at home or coping financially please ask a member of staff to refer you to our social assessment officer who can offer you advice and guidance. If you would like to talk to somebody about how you are feeling, or about a specific event or issue in your life, we have our own renal counselling service available to you and your family, and access to other organisations that might be able to help you. You can contact the renal counsellors directly on , via on ekhtr.krencoun@ nhs.net, or ask a member of staff to contact them on your behalf. They can see you in our central unit at Canterbury, in your dialysis unit, or at home. 4

5 Will I need to change how I take my medicines? The staff will administer any medicines which need to be taken during dialysis. For example erythropoietin and intravenous iron (treatments for anaemia) can be given via the dialysis lines. Repeat prescriptions for medication should be obtained from your GP. These are not routinely prescribed by the kidney doctor. The kidney doctor will keep your GP updated with any changes in your medications. If you are prescribed medication and do not understand why, please ask a member of staff to explain it to you. If you see your GP and any changes are made to your medication, please inform us, so that we can update your records. Will I need to make any changes to my diet? Our dietitians are available to provide answers to any questions you may have regarding diet and your kidneys. They can advise you how to keep your blood levels within a safe range and make sure you are well nourished. Your diet is based on your blood results, your normal intake of food, and your personal circumstances; your diet may not need to be altered. Therefore, please do not restrict your diet unless you are advised to do so by a renal dietitian, doctor, or nurse. The dietitians will plan to see you as soon as possible, once you start dialysis. In the meantime please ask the staff at your unit to help you get in touch with them if you have any queries. General information Diabetes If you have diabetes it will be necessary for you to continue to attend your clinic appointments with the consultant, nurse, podiatrist, and ophthalmologist. Infection Control We ask everyone entering the unit to wash/gel their hands. All staff will also wash/gel their hands before and after attending to you. If this does not happen, please feel free to challenge staff regardless of seniority. Patients with a known infection will be treated according to the Trust Infection Control Policy. Can I go on holiday? If you wish to go on holiday speak to a member of staff. Each of our dialysis units has a holiday dialysis co-ordinator who will be able to advise you on how to choose a suitable dialysis unit closest to your holiday destination either within the UK or abroad. We recommend that you dialyse without any complications for at least six months before going away. If you are planning to be away for more than four weeks or if you go away frequently, for example every two to three months, we cannot guarantee to keep your time and day available in the same unit. You will, of course, be able to dialyse with us on your return from holiday but it may be at a different unit until a space becomes available in your original unit. 5

6 Useful phone numbers Ashford Renal Unit Direct Line Dover Renal Unit Direct Line Maidstone Renal Unit Direct Line Medway Renal Unit Direct Line Renal Unit, Queen Elizabeth the Queen Mother Hospital Direct Line Thomas Becket Renal Unit, Canterbury Direct Line Marlowe Ward, Kent and Canterbury Hospital (24 hours) Matron for Dialysis Direct Line Any complaints, comments, concerns, or compliments If you have other concerns please talk to your doctor or nurse. Alternatively please contact our Patient Advice and Liaison Service (PALS) on or , or Further patient information leaflets In addition to this leaflet, East Kent Hospitals has a wide range of other patient information leaflets covering conditions, services, and clinical procedures carried out by the Trust. For a full listing please go to or contact a member of staff. After reading this information, do you have any further questions or comments? If so, please list them and bring to the attention of your nurse or consultant. Would you like the information in this leaflet in another format or language? We value equality of access to our information and services and are therefore happy to provide the information in this leaflet in Braille, large print, or audio - upon request. If you would like a copy of this document in your language, please contact the ward or department responsible for your care. Pacjenci chcący uzyskać kopię tego dokumentu w swoim języku ojczystym powinni skontaktować się z oddziałem lub działem odpowiedzialnym za opiekę nad nimi. Ak by ste chceli kópiu tohto dokumentu vo vašom jazyku, prosím skontaktujte nemocničné pracovisko, alebo oddelenie zodpovedné za starostlivosť o vás. Pokud byste měli zájem o kopii tohoto dokumentu ve svém jazyce, kontaktujte prosím oddělení odpovídající za Vaši péči. We have allocated parking spaces for disabled people, automatic doors, induction loops, and can provide interpretation. For assistance, please contact a member of staff. This leaflet has been produced with and for patients Information produced by Kent Kidney Care Centre Date produced: November 2016 (version 2) Next review date: March 2019 EKH825 6