The University of Michigan has received nearly $7 million to study how to make dialysis treatment sessions safer for patients. In numerous cases, the sessions can become unstable when patients experience low blood pressure or other complications.
"Session instability results from many factors: decisions made by patients, decisions by health care providers, and dialysis clinic policies," says Tiffany Veinot, an associate professor at U-M and the lead researcher of the study. "Our project targets all of these with educational interventions."
The Patient-Centered Outcomes Research Institute, a Washington, D.C.-based nonprofit, is funding the research, which will look at the sessions from both the patient's and the medical professional's perspective.
Veinot says treatment instability is largely preventable on both the patient's and medical professional's end. She says sometimes, dialysis facility staff remove too much fluid or do so too quickly, causing instability. She says patients should be encouraged to eat a healthy, low-salt diet, drink appropriate amounts of fluid, and stay at the dialysis clinic for the full length of sessions to prevent instability.
In the study, patients will attend six peer-mentoring sessions that aim to support behavior change. Medical professionals in the study will receive online education, team training, checklists, will regularly check patients' fluid status, and will make sure the rate of fluid removal stays at a safe level.
"It is important to fundamentally change the culture at dialysis facilities, where all too often the focus is to reach the minimum necessary treatment goals without a comprehensive strategy for fluid management," says Dr. Rajiv Saran, a professor of internal medicine and epidemiology at the U-M Medical School, and a co-leader of the study.