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Tables & Figures

Provider Pathway

 1. The Home Hemodialysis Hub: Physical Infrastructure and Integrated Governance Structure. View PDF — Image Gallery

Tables

Table 1. Comparison of Locations for Home HD Hub or Training
Table 2. Minimum Number of Home HD Training Stations Required for a Hub
Table 3. Components of a Home HD Hub
Table 4. Solo vs Open-Plan Configurations for HD Training Stations
Table 5. Roles and Responsibilities of the Program (Strategic) and Operations (Tactical) Managers in a Home HD Program
Table 6. Roles and Responsibilities of the Clinical Leadership in a Home HD Program
Table 7. Roles and Responsibilities of Technical Support in a Home HD Program

Figures

Figure 1. The home hemodialysis resource map.
Figure 2. Size of Home HD Programs in Australia and New Zealand and Japan.
Figure 3. Showcasing your home hemodialysis hub: the Northwest Kidney Centers Home Dialysis Hub in Seattle (courtesy of Aaron Herold).
Figure 4. The Northwest Kidney Centers Home Dialysis Hub in Seattle: A home dialysis training station (courtesy of Aaron Herold).
Figure 5. The Northwest Kidney Centers Home Dialysis Hub in Seattle: Large glass sections allow for patient monitoring during training (courtesy of Aaron Herold).
Figure 6. The Northwest Kidney Centers Home Dialysis Hub in Seattle: Rooms should include a counter with a sink, a faucet, and a mirror (courtesy of Aaron Herold).
Figure 7. The Northwest Kidney Centers Home Dialysis Hub in Seattle: The reception area (courtesy of Aaron Herold).
Figure 8. The Northwest Kidney Centers Home Dialysis Hub in Seattle: The greeter desk (courtesy of Aaron Herold).
Figure 9. The Northwest Kidney Centers Home Dialysis Hub in Seattle: Clinical workstations for nurses and clinical dialysis technicians (courtesy of Aaron Herold).
Figure 10. The Northwest Kidney Centers Home Dialysis Hub in Seattle: Clean utility bench space and shelving (courtesy of Aaron Herold).
Figure 11. A framework for integrated governance of a home hemodialysis program or hub.

 2. Funding and Planning of Home HD. View PDF — Image Gallery

Tables

Table 1. Key Requirements of a Business Case
Table 2. Patient Dialysis Modality Profiles
Table 3. Commonly Used Service Objectives in Business Cases for Home HD
Table 4. Commonly Used Service Objectives for Determining Critical Success Factors in Business Cases for Home HD
Table 5. Commonly Used Service Objectives and Sample Scoring Matrix for a Home HD Business Case

Figures

Figure 1. Size of Home HD Programs in Austrailia and New Zealand and Japan.

Appendices

Appendix Funding and Planning

 3. Workforce Development and Models of Care in Home Hemodialysis. View PDF — Image Gallery

Tables

Table 1. Comparative Care Models in Centers of Excellence
Table 2. Allied Services in Home HD Care Model

Figures

Figure 1. Domains for workforce challenges.
Figure 2. Integrated patient care pathway in home dialysis.

 4. Systems to Cultivate Suitable Patients for Home Dialysis. View PDF — Image Gallery

Tables

Table 1. Key Attributes of the Ideal Home HD Patient
Table 2. Key Strategies and Recommendations to Increase Home HD

Figures

Figure 1. Ideal Predialysis Patient Flow

 5. Patient Safety During Home Hemodialysis: Quality Assurance and Serious Adverse Events in the Home Setting. View PDF — Image Gallery

Tables

Table 1. Severe Procedure-Related Adverse Events in Home Hemodialysis Described in Published Literature
Table 2. Open Letter to Emergency Medical Service (EMS) and Emergency Room Personnel
Table 3. Processes to Initiate After a Serious Adverse Event or Near Miss

Figures

Figure 1. Patient Safety Quality Assurance Framework
Figure 2. Generic Hemodialysis Setup
Figure 3. Routine Blood Priming of the Hemodialysis Circuit
Figure 4. Variation of Blood Priming Without a Blood Sensor
Figure 5. Routine Rinse-back After Dialysis Completion
Figure 6. Rinse-back Procedure With Inadvertent Disconnection/Connection Errors
Figure 7. Dialyzer
Figure 8. Home Hemodialysis “Clamp and Call” Emergency Management Algorithm

Patient Pathway

 6. Patient Selection and Training for Home Hemodialysis. View PDF — Image Gallery

Tables

Table 1. Considerations for Patient Selection for Home HD
Table 2. Potential Barriers to Home HD and Possible Interventions
Table 3. Risk Factors for Nonadherence, and Possible Interventions
Table 4. Weekly Education and Training for Home HD
Table 5. Training Program Parameters for Home HD
Table 6. Reasons for Failure to Graduate from Home HD Training
Table 7. Key Performance Indicators for Home HD Training

 7. The Care and Keeping of Vascular Access for Home Hemodialysis Patients. View PDF — Image Gallery

Tables

Table 1. Advantages and Disadvantages of BH Cannulation Technique
Table 2. Indications For or Against BH Cannulation Technique
Table 3. Summary of Measures to Reduce Infection Risk
Table 4. Troubleshooting for Buttonhole Cannulation Difficulties

Appendices

iconPDF_24x24 A1. Buttonhole Tract Formation Using Polycarbonate Pegs
A2.Criteria for Determining Type of Self-Cannulation
A3.Arteriovenus Fistula/Graft Audit Tool
A4.Central Venous Catheter Audit Tool
A5.Mupirocin Protocol: Information for Patients
A6.Fear of Needles
A7.Buttonhole Cannulation for Creation and Maintenance of Tract with Intravenous Needle and Cannula
A8.Removal of Intravenous Needle with Cannula
A9.Buttonhole Cannulation Technique with Dull (Blunt) Bevel
iconPDF_24x24 A10.Removal of Dull/Blunt Dull (Blunt) Bevel Needles from Arteriovenous Fistula
A11.Taping Method for Hemodialysis Needle
A12.Taping Method for Intravenous Needle with Cannula
A13.Heparin Locking of Central Venous Catheters
A14.Heparin Flushing of Cannulas
A15.Showering Protocol
A16.Central Venous Catheter Antibiotic Treatment Protocol
A17.Alteplase Use in Hemodialysis Central Venous Catheters

 8. Infrastructure, Water, and Machines. View PDF — Image Gallery

Tables

Table 1. Potential Legal Concerns to Address when Starting Home HD
Table 2. Necessary Plumbing Questions Checklist

Figures

Figure 1. Tundish (photo courtesy of John Agar).
Figure 2. The dialysis room. The dialysis room should feel like “home” (photo courtesy of James Heaf)
Figure 3. Home HD storage (photo courtesy of James Heaf).
Figure 4. Placement of the home HD machine. This patient initially chose the living room, but changed his mind

because the armrest on his sofa was too wide (photo courtesy of James Heaf).
Figure 5. Examples of temporary water configurations. Home HD should not be excluded from those who have rental agreements that prevent permanent installation of fittings and equipment (photos courtesy of Anthony Perkins).
Figure 6. Water purification unit (photo courtesy of James Heaf).
Figure 7. Water filter (photo courtesy of James Heaf).
Figure 8. Practical and accessible home HD room (photo courtesy of John Agar).

Appendices

Appendix Infrastructure

 9. Prescriptions for Home Hemodialysis. View PDF — Image Gallery

Tables

Table 1. Fundamental Principles of Home HD Prescription
Table 2. Traditional Standard-Hours Home HD Prescription Using Standard Dialysate Flow Machines
Table 3. Alternate-Night Nocturnal Home HD Prescription Using Standard Dialysate Flow Machines
Table 4. Traditional Short Daily Home HD Prescription Using Standard Dialysate Flow Machines
Table 5. Traditional Nocturnal Home HD Prescription Using Standard Dialysate Flow Machines
Table 6. Low-flow dialysate short daily home HD prescription
Table 7. Low-flow dialysate home NHD
Table 8. Home HD Modality Prescriptions
Table 9. Comparative Efficacy Across Prescriptions Relative to Renal Transplant

 10a. Psychosocial Aspects in Home Hemodialysis: A Review View PDF — Image Gallery

10b. Psychosocial Guide for Healthcare Professionals. View PDF

Tables

Table 1. Communication Strategies for Trainers to Share with Patients and Care Partners
Table 2. Informal Questions to Detect Anxiety and Depression


10c. Psychosocial Guide for Patients, Families, and Dialysis Partners. View PDF

 

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