NCT02553564

30 Day Rehospitalization Risk in Hemodialysis Patients

A Randomized Controlled Trial of a Checklist Intervention to Reduce 30 Day Rehospitalization Risk in Hemodialysis Patients

• Status: Terminated
• Phase: N/A
• Study type: Interventional
• Enrollment: 3 (actual)
• Sponsor: Northwell Health · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

After a hospitalization, dialysis patients have a high risk of being admitted to the hospital again within 30 days. The purpose of this research study is to test a new way of reducing the chance of patients being hospitalized again. In this study investigator will evaluate a checklist driven evaluation upon return to the dialysis facility as a method to reduce the rate of rehospitalizations in hemodialysis patients.

Detailed description

There are an excessive number of 30 day readmissions after hospital discharges of dialysis patients in the U.S. (35.2%). Investigators recent research has found that approximately 2/3 of these readmissions are potentially avoidable. Investigators believe that among the causes for the excessive number of readmissions, the most important may be that patients usually do not receive a clinical assessment upon return to dialysis after a hospitalization. An all too common practice in the U.S. is for the nephrologist to not see the patient but to give verbal orders to the dialysis nurse to resume previous orders. This increases readmission risk in that there are a number of key clinical processes that if completed on return to dialysis might greatly reduce rehospitalization risk. Nephrologists are often not available to see patients in the peri-discharge period, but there is a trend towards an increasing number of U.S. dialysis facilities now having nurse practitioners (NP) working in the units. Investigators believe that NPs using a checklist can conduct a post-discharge clinical encounter that would allow for key care processes to be carried out and to direct telephone communication with the treating nephrologist. Our objective is to reduce the risk of dialysis patient readmissions within 30 days through the use of this intervention. Our research question is whether this intervention would be effective for reducing 30 day readmission risk. Our hypothesis is that the intervention will prove to be more effective then usual care for reducing 30 day readmission risk.

Conditions

• Re-hospitalization Hemodialysis

Interventions

Type	Name	Description
OTHER	Checklist driven clinical encounter after hospital discharge	Within 96 hours of hospital discharge an Nurse Practitioner will perform a checklist guided assessment to preventing rehospitalizations. The assessment consists of the following: 1. The participants's hospital course will be reviewed and their clinical recovery and stability assessed. 2. Determination of the participants's estimated dry weight (EDW). 3. The participants's post discharge medications will be checked, compared to the prehospitalization medication, and discrepancies will be reviewed and corrected. 4. Blood tests will be ordered for the participants's first return dialysis treatment if medically appropriate after clinical assessment. 5. Write new dialysis orders. 6. Dialysis Access- review access and determine any changes required in treatment

Timeline

• Start date: 2017-11-22
• Primary completion: 2018-03-15
• Completion: 2018-03-15
• First posted: 2015-09-17
• Last updated: 2018-04-02

Locations

1 site across 1 country: United States