Some clinics encourage patients to take an active role in their treatment. Self-care haemodialysis can be performed in the normal in-centre dialysis clinics. Often self-care clinics are located away from the main dialysis clinic (e. g. in small hospitals or health centres or in a free standing clinic).
In this type of setting, instruction is given about the procedures required to do the dialysis. Patients do some of these procedures, but nursing staff continue to assist them. This means patients take a much more active part in the dialysis treatment and sometimes take full control.
The training period depends on how much responsibility is to be taken for the treatment. Training can be given in small batches so the patient gradually takes more control of their treatment.
During training, the patient learns to do some of the following tasks when they feel confident:
- prepare equipment and supplies;
- place the needle in the vascular access;
- administer medication;
- monitor the machine;
- check blood pressure and pulse;
- keep records of the treatments;
- clean the equipment and the room where dialysis is done.
The benefits of self-care haemodialysis:
- more control over the treatment;
- better informed about dialysis, medications and treatment outcomes;
- patients are surrounded by ‘well’ patients who have an interest in their dialysis;
- there is often more flexibility with the dialysis schedule.
The disadvantages of self-care haemodialysis:
- extra time is needed for setting up and dismantling the machine;
- a schedule must be followed for dialysis times and days;
- travel time to and from the unit and parking.
In some clinics you may be given the opportunity to perform some or all self-care activities depending upon what you feel comfortable to do. This is called shared care. In this situation the nurse will agree on a plan with you and will regularly review your current shared care activities.