Noncompliance Patients in Hemodialysis: Developing an Implementation Plan (Research Paper Sample)

Noncompliance Patients in Hemodialysis: Developing an Implementation Plan
Name:
Institution:
Noncompliance Patients in Hemodialysis: Developing an Implementation Plan
ABSTRACT
This paper offers an implementation plan for noncompliance in hemodialysis patients; this involves mechanisms of obtaining the much-needed approvals from an organization’s leadership and personnel. The plan outlined herein requires a meticulous approach, considering the delicate nature of this health problem. A proposal for solution to the problem is also offered with particular review of relevant literature as supporting substantiation. As for the implementation logistics, notable changes to organizational structure and culture are without doubt warranted.
Special emphasis is placed on resources required for implementation, especially the human resources, who will be directly involved in plan implementation and follow-up. Important as well, is the aspect of financial resources in addition to teamwork, coordination and consultation, which altogether reduce the impacts of any forthcoming attitudes of resistance to change.
Introduction
Hemodialysis (HD) involves processes of cleansing blood of accumulated waste matter and correcting the water, electrolyte and acid base abnormalities linked with renal failure (Murphy, 2006).Patients undergoing dialyses often have to face the burden of long term illness and many treatments and stresses. The burden may include medical complications relating to inadequate food and fluid intake and constraints, as well as psychological pressures associated with feelings of uncertainty regarding the future, for instance job dismal due to poor performance.
Noncompliance in HD treatment has unquestionably adverse effects on the outcome of the procedure. According to (Sehgal, 2002)) noncompliance rates in the United States are highest in the world. In formulating and implementing a treatment plan of action for noncompliant hemodialysis patients, which leads to a successful dialysis procedure, assessment (as a basic step) is fundamental. Several assessment may be carried out, the most important being physical assessment, which employs the use of patient and laboratory data analyses as tools of devising the implementation plan (Cicolini, et al. 2012). Blood pressure regimens can also be used as predictors of non-adherence (Kauric-Klein, 2013). Assessing such crucial information leads offers hints as to why many HD patients fail to adhere or comply with treatment procedures. Several reasons (to be discussed hereunder) have been given by patients as to why they fail to comply with HD treatment and with required diet.
Compliance can be described as an end product of a relationship between a patient and a health professional; this relationship should be based on mutual respect between the parties as well as active participation between the patient and the health professional and it should not in any way involve coercion or manipulation from either party (Murphy, 2006). Considering this reality is very important in developing an implementation plan to counter compliance or adherence problems to hemodialysis treatment.
For HD to be effective it’s important that every party (stakeholder) is involved, and especially the health professionals who should always monitor the patients compliance with HD treatments through both subjective and objective measures as this human relationship between the two is the foundation of long term management of chronic illness.
Literature Review
A development plan for noncompliance in HD treatment ought to focus on the all stake holders involved in ensuring compliance of patients and suitable diet as well. The stakeholders can be classified into three categories, namely the patient, the health professionals and human elements in the patient’s social life of, such as family members and close friends of the patient (Cicolini, et al. 2012).
Undoubtedly, home caregivers, just as nurses and dieticians or other medical personnel, play an important role in assisting patients to adapt to their hemodialysis treatment program. They should therefore be educated as well to be able to support the patient in adhering to hemodialysis treatment (Cicolini, et al. 2012). Many patients sometimes skip or fail to show up for HD treatment without prior notification to health professionals and or other stakeholders (Gordon, et al. 2003). Patients have often given several reasons for not complying with the HD treatment. Most young patients and those who have started HD early skip sessions since most of them fail to come to terms with the fact that they have started treatment procedures for chronic or life-threatening illness so early in life and this could lead to anger and resentment among patients (Murphy, 2006). Indeed, this occurrence is very common to patients and could be attributed to lack of awareness, encouragement and or proper care. Needless to say, the consequences of skipping such treatments and the development of resentment and anger bear serious physiological and psychological challenges altogether (Saran, et al. 2003). This more than often leads to inadequate dialysis
According to Murphy (2006) anger is a common problem among patients suffering from this chronic diseases early in their lives. Patients have to be educated on the importance of complying with HD treatment and diet as this will serve to save and prolong their lives. Patients skipping HD treatment have always caused inconveniences to the health professionals and other patients as well. Professionals complain of financial implications, which include wastage of the supplies used for preparation of the patients’ treatment, time wastage, as they are not able to accommodate other patients in their requests of their preferred availability. All this could be avoided through proper education and creation of an understanding between the patient and health professionals. To reinforce patients’ education of patients, healthcare workers ought to offer informational materials to their family members. These materials could include handouts and detailed pamphlets about the medical condition, desirable behavior patterns and risks involved, to fulfill motivational rationale (Russell, et al. 2007).
Nurses, as mentioned, play a very important role in ensuring patients comply with HD treatment and diet. It is in their place to effectively educate patients about the effect of missing occasions of treatment. In collaboration with dieticians, they ought to insist on patients to partake of dietary and fluid prescriptions, both at home and in health facilities (Welch, et al. 2013). However, HD patients’ relevant edification about the nature of the disease and treatment procedures tends to show better adherence assessed by laboratory values (Murphy, 2006). Kugler, et al (2005) indicate that Nurses should study HDs patients’ behavior regarding compliance to treatment, diet and fluids intake by identify reasons why the patients opt to skip treatments (Gordon, et al. 2003).
As part of implementation of treatment plan, a healthcare organization should devise ways of ensuring compliance by assessing the negative impacts of noncompliance to patients using logs and record data and consequently disseminate this information. This should be done on a personalized level via doctor, dietician or nurse interactions. This should also include regular educational follow-ups (Baraz, et al. 2009). Health professionals should therefore plan early interventions to minimize risks of non-adherence. Interventions that are more effective should therefore be implemented to improve adherence by the patients (Brogdon, 2013).
It is also essential to have nurses constantly trained on emergent medical technologies in addition to dealing with patients of different and diverse backgrounds. In this context arises the matter of ethical considerations, the approach to interacting with the patient should be based on the individual’s social needs as opposed to conventional standards. Even for highly noncompliant patients, the healthcare providers better be friendly, warm and encouraging, ensuring not to blame them (Hercz, 2014)).
It is important for all members of the healthcare organization’s dialysis unit to be involved in the implementation process for patient HD compliance. This would enable a smooth integration of the change in approach into the overall organizational structure and culture. More importantly though, and as mentioned, specialized nurses and dieticians in this section bear greater responsibilities in terms of initiating change. During this process, as it has been established over recent years, the use of technological applications should be considered to encourage compliance. With increased use of smart mobile devices, patients can self-monitor their food and fluid intake as part of HD treatment (Welch, et al. 2013).
Moral and social support is crucial to HD treatment and compliance to the same, many patients has complained of lack of social support from friends and family members (Cicolini, et al. 2012). Increased social support has been directly associated with increased adherence to HD treatments. Most patients under dialysis find it hard to accept their conditions hence disregarding their need to compliance to HD; this often goes on until the adverse effects of noncompliance become unbearable. Family support in ensuring patients comply with treatment is key since it creates a sense of belonging.
Indeed, social support may reduce the burden of illness and improve the HD patients’ perceived health. Nurses should therefore be advised to involve family members more often in the everyday care of the patients. In cases where family members are not readily, available they should spend more time with the patient ...