Introduction and Aims: The aim of the study was to identify the benefits of introducing a treatment monitoring system into a dialysis ward. The workflow steps that are optimized and automated were analyzed. Furthermore, the benefits for users and patients were studied. Methods: The study was performed in a dialysis unit of a hospital in Saarbrücken, Germany. The dialysis workflow of two nurses for the treatment of 12 patients was analyzed before and 3 months after introducing the treatment monitoring system. The study followed two approaches in order to identify the benefits: The measurement of all dialysis related process times was used for a quantitative analysis, whereas interviews with doctors and nurses formed the qualitative part of the study. Results: Introducing a treatment monitoring system reduces the number of manually performed steps directly influencing the treatment (e.g. calculations and setting the dialysis device). This reduces the risk of treatment errors and leads to more confidence of caretakers. The documentation quality is improved, leading to better data security and higher confidence of the nursing personnel. The electronic documentation is eliminating errors related to reading hand written documents and oral communication of observations. The reduction of documentation effort is another major benefit for the dialysis center. Before using a treatment monitoring system, the nurses spent about 1 hour with treatment related tasks not involving the patient during a typical dialysis treatment of about 4 hours. Eight workflow steps directly influenced by the treatment monitoring system were identified in the analysis: • Documenting pre-dialysis patient weight • Calculating and entering of UF-goal and -rate • Setting of treatment parameters at the dialysis device • Measuring and documenting blood pressure • Documenting medication • Reading and documenting dialysis device parameters • Documenting post-dialysis patient weight • Archiving treatment data. The time spent for these steps was around 16 minutes and has been reduced to approximately 6 minutes (-61%) by introducing the treatment monitoring system. Furthermore, the overall process time requiring nurse action was reduced by 25 minutes. This means in total 40% of the nursing time can be saved per treatment. The additional savings are mainly related to nurses waiting for multiple blood pressure and pre- and post-dialysis weight measurements. Conclusions: The elimination of manual process steps and the related reduction of the patient risk raise the confidence of the caretakers. The increased data quality due to electronic transfer of the prescription and the treatment documentation might lead to fewer complications during the treatment and enables longitudinal data evaluation by physicians. The associated time savings offer the possibility to improve treatment quality, as nurses have more time available for patient care, especially during the connection and disconnection periods in hemodialysis, where elderly and weak patients need more care. Alternatively the nursing personnel can be enabled to take care of more patients and therefore raise the reimbursement without raising personnel costs. Finally, the benefits of introducing a treatment monitoring system can lead to a very fast return of investment for the center. (Figure Presented).
CITATION STYLE
Keil, M. (2015). SP761WORKFLOW OPTIMIZATION AND PROCESS AUTOMATION IN DIALYSIS WARDS BY INTRODUCING A TREATMENT MONITORING SYSTEM. Nephrology Dialysis Transplantation, 30(suppl_3), iii628–iii629. https://doi.org/10.1093/ndt/gfv200.80
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