Heart of England foundation trust Shared Care Heart of England foundation trust

What is Shared Care? From the start of Dialysis patients always took an active role in their treatment. Over the last two decades with the expansion of in centre haemodialysis the role has shifted to the patient being a passive recipient of care and healthcare worker delivering the treatment.

What is Shared Care? ‘this may be due, in part, an assumption about the level of patient dependency, as well as a perception that greater patient involvement would slow the throughput’(Yorkshire and Humber 2016)

What is Shared Care? Our aim is to encourage, support, educate and teach our patients to be involved in the treatment they receive at any of our four units. This will enable them To take ownership of their health To take control Feel valued To have a voice

Shared Haemodialysis care questionnaire Tasks Weight Blood pressure and pluse Temperature Washing hands Lining Priming Prepare dressing pack Programming machine Needling fistula/graft Tasks Preparing tunnelled line Hooking up Problem awareness Disconnecting treatment Applying pressure to needle site Giving own epo / low molecular weight heparin Shared Haemodialysis Care Questionnaire Across three units 98% of patients have completed the questionnaire and data has been collated (Solihull 50%) identified which tasks patients would like to get involved in Identified if patients would like to home – opportunity to educate on home therapies Identified if there are learning requirements, learning needs we need to consider and to implement training aids such as…………………

Shared care leaflet Inform patients what shared care is For all new starters Patient story Within a two week period all patients will be learning 5 achievable tasks Weight / wash hands / temperature / blood pressure / applying pressure to needle site post hd To encourage further learning – progressing onto learning more task Self-care Home hd

Barriers to learning Time Health Tiredness Work Transport Fear Teaching methods Consistency of teaching Uninformed Nurses Dyscalculia: affects the person to understand numbers and learn math facts Dysgraphia: affects a person’s handwriting ability and fine motor skills Dyslexia: affects reading and related language-based processing skills Dyspraxia: causes problems with movement and coordination, language and speech Memory: impairing the ability to store and retrieve information stored and retrieve information required to carry out tasks

Improving learning Aids: Flash cards: setting up machine, priming the machine New progress sheet Training booklet Coloured sheets if required A4 UF wipe board What you can do Identify requirements Enhance the learning environment Give the patient time Do not overload the patients Reduce terminology Be consistent Use the booklet Allow the patient time to process information Do not be tempted to jump in – their own thought process Encourage Avoid negative comments Be positive

Patient feedback ‘feel valued’ ‘enjoyed learning and being part of the team’ ‘I am taking control’ ‘why allow someone else to cause me pain when I can needle myself’ ‘I feel I can be involved in my partners treatment and psychological I feel it has helped me with dealing with his illness’ ‘reduces my time of waiting around’ ‘doing self-care I can come straight into the unit and set my machine’ ‘understanding how my body work I feel I have more control’ ‘while I wait I can help the nurses getting my table ready’

Thank you