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Comparative Analysis of two Multi-Superspeciality Hospitals for assessing the performance of Dialysis Unit

  • Vritti Lumba
  • Agency : Dialysis Unit, Dialysis Unit Records, Quality Care Control
  • Objective : To find out the gaps between the standard guidelines and the processes followed. The objective of the study was to do a gap analysis of the parameters that reflect the efficacy of the dialysis unit with standard guidelines and to compare it with its older peers and then give recommendations so as to improve the quality of life of dialysis patients. In this endeavour studied.
  • Background : Chronic kidney disease is increasing worldwide, but due to lack of awareness the incidence is increasing in the developing countries. In India, there is no existing data available and the patients undergoing renal replacement therapy form only tip of the iceberg. In India the setups providing dialysis are not doing a great job either.
  • Methodology : Secondary data available in hospital records in the form of patient files, dialysis unit documentation registers and records on hospital information system the patients who had been examined on outpatient basis when they were in chronic kidney disease stage-IV was studied. The data was analyzed using Microsoft excel.
  • Findings : It was found that the hospital is a new setup, its dialysis unit was being underutilized, no. of dialysis being thrice weekly in 68% patients; AVFistulas created prior to first hemodialysis in 52% patients; improper documentation of time of vaccination for hepatitis and pneumococcus; target hemoglobin of 11-12 achieved in 32%; serum albumin of 52% patients meeting the standards. No seroconversions and line infection rates of 14% more than the standards.   When compared to second hospital it was found that there was better utilization of the dialysis unit but the staff patient ratio was not meeting the standards; almost all patients had hemodialysis done twice/week and AVFistulas were created prior to first dialysis in none of the patients. Hemoglobin level was in the standard range in 20% patients while urea reduction ratio was not evaluated, though serum albumin was meeting standard in 48% but the lowest value was 2.2mg/dl. Seroconversion rates for hepatitis B, C and HIV were 16%, 16%, and 4% respectively. There were no records available for the time of immunization of patients and no records were there for line infections. On comparing the two, the dialysis unit is doing better than its old competitor, yet lot needs to be done in order to achieve the standards and reach to a state where it can give real quality of life to its patients.
  • Recommendations : VIP rooms may be utilized by other patients when there is no booking of VIP rooms. Night shifts to be started to incr5ease the utilization of dialysis unit. Results should be monitored as part of comprehensive quality care control programme. Proper documentation needs to be done in order to ensure quality.
the study was to do a gap analysis of the parameters that reflect the efficacy of the dialysis unit with standard guidelines