1. Heart of England foundation trust
Shared Care
Heart of England foundation trust

2. 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.

3. 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)

4. 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

5. 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…………………

6. 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

7. 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

8. 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

9. 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’

10. Thank you